Skip to main content
Top
Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 5/2014

01-09-2014 | Original article

Assessing bone volume for orthodontic miniplate fixation below the maxillary frontal process

Authors: Dr. Dr. T.M. Präger, H.G. Brochhagen, R. Mischkowski, P.-G. Jost-Brinkmann, R. Müller-Hartwich

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Issue 5/2014

Login to get access

Abstract

Objectives

The maxillary bone below the frontal process is used for orthodontic anchorage; indications have included skeletally anchored protraction of the maxilla for treating Class III malocclusions or the intrusion of teeth in patients with a deep bite. This study was conducted to assess the condition of bone before cortically implanting miniplates in that area of the maxilla.

Patients and methods

A total of 51 thin-sliced computed tomography scans of 51 fully-dentate adult patients (mean age 24.0 ± 8.1 years; 27 men and 24 women) obtained prior to third-molar osteotomy were evaluated. Study parameters included total bone thickness, thickness of the facial cortical plate, and width of the nasal maxillary buttress. All these parameters were measured at different vertical levels.

Results

The bone volume adjacent to the piriform aperture was most pronounced at the basal level and decreased progressively toward more cranial levels. The basal bone structure had a mean total thickness of 7.8 mm, facial cortical plate thickness of 1.9 mm, and nasal maxillary buttress width of 9.2 mm. At 16 mm cranial to the aperture base, these values fell to 5.6 mm, 1.3 mm, and 5.8 mm, respectively.

Conclusion

These bone measurements suggest that screws 7 mm in length can be inserted at the base level of the piriform aperture and screws 5 mm long at the cranial end of the bone.
Literature
1.
go back to reference Baccetti T, McGill JS, Franchi L et al (1998) Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and face-mask therapy. Am J Orthod Dentofacial Orthop 113:333–343PubMedCrossRef Baccetti T, McGill JS, Franchi L et al (1998) Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and face-mask therapy. Am J Orthod Dentofacial Orthop 113:333–343PubMedCrossRef
2.
go back to reference Billiet T, Pauw G de, Dermaut L (2001) Location of the centre of resistance of the upper dentition and the nasomaxillary complex. An experimental study. Eur J Orthod 23:263–273PubMedCrossRef Billiet T, Pauw G de, Dermaut L (2001) Location of the centre of resistance of the upper dentition and the nasomaxillary complex. An experimental study. Eur J Orthod 23:263–273PubMedCrossRef
3.
go back to reference Cavalcanti MG, Yang J, Ruprecht A et al (1999) Accurate linear measurements in the anterior maxilla using orthoradially reformatted spiral computed tomography. Dentomaxillofac Radiol 28:137–140PubMedCrossRef Cavalcanti MG, Yang J, Ruprecht A et al (1999) Accurate linear measurements in the anterior maxilla using orthoradially reformatted spiral computed tomography. Dentomaxillofac Radiol 28:137–140PubMedCrossRef
4.
go back to reference Cavalcanti MG, Rocha SS, Vannier MW (2004) Craniofacial measurements based on 3D-CT volume rendering: implications for clinical applications. Dentomaxillofac Radiol 33:170–176PubMedCrossRef Cavalcanti MG, Rocha SS, Vannier MW (2004) Craniofacial measurements based on 3D-CT volume rendering: implications for clinical applications. Dentomaxillofac Radiol 33:170–176PubMedCrossRef
5.
go back to reference Crismani AG, Bertl MH, Celar AG et al (2010) Miniscrews in orthodontic treatment: review and analysis of published clinical trials. Am J Orthod Dentofacial Orthop 137:108–113PubMedCrossRef Crismani AG, Bertl MH, Celar AG et al (2010) Miniscrews in orthodontic treatment: review and analysis of published clinical trials. Am J Orthod Dentofacial Orthop 137:108–113PubMedCrossRef
6.
go back to reference De Clerck EE, Swennen GR (2011) Success rate of miniplate anchorage for bone anchored maxillary protraction. Angle Orthod 81:1010–1013CrossRef De Clerck EE, Swennen GR (2011) Success rate of miniplate anchorage for bone anchored maxillary protraction. Angle Orthod 81:1010–1013CrossRef
7.
go back to reference De Clerck HJ, Cornelis MA, Cevidanes LH et al (2009) Orthopedic traction of the maxilla with miniplates: a new perspective for treatment of midface deficiency. J Oral Maxillofac Surg 67:2123–2129CrossRef De Clerck HJ, Cornelis MA, Cevidanes LH et al (2009) Orthopedic traction of the maxilla with miniplates: a new perspective for treatment of midface deficiency. J Oral Maxillofac Surg 67:2123–2129CrossRef
8.
go back to reference Dellinger EL (1973) A preliminary study of anterior maxillary displacement. Am J Orthod 63:509–516PubMedCrossRef Dellinger EL (1973) A preliminary study of anterior maxillary displacement. Am J Orthod 63:509–516PubMedCrossRef
9.
go back to reference Ellis E III, McNamara JA Jr (1984) Components of adult Class III malocclusion. J Oral Maxillofac Surg 42:295–305PubMedCrossRef Ellis E III, McNamara JA Jr (1984) Components of adult Class III malocclusion. J Oral Maxillofac Surg 42:295–305PubMedCrossRef
10.
go back to reference Enacar A, Giray B, Pehlivanoglu M et al (2003) Facemask therapy with rigid anchorage in a patient with maxillary hypoplasia and severe oligodontia. Am J Orthod Dentofacial Orthop 123:571–577PubMedCrossRef Enacar A, Giray B, Pehlivanoglu M et al (2003) Facemask therapy with rigid anchorage in a patient with maxillary hypoplasia and severe oligodontia. Am J Orthod Dentofacial Orthop 123:571–577PubMedCrossRef
11.
go back to reference Fuhrmann R, Wehrbein H, Diedrich P (1993) Dreidimensionale computertomographische Darstellung des bezahnten Alveolarkamms. Fortschr Kieferorthop 54:91–100PubMedCrossRef Fuhrmann R, Wehrbein H, Diedrich P (1993) Dreidimensionale computertomographische Darstellung des bezahnten Alveolarkamms. Fortschr Kieferorthop 54:91–100PubMedCrossRef
12.
go back to reference Greiner M, Greiner A, Hirschfelder U (2007) Variance of landmarks in digital evaluations: comparison between CT-based and conventional digital lateral cephalometric radiographs. J Orofac Orthop 68:290–298PubMedCrossRef Greiner M, Greiner A, Hirschfelder U (2007) Variance of landmarks in digital evaluations: comparison between CT-based and conventional digital lateral cephalometric radiographs. J Orofac Orthop 68:290–298PubMedCrossRef
13.
go back to reference Hofmann E, Medelnik J, Keller T et al (2011) Measuring mesiodistal width of impacted maxillary canines: CT-assisted determination. J Orofac Orthop 72:33–44PubMedCrossRef Hofmann E, Medelnik J, Keller T et al (2011) Measuring mesiodistal width of impacted maxillary canines: CT-assisted determination. J Orofac Orthop 72:33–44PubMedCrossRef
14.
go back to reference Hong H, Ngan P, Han G et al (2005) Use of onplants as stable anchorage for facemask treatment: a case report. Angle Orthod 75:453–460PubMed Hong H, Ngan P, Han G et al (2005) Use of onplants as stable anchorage for facemask treatment: a case report. Angle Orthod 75:453–460PubMed
15.
go back to reference Kokich VG, Shapiro PA, Oswald R et al (1985) Ankylosed teeth as abutments for maxillary protraction: a case report. Am J Orthod 88:303–307PubMedCrossRef Kokich VG, Shapiro PA, Oswald R et al (1985) Ankylosed teeth as abutments for maxillary protraction: a case report. Am J Orthod 88:303–307PubMedCrossRef
16.
go back to reference Kravitz ND, Kusnoto B (2007) Risks and complications of orthodontic miniscrews. Am J Orthod Dentofacial Orthop 131:S43–S51PubMedCrossRef Kravitz ND, Kusnoto B (2007) Risks and complications of orthodontic miniscrews. Am J Orthod Dentofacial Orthop 131:S43–S51PubMedCrossRef
17.
go back to reference Leung MT, Lee TC, Rabie AB et al (2008) Use of miniscrews and miniplates in orthodontics. J Oral Maxillofac Surg 66:1461–1466PubMedCrossRef Leung MT, Lee TC, Rabie AB et al (2008) Use of miniscrews and miniplates in orthodontics. J Oral Maxillofac Surg 66:1461–1466PubMedCrossRef
18.
go back to reference Liu C, Hou M, Liang L et al (2005) Sutural distraction osteogenesis (SDO) versus osteotomy distraction osteogenesis (ODO) for midfacial advancement: a new technique and primary clinical report. J Craniofac Surg 16:537–548PubMedCrossRef Liu C, Hou M, Liang L et al (2005) Sutural distraction osteogenesis (SDO) versus osteotomy distraction osteogenesis (ODO) for midfacial advancement: a new technique and primary clinical report. J Craniofac Surg 16:537–548PubMedCrossRef
19.
go back to reference Montazem A, Valauri DV, St-Hilaire H et al (2000) The mandibular symphysis as a donor site in maxillofacial bone grafting: a quantitative anatomic study. J Oral Maxillofac Surg 58:1368–1371PubMedCrossRef Montazem A, Valauri DV, St-Hilaire H et al (2000) The mandibular symphysis as a donor site in maxillofacial bone grafting: a quantitative anatomic study. J Oral Maxillofac Surg 58:1368–1371PubMedCrossRef
20.
go back to reference Nguyen T, Cevidanes L, Cornelis MA et al (2011) Three-dimensional assessment of maxillary changes associated with bone anchored maxillary protraction. Am J Orthod Dentofacial Orthop 140:790–798PubMedCentralPubMedCrossRef Nguyen T, Cevidanes L, Cornelis MA et al (2011) Three-dimensional assessment of maxillary changes associated with bone anchored maxillary protraction. Am J Orthod Dentofacial Orthop 140:790–798PubMedCentralPubMedCrossRef
21.
go back to reference Nienkemper M, Wilmes B, Pauls A et al (2013) Impact of mini-implant length on stability at the initial healing period: a controlled clinical study. Head Face Med 9:30PubMedCentralPubMedCrossRef Nienkemper M, Wilmes B, Pauls A et al (2013) Impact of mini-implant length on stability at the initial healing period: a controlled clinical study. Head Face Med 9:30PubMedCentralPubMedCrossRef
22.
go back to reference Polat-Ozsoy O, Arman-Ozcirpici A, Veziroglu F et al (2011) Comparison of the intrusive effects of miniscrews and utility arches. Am J Orthod Dentofacial Orthop 139:526–532PubMedCrossRef Polat-Ozsoy O, Arman-Ozcirpici A, Veziroglu F et al (2011) Comparison of the intrusive effects of miniscrews and utility arches. Am J Orthod Dentofacial Orthop 139:526–532PubMedCrossRef
23.
go back to reference Reddy MS, Mayfield-Donahoo T, Vanderven FJ et al (1994) A comparison of the diagnostic advantages of panoramic radiography and computed tomography scanning for placement of root form dental implants. Clin Oral Implants Res 5:229–238PubMedCrossRef Reddy MS, Mayfield-Donahoo T, Vanderven FJ et al (1994) A comparison of the diagnostic advantages of panoramic radiography and computed tomography scanning for placement of root form dental implants. Clin Oral Implants Res 5:229–238PubMedCrossRef
24.
go back to reference Sar C, Arman-Ozcirpici A, Uckan S et al (2011) Comparative evaluation of maxillary protraction with or without skeletal anchorage. Am J Orthod Dentofacial Orthop 139:636–649PubMedCrossRef Sar C, Arman-Ozcirpici A, Uckan S et al (2011) Comparative evaluation of maxillary protraction with or without skeletal anchorage. Am J Orthod Dentofacial Orthop 139:636–649PubMedCrossRef
25.
go back to reference Singer SL, Henry PJ, Rosenberg I (2000) Osseointegrated implants as an adjunct to facemask therapy: a case report. Angle Orthod 70:253–262PubMed Singer SL, Henry PJ, Rosenberg I (2000) Osseointegrated implants as an adjunct to facemask therapy: a case report. Angle Orthod 70:253–262PubMed
26.
go back to reference Singh GD (1999) Morphologic determinants in the etiology of class III malocclusions: a review. Clin Anat 12:382–405PubMedCrossRef Singh GD (1999) Morphologic determinants in the etiology of class III malocclusions: a review. Clin Anat 12:382–405PubMedCrossRef
27.
go back to reference Tanne K, Hiraga J, Sakuda M (1989) Effects of directions of maxillary protraction forces on biomechanical changes in craniofacial complex. Eur J Orthod 11:382–391PubMed Tanne K, Hiraga J, Sakuda M (1989) Effects of directions of maxillary protraction forces on biomechanical changes in craniofacial complex. Eur J Orthod 11:382–391PubMed
28.
go back to reference Testori T, Weinstein RL, Taschieri S et al (2012) Risk factor analysis following maxillary sinus augmentation: a retrospective multicenter study. Int J Oral Maxillofac Implants 27:1170–1176PubMed Testori T, Weinstein RL, Taschieri S et al (2012) Risk factor analysis following maxillary sinus augmentation: a retrospective multicenter study. Int J Oral Maxillofac Implants 27:1170–1176PubMed
29.
go back to reference Teuscher U (1976) Principles of extraoral force. Inf Orthod Kieferorthop 8:9–16PubMed Teuscher U (1976) Principles of extraoral force. Inf Orthod Kieferorthop 8:9–16PubMed
30.
31.
go back to reference Ueno D, Sato J, Igarashi C et al (2010) Accuracy of oral mucosal thickness measurements using spiral computed tomography. J Periodontol 82:829–836PubMedCrossRef Ueno D, Sato J, Igarashi C et al (2010) Accuracy of oral mucosal thickness measurements using spiral computed tomography. J Periodontol 82:829–836PubMedCrossRef
32.
go back to reference Varghese S, Kailasam V, Padmanabhan S et al (2010) Evaluation of the accuracy of linear measurements on spiral computed tomography-derived three-dimensional images and its comparison with digital cephalometric radiography. Dentomaxillofac Radiol 39:216–223PubMedCentralPubMedCrossRef Varghese S, Kailasam V, Padmanabhan S et al (2010) Evaluation of the accuracy of linear measurements on spiral computed tomography-derived three-dimensional images and its comparison with digital cephalometric radiography. Dentomaxillofac Radiol 39:216–223PubMedCentralPubMedCrossRef
33.
go back to reference Vlassis JM, Fugazzotto PA (1999) A classification system for sinus membrane perforations during augmentation procedures with options for repair. J Periodontol 70:692–699PubMedCrossRef Vlassis JM, Fugazzotto PA (1999) A classification system for sinus membrane perforations during augmentation procedures with options for repair. J Periodontol 70:692–699PubMedCrossRef
34.
go back to reference Wehrbein H, Glatzmaier J, Mundwiller U et al (1996) The Orthosystem – a new implant system for orthodontic anchorage in the palate. J Orofac Orthop 57:142–153PubMedCrossRef Wehrbein H, Glatzmaier J, Mundwiller U et al (1996) The Orthosystem – a new implant system for orthodontic anchorage in the palate. J Orofac Orthop 57:142–153PubMedCrossRef
35.
go back to reference Wehrbein H, Merz BR, Diedrich P et al (1996) The use of palatal implants for orthodontic anchorage. Design and clinical application of the orthosystem. Clin Oral Implants Res 7:410–416PubMedCrossRef Wehrbein H, Merz BR, Diedrich P et al (1996) The use of palatal implants for orthodontic anchorage. Design and clinical application of the orthosystem. Clin Oral Implants Res 7:410–416PubMedCrossRef
36.
go back to reference Wilmes B, Drescher D, Nienkemper M (2009) A miniplate system for improved stability of skeletal anchorage. J Clin Orthod 43:494–501PubMed Wilmes B, Drescher D, Nienkemper M (2009) A miniplate system for improved stability of skeletal anchorage. J Clin Orthod 43:494–501PubMed
37.
go back to reference Wilmes B, Nienkemper M, Ludwig B et al (2011) Early Class III treatment with a hybrid hyrax-mentoplate combination. J Clin Orthod 45:15–21 (quiz 39)PubMed Wilmes B, Nienkemper M, Ludwig B et al (2011) Early Class III treatment with a hybrid hyrax-mentoplate combination. J Clin Orthod 45:15–21 (quiz 39)PubMed
38.
go back to reference Yavuz MS, Buyukkurt MC, Tozoglu S et al (2009) Evaluation of volumetry and density of mandibular symphysis bone grafts by three-dimensional computed tomography. Dent Traumatol 25:475–479PubMedCrossRef Yavuz MS, Buyukkurt MC, Tozoglu S et al (2009) Evaluation of volumetry and density of mandibular symphysis bone grafts by three-dimensional computed tomography. Dent Traumatol 25:475–479PubMedCrossRef
Metadata
Title
Assessing bone volume for orthodontic miniplate fixation below the maxillary frontal process
Authors
Dr. Dr. T.M. Präger
H.G. Brochhagen
R. Mischkowski
P.-G. Jost-Brinkmann
R. Müller-Hartwich
Publication date
01-09-2014
Publisher
Springer Berlin Heidelberg
Published in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Issue 5/2014
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-014-0234-8

Other articles of this Issue 5/2014

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 5/2014 Go to the issue