Introduction Absolute anchorages obtained from temporary anchorage devices (TADs, miniscrews) considerably facilitate dental movements and make some very difficult movements such as full-arch intrusions possible. Despite the significance of assessing… Click to show full abstract
Introduction Absolute anchorages obtained from temporary anchorage devices (TADs, miniscrews) considerably facilitate dental movements and make some very difficult movements such as full-arch intrusions possible. Despite the significance of assessing strategies to fully intrude the arch using mini-implants, there is no study in this regard except a few case reports. Therefore, we simulated/tested 4 scenarios. Methods Four maxilla models were created with different miniscrews/appliances: (1) two miniscrews were placed distal to laterals and one in the mid sagittal region. (2) Two mini-implants were inserted in mesial of canines and 2 others between bilateral first and second molars, plus another TAD in the midpalatal area, plus a transpalatal arch (TPA). (3) Two mini-implants were inserted between bilateral canines and first premolars and 2 others between bilateral first and second molars + TPA. (4) Two mini-implants were installed between lateral-and-canine and 2 miniscrews between second premolars and first molars + TPA. Intrusive forces (80 g anterior, 150 g posterior) were exerted using stainless-steel coil springs. Stresses/displacements were measured. Risk of external root resorption was evaluated. Results The highest amounts of incisor/molar intrusion were seen in model 1. Model 2 had fewer intrusions, but its control over undesired movements was greater. Model 4 drastically reduced molar intrusion and considerably increased premolar intrusion. Overall amounts of intrusion were highest in the first 2 models, marking them as proper candidates for cases needing greater intrusion extents. Model 2 may be useful when miniscrew loosening/failure is a concern, while model 1 is recommended when fewer miniscrews are allowed. Overall, the highest and lowest root resorptions might occur in models 1 and 4, respectively. Conclusions Each model showed certain efficacies/drawbacks and thus is recommended for a particular set of cases. Therefore, depending on the diagnosis and treatment plan, one or more of these scenarios might be desirable.
               
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