American Journal of Orthodontics and Dentofacial Orthopedics
Clinician's CornerSurgical positioning of orthodontic mini-implants with guides fabricated on models replicated with cone-beam computed tomography
Section snippets
Methods for locating the proper position
There have been various efforts to standardize the proper positioning of mini-implants.4, 5, 7, 13 The placement site is critical to ensure a successful outcome, but the more important point is the implant guide itself. Bae et al13 reported on a guide wire that provides a reference in the x-rays. However, wire guide systems require several x-rays for determining the proper position; this limits accuracy during drilling. The wires can be deformed or bent in the oral cavity during x-ray taking.
SURGICAL GUIDE FABRICATION AND IMPLANTATION PROCEDURE
Three-dimensional CBCT images were taken of the posterior maxilla by using a new type of CBCT system (PSR 9000N, Asahi Roentgen, Kyoto, Japan) that delivers 0.1 mm in voxel size. An advantage of this model was improved reproducibility of anatomical structures with acquisition of a 0.15-mm slice. A CBCT record that was transformed into DICOM format was changed into 3D images (Fig. 2, Fig. 3). A replica model of the right posterior maxilla was fabricated by using the SLA method (Fig 4).
A
DISCUSSION
A CBCT guide is recommended for mini-implant placement for the following reasons.
CONCLUSIONS
The benefits of CBCT include its low radiation dose and higher resolution in 3 dimensions, and it has been gaining popularity for diagnosis and treatment. Placement of mini-implants is easier and safer with a CBCT guide.
Further study is needed to construct the guide directly without the additional process of making a cast, just as the prosthetic implant guides were made with computed analysis.
ACKNOWLEDGEMENT
This study was partly supported by the Korean Society of Speedy Orthodontics, Alumni fund of the Department of Dentistry, and Graduate School of Clinical Dental Science, The Catholic University of Korea. We also thank Dr Hyun-A Heo, Su-Hyun Park, Woon-kyung Seo, and Mr Chang-Uk Kim in the Uijongbu St Mary's Hospital for preparing this manuscript and Mr Jong-Min Yoon from the Humobot Company for technical assistance for replica model fabrication.
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