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Paramedian vertical palatal bone height for mini-implant insertion: a systematic review
H Winsauer1, C Vlachojannis1, A Bumann2
1*Institute of Forensic Medicine, University of Freiburg, Albertstr. 9, 79104 Freiburg, Germany and.
European Journal of Orthodontics
|December 11, 2012
Summary
Paramedian orthodontic mini-implants offer reliable anchorage for molar distalizers. Optimal placement requires assessing vertical palatal bone height (VBH) via computed tomography (CT) due to significant patient variability.
Area of Science:
- Orthodontics
- Dental Implantology
- Maxillofacial Radiology
Background:
- Paramedian orthodontic mini-implants are increasingly utilized for molar distalizer anchorage.
- Understanding vertical palatal bone height (VBH) is crucial for safe and effective mini-implant placement.
Purpose of the Study:
- To systematically review existing measurements of vertical palatal bone height (VBH).
- To determine optimal anatomical regions for paramedian mini-implant insertion for molar distalization.
Main Methods:
- Systematic literature search of major databases (PubMed, MEDLINE, Cochrane).
- Inclusion of 16 studies (19 articles) measuring VBH or palatal bone thickness.
- Analysis of 10 computed tomography (CT)-based studies involving 956 orthodontic patients.
Main Results:
- Data compilation suggests sufficient VBH in the region 3-4mm behind the incisive foramen and 3-9mm lateral to the midpalatal suture.
- Significant heterogeneity in study methods and patient data prevented data pooling.
- Identified potential risks of unwanted effects during distalization, though generally considered small.
Conclusions:
- Paramedian anterior palatal anchorage is recommended for molar distalization.
- Pre-operative CT-based imaging is essential due to substantial inter-individual VBH variability.
- CT imaging is vital for patients identified as high-risk through routine investigations.
