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Mini-screws success rates sufficient for orthodontic treatment
1Glasgow Dental School and Hospital, University of Glasgow, Glasgow, Scotland, UK.
Data Sources:
Medline.
Study Selection:
Clinical trials of orthodontic mini-screws with a minimum of 30 cases providing data on the patient, mini-screw, surgery and loading available for correlation with the mini-screws' success rates in English or German were included.
Data Extraction And Synthesis:
Data were extracted that correlated with the miniscrews' success rate: patient sex and age, screw length and diameter, method and location of placement, time and amount of loading. The statistical analyses were performed using SPSS software (version 13 for Mac OS X, SPSS, Chicago, Ill).
Results:
Fourteen clinical trials (452 patients and 1519 screws) were included, with overall success rates ranging from 59.4% to 100%. The mean success rate was 83.6% ± 10.2%. Screw diameters of 1 to 1.1 mm yielded significantly lower success rates than those of 1.5 to 2.3 mm. One study reported significantly lower success rates for 6 mm vs 8 mm long mini-screws (72% vs 90%). Screw placement with or without a surgical flap showed contradictory results between studies. Three studies showed significantly higher success rates for maxillary than for mandibular screws. Loading and healing periods were not significant in the mini-screws' success rates. There was no influence of patient sex and one study found significantly greater success in patients over 30 years of age.
Conclusions:
All 14 articles described success rates sufficient for orthodontic treatment. Placement protocols varied markedly. Screws under 8 mm in length and 1.2 mm in diameter should be avoided. Immediate or early loading up to 200 cN was adequate and showed no significant influence on screw stability.
