Orthodontic bone screws: A quick update and its promising future

Area of Science:

• Orthodontics
• Dental Implantology
• Biomaterials

Background:

• Orthodontic bone screws (OBSs) offer intraoral anchorage by integrating with basilar bone (BB).
• Previous extra-alveolar (E-A) implants for BB anchorage were complex and costly.
• Inter-radicular (I-R) miniscrews are convenient but often require multiples and can impede tooth movement.

Purpose of the Study:

• To introduce and summarize the Extra-alveolar Orthodontic Bone Screw (E-A OBS) system.
• To highlight the advantages of combining BB anchorage with miniscrew convenience.
• To present current concepts for managing complex malocclusions using the E-A OBS system.

Main Methods:

• Placement of larger diameter (2mm), strong stainless steel E-A OBSs in the infra-zygomatic crest (IZC) and mandibular buccal shelf (MBS) for BB anchorage.
• Utilizing E-A OBSs for dentition retraction, arch rotation, and managing impacted teeth with lever arm springs.
• Integrating E-A OBSs with fixed appliances and clear aligners for comprehensive malocclusion correction.

Main Results:

• E-A OBSs provide robust osseous anchorage, enabling effective tooth movement and correction of severe malocclusions.
• The system simplifies complex orthodontic procedures by offering a convenient yet strong anchorage solution.
• Successful management of severe crowding, skeletal discrepancies, asymmetries, and impactions has been demonstrated.

Conclusions:

• The E-A OBS system effectively combines the benefits of basilar bone anchorage and miniscrew convenience.
• This approach offers a versatile and conservative method for managing a wide spectrum of complex malocclusions.
• The E-A OBS system represents a significant advancement in orthodontic anchorage, applicable with both fixed appliances and clear aligners.