Search Results (197)

Background: Tooth agenesis, particularly hypodontia, poses a clinical and esthetic challenge in growing patients due to limitations in definitive implant placement before skeletal maturity. Traditional solutions such as removable prostheses or orthodontic space closure often fail to provide adequate long-term stability, function, and tissue preservation. In recent years, orthodontic mini-implants have emerged as a promising interim solution. This narrative review aims to synthesize current clinical evidence on the use of orthodontic mini-implants as temporary prosthetic abutments in children and adolescents with hypodontia or post-traumatic tooth loss. Methods: A literature search was conducted using PubMed and Google Scholar databases, covering studies published between January 2004 and March 2025. Inclusion criteria were clinical reports involving skeletally immature patients with congenital or traumatic tooth loss treated with mini-implants, with mandatory radiographic diagnostics and outcome data. Data extracted included patient demographics, etiology, implant site, imaging, follow-up, complications, and outcomes. A total of 17 studies comprising 42 cases were analyzed and summarized in tabular form. Results: Patients aged 6 to 16 years were treated primarily for agenesis of maxillary lateral or central incisors. The mean follow-up duration was 36.9 months. CBCT was used in 28.6% of cases. Mini-implants demonstrated high clinical success with stable soft tissue contours and preservation of alveolar volume. Complications were reported in 21.4% of cases and included crown debonding, minor infraocclusion, soft tissue irritation, and rare instances of osseointegration. Conclusions: Orthodontic mini-implants may provide a minimally invasive and reversible approach to interim tooth replacement in growing patients. Preliminary evidence suggests favorable outcomes in terms of stability, esthetics, and tissue preservation, but further prospective research is needed to validate their long-term effectiveness and standardize clinical application. Full article

The objective of the present study was to evaluate and compare the accuracy of the computer-aided static navigation technique (NAV), augmented reality (AR) and freehand placement technique (FHT) for the bicortical orthodontic self-drilling mini-implants for maxillary skeletal expansion (MSE) appliances placed in palate. Material and Methods: A total of 120 bicortical orthodontic self-drilling mini-implants were placed in the palate of ten 3D printed anatomically based polyurethane models of a completely edentulous upper maxilla. The orthodontic mini-implants were randomly assigned to the following placement techniques: (A) computer-aided static navigation technique (n = 40) (NAV), (B) augmented reality device (n = 40) (AR) and (C) conventional freehand technique (n = 40) (FHT). Moreover, two implants were placed in each side of the midpalatal suture in every model according to the digital planification of the expander device. Subsequently, the orthodontic mini-implants were placed and postoperative CBCT scans were performed. Finally, coronal entry-point (mm), apical end-point (mm) and angular deviations (°) were calculated using a t-test. Results: Statistically significant differences were shown at coronal entry-point (p < 0.001), apical end-point (p < 0.001) and angular deviations (p < 0.001) between the three placement techniques of bicortical orthodontic mini-implants. Additionally, statistically significant differences were also shown between the orthodontic mini-implant positions concerning the entry point (p = 0.004) and angular deviation (p = 0.004). Conclusions: The augmented reality placement technique results are more accurate, followed by the computer-aided static navigation technique and the freehand technique for MSE appliances placed in palate. Full article

Objectives: This study compared the clinical outcomes of Vivinex Impress (XY1-EM) enhanced monofocal and standard Vivinex (XY1) intraocular lenses (IOLs) in mini-monovision cataract surgery. In this retrospective study, patients underwent bilateral implantation with either XY1-EM (33 patients, 66 eyes) or XY1 (24 patients, 48 eyes) in a −1D mini-monovision configuration. Methods: Visual acuity was evaluated from 5 m to 30 cm, along with spectacle dependence, contrast sensitivity, and patient-reported outcomes. Results: The XY1-EM group demonstrated significantly better intermediate and near visual acuity at distances of 30−50 cm (p < 0.05) and reduced spectacle dependence for intermediate distances (p = 0.02). Visual function questionnaire (VFQ-25) scores were significantly higher in the XY1-EM group for general vision, role difficulty, mental health, dependency, and near activity domains (p < 0.05). No significant differences were found in glare, contrast sensitivity, or quality of vision scores. Conclusions: The XY1-EM lens in mini-monovision configuration provides enhanced intermediate and near visual acuity with reduced spectacle dependence compared to standard monofocal IOLs, offering a valuable option for patients seeking improved quality of vision with reduced spectacle use. Full article

Background: Canine impaction complicates treatment and prolongs duration, requiring precise localization. CBCT is the gold standard for diagnosis and assessment. However, it involves high radiation exposure and cost. This study aimed to evaluate the effectiveness of a combined biomechanical approach for orthodontic traction of impacted maxillary canines (IMCs) and to determine whether intraoral scans (STL files) could replace a final CBCT in assessing canine repositioning. Methods: The sample included 10 patients (7 males and 3 females) with 13 severely displaced IMCs, treated with a protocol combining Invisalign^® aligners, elastics, mini-implants, and sectional wires. In all, 9 IMC were palatally impacted, while 4 were buccally impacted. A representative clinical case is presented to illustrate the biomechanics used in one of the complex cases. Canine movement was evaluated at the cusp and apex through two methods: overlay of pre- and post-treatment CBCTs, and overlay of initial and final STL scans onto the initial CBCT. Results: A Class I canine relationship was successfully achieved in all patients. No statistically significant differences were found between the two measurement methods (p > 0.05). Conclusions: Orthodontic traction of IMC, especially in complex cases, can be achieved using aligners, elastics, mini-implants, and sectional wires. Once the canine crown has erupted and is clinically visible, STL scans overlaid with the initial CBCT can accurately assess the final position of the crown and root. This allows clinicians to avoid a second CBCT in selected cases, reducing patient radiation exposure while maintaining diagnostic accuracy. Full article

The precise planning of orthodontic temporary anchorage devices (TADs) in the anterior maxilla is crucial due to anatomical complexity. This study aimed to evaluate the bone parameters for mini-implant placement using cone-beam computed tomography (CBCT). A total of 65 patients aged 15–50 years underwent CBCT analysis. Measurements were taken in three anterior regions (between and adjacent to central/lateral incisors and canines) at four vertical levels (2 mm, 4 mm, 6 mm, and 8 mm from the alveolar crest). Parameters included interdental width (IDW), buccopalatal bone depth (BPD), and distances from ideal implant points (IPPs) to adjacent structures. Descriptive statistics included means, standard deviations, confidence intervals, and frequency distributions. Statistical analysis revealed age-related differences, with subjects aged 21–30 showing higher CP-IPP and IDW values, and those aged 15–20 showing higher BPD values. Gender differences were noted in IDW and BPD, but not in CP-IPP. The most favorable IDW (≥3 mm) was observed in regio 1 at level A, while unfavorable values were found in regio 2′ at levels C and D. Positive correlations between IDW and BPD were found in multiple regions and levels. These results may guide safer and more predictable TAD placement. Considering that radiographic analysis forms the basis of this study, future in vivo studies are needed to confirm the practical impact of the proposed measurements. Full article

Background: Patients who undergo cardiac surgery and procedures often experience functional impairments. However, few studies have compared changes in physical function, cognitive function, mental health, and sleep quality before and after the interventions. Methods: Intensive care unit (ICU) nurses visited the ward and conducted the assessments. The Japanese version of the Cardiovascular Health Study (J-CHS) and the Barthel index for physical function, mini-mental state examination (MMSE) for cognitive function, hospital anxiety and depression scale for anxiety (HADS-A) and depression (HADS-D) for mental health, and a 5-point Likert scale for sleep quality were used. Results: Of the 210 cases, 156 were included. Cardiac surgeries and procedures included valve replacement or valvuloplasty (43%), coronary artery bypass graft (9%), and transcatheter aortic valve implantation (39%). At a median of 7 (4–9) days after ICU discharge, the J-CHS score worsened from 2 (1–3) to 3 (2–3) (p < 0.01), and the Barthel index worsened from 95 (85–100) to 75 (55–85) (p < 0.01). The HADS-A score improved from 3 (1–6) to 1 (0–4) (p < 0.01), and the HADS-D score improved from 4 (1–7) to 2 (1–6) (p < 0.01). The MMSE score remained unchanged at 26 (24–29; p = 0.91). Sleep quality worsened from 4 (3–5) to 3 (2–4) (p < 0.01). In the multivariate analysis, sleep quality deterioration was associated with open thoracotomy. Conclusions: After cardiac surgeries and procedures, physical function and sleep quality worsened, whereas anxiety and depression improved, and cognitive function remained unchanged. Full article

Orthodontic mini-implants (MIs) are excellent alternative skeletal anchorage devices. Their stability is important for their survival, requiring appropriate torque application during insertion and removal. Objective: This study aimed to evaluate the influences of the diameter and brand of MIs on their stability by measuring the maximum insertion and removal torques after they had been aged in a pH 7 artificial saliva for 4 weeks at 37 °C. Methods: Forty Ti6Al4V alloy MIs of two different brands and diameters were divided into four groups. They were placed in artificial bone blocks using the NSK^® Surgic Pro coupled with a digital torque gauge (Centor Touch Star TH^®) to measure the maximum insertion and removal torques. Results: After ageing, the Fatscrew (Fts) MIs were more stable when removed than the white brand (WB) MIs. The WB MIs lost stability over time, while the Fts MIs—especially the 2.0 mm ones—maintained good stability. Conclusions: The significant differences between the tested groups, especially the stability observed in the 2.0 mm Fts MIs compared to the other groups, highlight the importance of brand and diameter size in the effectiveness of MIs. Full article

Background/Objectives: Orthodontic temporary anchorage devices (TADs) in the lateral maxillary region are useful tools for successful orthodontic treatment. Radiological anatomical knowledge is crucial for the successful placement of TADs. The use of cone-beam computed tomography (CBCT) is essential for evaluating the relationship between the ideal placement point (IPP) and dental structures, particularly in cases with anatomical limitations. Accordingly, this study aims to assess the anatomical conditions for orthodontic mini-implant (MI) insertion in the posterior maxilla using CBCT as the gold standard. Methods: This retrospective study included 62 patients (37.1% male, 62.9% female) aged 11 to 50 years. CBCT scans (sagittal and axial cross-sections) were used to evaluate interdental bone characteristics in different regions. The evaluated regions were defined as follows: Region 1 (canine and first premolar), Region 2 (first and second premolars), Region 3 (second premolar and first molar), and Region 4 (first and second molars). All parameters were assessed at three predefined levels: A, B, and C, located 4, 3, and 2 mm, respectively, from the alveolar crest. At the aforementioned levels, we performed measurements, such as the interdental width (IDW) in the mesiodistal direction and buccopalatal depth (BPD). The last observation was the relationship between the ideal TAD placement point (IPP) and dental structures, such as contact points (CPs) and cusp tips (C1-cusp of mesial tooth, C2-cusp of distal tooth, in each region). Results: A statistically significant positive correlation was found between the IDW and BPD at Levels A, B, and C in Region 1, while a negative correlation was observed between the IDW and BPD at Level C in Region 2′. The highest percentages of IDW exceeding 3 mm were found in Region 4 at Level A (67.7%), followed by Region 1′ and 2′, both at Level A. The mean interdental width measured at each level on the right and left sides was highest at Level A, exceeding 3 mm, and the width decreased with each successive level. The mean BPD measured at each level on the right and left sides was also highest at Level A. Conclusions: This methodological approach could assist in ensuring precise and efficient implant insertion. Furthermore, it can be concluded that the safe zone for buccal and interdental mini-implant placement is located 4 mm from the alveolar crest at Level A. Also, the CBCT analysis algorithm may serve as a valuable tool for clinicians in determining optimal TAD placement in different dental regions. Full article

Total hip replacement (THR) is a common procedure used in veterinary medicine to treat hip joint diseases, particularly in medium- and large-sized dogs. Although cementless techniques have become the standard owing to concerns regarding the aseptic loosening of cemented implants, complications such as stem fractures can still occur. This study reports a case of a 1-year-old, 2.8 kg Toy Poodle that underwent cementless THR using the Zurich mini-cementless hip system to treat Legg–Calvé–Perthes disease. Six months post-surgery, the dog developed a fractured stem, and a second surgery was performed using the “window technique” to replace the broken stem. The procedure involved creating a small window in the femoral cortex to remove the damaged stem and insert a new one. The dog recovered successfully with no further lameness. This case highlights the effectiveness of the window technique for stem replacement in small dogs and emphasizes the importance of optimal stem selection and positioning during the initial THR. Full article

Background/Objectives: The structural integrity and strength of the transgingival soft tissue seal around dental implant surfaces remain critical challenges. Therefore, animal models should include all three implant/tissue interfaces: bone, connective tissue, and epithelium. Thus, we sought to explore the rabbit mandibular diastema as a site for candidate intra-oral implant placement. Methods: Ninety-six custom mini-implants (with one of four different surfaces: machined, acid-etched, and with or without a nanotube coating) made from titanium 6/4 alloy were placed in the mandibular diastemas of twenty-four 16-week-old New Zealand white rabbits, with the implant collar above the alveolar crest. After 7, 21, and 42 days, the bony and connective tissue/implant interfaces were examined by light and scanning electron microscopy (SEM). Results: Of ninety-six implants, eight implants were found exposed to the oral cavity, with no evidence of soft tissue inflammation, suggesting that transmucosal implant placement would have been feasible. No significant differences were observed in collagen fiber orientation and fibrous tissue thickness by polarized light microscopy. However, SEM images showed that at all three time points, topographically complex nanotube surfaces had a profound effect on soft tissue peri-implant deposition, although functionally oriented collagen fibers were not identified attached to the implant surface. These surfaces also showed reparative peri-implant bone in the collar region. An intramembranous form of de novo bone formation was observed, together with tartrate-resistant acid-phosphatase-positive osteoclasts and multinucleate giant cells in the peri-implant endosseous compartment. Conclusions: Our results demonstrate that the rabbit mandibular diastema provides an intra-oral method of implant placement without the necessity of an extra-oral approach, tooth extractions, or bone augmentation procedures. Furthermore, given that three implant tissue interfaces can potentially be studied (bone, connective tissue, and epithelium) this model provides advantages over more traditional implant placement sites in the appendicular skeleton. Full article

Objective: This study compared the tooth movement patterns of a power arm and a lever jig during mandibular canine retraction into a premolar extraction space using skeletal anchorage. Methods: A finite element model was developed based on anatomical structures. A mini-implant was placed between the mandibular second premolar and first molar, and canine retraction was simulated using a power arm and a lever jig. The lever jig’s vertical arm lengths were 6 mm, 8 mm, and 10 mm, corresponding to force application distances of 4.5 mm, 6.4 mm, and 8.2 mm from the archwire, matching the power arm. Finite element analysis was performed using linear mechanical properties and an explicit method. Results: With the power arm, increasing vertical length led to greater extrusion, while the posterior force remained unchanged. The lever jig also showed increased extrusion with length but to a lesser extent. Posterior force increased proportionally with the lever jig length. Initial displacement analysis showed greater extrusion and distal tipping with the power arm, while the lever jig suppressed extrusion and facilitated controlled tipping. Stress analysis revealed a more uniform periodontal ligament stress distribution with the lever jig. Conclusion: The lever jig minimizes extrusion and enhances force concentration posteriorly, promoting efficient distal movement. Full article

Background/Objectives: Heart failure (HF) with reduced ejection fraction remains a significant global health challenge despite advances in medical therapy. Cardiac contractility modulation (CCM) is a promising treatment for symptomatic HF patients who are ineligible for cardiac resynchronization therapy (CRT). Non-invasive methods to assess the acute hemodynamic effects of CCM are critical to optimize care and guide treatment. This study aimed to evaluate the acute impact of CCM on stroke volume (SV) and total peripheral resistance index (TPRI) using the non-invasive bioimpedance-based system (NICaS^®). Methods: Eight HF patients (median age: 64.6 years, median left ejection fraction (LVEF): 34.5%) underwent implantation of the Optimizer Smart Mini CCM device. Hemodynamic parameters, including SV and TPRI, were measured using NICaS^® at baseline (pre-implantation) and at 1 week, 1 month, and 3 months post-implantation. Measurements were repeated eight times per session and analyzed using non-parametric statistical tests, including the Kruskal–Wallis test, Mann–Whitney test, and Kolmogorov–Smirnov test. Results: Median SV increased significantly from 40.02 mL (interquartile range (IQR): 32.62–78.16 mL) at baseline to 69.83 mL (IQR: 58.63–86.36 mL) at 3 months (p < 0.0001). Median TPRI decreased significantly from 2537 dn s/cm⁵ m² (IQR: 1807–3084 dn s/cm⁵ m²) to 1307 dn s/cm⁵ m² (IQR: 1119–1665 dn s/cm⁵ m²) over the same period (p < 0.0001). CCM therapy significantly improved SV and reduced TPRI in HF patients within three months of implantation. Conclusions: NICaS^® provided a reliable, non-invasive tool for monitoring these acute hemodynamic changes, supporting its use in clinical practice. Full article

Aim: This study aims to assess the suitability of the Göttingen Mini-pig (G-MP) as a large animal model for preclinical research on articular cartilage treatment procedures. Additionally, this study compares the G-MP to the domestic pig (DP) regarding surgical anatomy, postoperative care, and the challenges associated with the follow-up period. Materials and methods: Six G-MPs and four DPs underwent a two-stage surgical procedure: first, cartilage was harvested using a superolateral approach, followed by cartilage implantation via a medial parapatellar tendon approach. Results: The superolateral approach exposed 11% (SD ± 5) of the trochlea in G-MPs and 20% in DPs. The medial parapatellar tendon approach exposed 63% (SD ± 4) of the trochlear surface and 34% (SD ± 13) of the medial femoral condyle in G-MPs, allowing for the creation of four 6 mm trochlear lesions and one medial condyle lesion in four out of six G-MPs and all DPs. Cartilage thickness was less than 1 mm in G-MPs, compared to over 2 mm in DPs. Weight gain was +4 kg/week in DPs and +0.2 kg/week in G-MPs. Conclusion: Overall, the G-MP proves to be a viable model for cartilage research, offering sufficient joint access via the dual approach, which allows for 4–5 lesions of 6 mm each. However, the thinner cartilage in G-MPs should be taken into account. Full article

Background: Mini-implants have transformed orthodontic treatment by providing reliable anchorage and addressing challenges in anchorage control. This in vitro study aimed to compare the insertion torque (IT) values of three types of orthodontic mini-implants. The null hypothesis stated that no significant difference would be found in IT based on mini-implant type. Methods: We analyzed the mechanical ITs of 12 mini-implants categorized into four groups based on lengths (6, 8, 10, and 12 mm) and diameters (1.4, 1.6, and 2.0 mm). Mini-implants were inserted at a 90° angle into artificial bone (Sawbones^®) without pre-drilling. The ANOVA and Tukey’s post hoc test assessed differences, and Spearman’s correlation evaluated relationships between IT, diameter, and length. Results: The Lomas Mondefit^® 2 × 8 mm mini-implant had the highest IT (35 N), while the Jeil 2 × 12 mm had the lowest. Torque correlated with diameter (ρ = 0.609, p = 0.047) and length (ρ = 0.890, p < 0.001). The ANOVA showed significant differences (p = 0.035), with Leone^® and Lomas Mondefit^® differing significantly (p = 0.029). Mini-implant dimensions strongly influence IT. Conclusions: Mini-implant diameter and length significantly influence IT, highlighting their importance in clinical applications for optimal stability and performance. Full article

Background/Objectives: The stabilization disc (SD) for orthodontic mini-implants is a novel device designed to enhance anchorage stability and minimize the risk of mini-implant mobility. The disc features a flat structure with four prongs and is crafted from biocompatible materials such as titanium or stainless steel. It provides additional support to mini-implants by improving force distribution and reducing stress concentration around the insertion site. This study aims to evaluate the biomechanical performance of mini-implants with an SD compared to without-SD mini-implants, with a specific focus on their ability to maintain anchorage under orthodontic loading conditions. Methods: A finite element analysis (FEA) model was created for a commercially available mini-implant (2.0 mm in diameter and 12 mm in length). The mandible’s anatomical structure was reconstructed in 3D from computed tomography (CT) scans using SpaceClaim software 2023.1. To simulate real-world orthodontic conditions, forces of 10 N were applied at an angle of 30°. This retrospective study explores the role of SDs in enhancing mini-implant stability by reducing displacement and optimizing stress distribution. The evaluation included analyzing von Mises stress, cortical bone deformation, and mini-implant movement under simulated orthodontic loading. Results: The results demonstrate that the SD significantly reduces maximum total displacements by over 41% and redistributes von Mises stresses more evenly across the mini-implant and surrounding bone. Cortical bone stress and deformation were reduced in cases utilizing the SD, indicating enhanced implant stability and durability. Conclusions: The stabilization disc enhances mini-implant stability by improving stress distribution and reducing deformation without requiring permanent implant modifications. Its adaptability makes it a valuable solution for managing variable bone density and high orthodontic forces, offering a promising advancement in orthodontic anchorage. Full article