Optimizing Infrazygomatic Miniscrew Insertion Parameters: Systematic Review and Meta-Regression Analysis of Bone...

Area of Science:

• Orthodontics
• Dental Implantology
• Biomedical Engineering

Background:

• Infrazygomatic crest (IZC) miniscrews are crucial for orthodontic skeletal anchorage.
• Optimal insertion parameters for IZC miniscrews lack consistent evidence.
• Existing data on IZC miniscrew placement is fragmented and inconsistent.

Purpose of the Study:

• To determine optimal IZC miniscrew insertion position, height, and angulation for maximal bone insertion.
• To analyze the influence of facial skeletal patterns on IZC bone morphology.
• To develop a predictive model for IZC miniscrew placement using cone-beam computed tomography (CBCT).

Main Methods:

• Systematic review following PRISMA 2020 guidelines.
• Meta-analysis and meta-regression of CBCT-based IZC bone thickness data from 17 studies (1840 measurements).
• Assessment of study quality using the STROBE checklist.

Main Results:

• Significant inverse relationship between insertion height and bone thickness (β = -0.53; p < 0.001).
• Significant positive correlation between angulation and bone thickness (β = 0.09; p < 0.001).
• Optimal site: U67 region, 9.9 mm height, 80° angulation, yielding 3.52 mm mean cortical bone thickness.

Conclusions:

• The study provides the first meta-regression-based predictive model for IZC miniscrew placement.
• The U67 site at 9.9 mm height and 80° angulation is identified as the optimal insertion protocol.
• Data-driven guidelines enhance miniscrew stability and minimize complications in orthodontic treatment.