Usage and Preferences of Orthodontic Mini-Implants Among Romanian Practitioners: A Survey Study

Background/Objectives: Dental malocclusions are highly prevalent worldwide, negatively impacting patients' quality of life and leading to complex, often costly, orthodontic treatments. In Romania, the economic status of patients and the limited public funding for orthodontic care significantly influence treatment accessibility and choices. Advanced technologies, such as mini-implants (MIs), offer improved anchorage and treatment efficiency but are often underutilized due to financial constraints and variability in clinical training. In this context, there are limited data regarding the use and preferences of MI among orthodontists in Romania. This study aims to explore the characteristics, preferences, and challenges of Romanian orthodontists in their use of MI systems. Methods: A survey was conducted between June and September 2024, targeting orthodontists across Romania. The questionnaire, distributed via social media platforms, consisted of 24 items addressing professional experience, MI system preferences, insertion methods, and complications. Statistical analyses were conducted using IBM SPSS Statistics 25. Fisher's Exact Test and Pearson's Chi-Square Test were employed to evaluate relationships between categorical variables. When appropriate, logistic binomial univariable regression models were applied to predict key dependent variables (e.g., MI placement zones, MI experience, and MI complications) based on independent variables such as specific MI system usage and frequency of MI usage. A significance threshold of α = 0.05 was used for all tests. Results: Out of 105 participants, 85.7% reported using mini-implants (MIs) in their orthodontic practice, with the Dual Top and Benefit systems being the most frequently used (60% and 43.3%, respectively). The interradicular area was the most common placement site (60%), while the palatal and retromolar regions showed significant correlations with the Benefit system (p = 0.008). Practitioners with more than 10 years of experience reported a significantly higher frequency of MI use (p = 0.001), with frequent use being observed in 60.9% of these practitioners. Complications were common, with MI mobility reported by 92.2% and soft tissue damage by 57.8%. The midpalatal area was significantly associated with higher complication rates compared to other sites (p < 0.001). The success rates of MI usage ranged from 76% to 100% in 57.8% of respondents, with higher success rates being associated with infrazygomatic placements (p < 0.05). Conclusions: MI usage is prevalent among Romanian orthodontists, with experienced practitioners utilizing them more frequently. Despite high success rates, common complications highlight the need for improved insertion techniques and post-operative care. Further research and training are recommended to optimize MI application and reduce complication rates.