Orthodontic Miniscrew Placement in Interradicular Regions using a Chairside Digital CAD-CAM Surgical Guide

This study aims to introduce a novel chairside digital technique for creating surgical guides to assist in the placement of orthodontic miniscrews. In this clinical validation study, 12 orthodontic miniscrews were placed in six patients using a chairside economical restoration of esthetic ceramics (CEREC) system combined with cone-beam computed tomography (CBCT). A three-dimensional image was generated by integrating CBCT scans with digital dental models acquired via the chairside digital system. The optimal insertion angle and position for orthodontic miniscrews were planned using this image. A surgical guide was then designed in the computer-aided design (CAD) software and manufactured using the computer-aided manufacturing (CAM) system. Preoperative and postoperative CBCT scans obtained from patients were superimposed to compare the angular deviation, entry-point deviation, and endpoint deviation between the planned and actual miniscrew positions. The mean entry-point and endpoint deviations were 2.4 ± 0.7 mm (range: 1.2-3.4 mm) and 2.4 ± 0.6 mm (range: 1.3-3.4 mm), respectively. The mean angular deviation was 3.8° ± 2.3° (range: 0.4°-7.2°). No miniscrew failures were observed during the 6-month follow-up period. This study successfully developed a chairside CAD/CAM-based miniscrew surgical guide method, and its accuracy and stability were preliminarily validated in patients.