Insertion torque and Periotest values are important factors predicting outcome after orthodontic miniscrew placement

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IntroductionApproximately 14% of orthodontic anchor screws (miniscrews) become dislodged regardless of the accuracy of placement. It is therefore important to investigate the factors causing dislodgement. We evaluated the stability of miniscrews after placement to identify factors influencing outcome in orthodontic treatment using miniscrews.MethodsWe investigated 120 miniscrews (Dual-top Auto Screw III; Jeil Medical, Seoul, Korea) (diameter, 1.4 mm; length, 6 mm) placed on the buccal or lingual side between the maxillary second premolar and the first molar in women. Patient age and rate and time of screw dislodgement were examined. Insertion torque values and Periotest (Tokyo Dental Industrial, Tokyo, Japan) measurements indicating horizontal and vertical mobility of the inserted screws were compared between groups with and without dislodgement (failure and success groups, respectively).ResultsMean insertion torque values were 10.7 ± 1.9 N·cm and 8.5 ± 2.1 N·cm in the failure and success groups, respectively. Cortical bone thickness measurements (success group, 1.34 ± 0.35 mm; failure group, 0.99 ± 0.09 mm) were significantly higher, whereas Periotest values at placement (success group, horizontal, 4.9 ± 1.4; vertical, 4.7 ± 1.3; failure group, horizontal, 7.0 ± 0.8; vertical, 7.1 ± 0.9) were significantly lower in the success group than in the failure group.ConclusionsThe Periotest value, together with insertion torque and cortical bone thickness, could serve as an index of initial stability for predicting the outcome of miniscrew placement.HighlightsAppropriate insertion torque values obtain good stability after miniscrew placement.Failure rate significantly increases when cortical bone thickness is ≤1 mm.Periotest values at placement were significantly higher in the failure group.Periotest instead of CBCT may give an initial stability index for miniscrew outcome.

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