Introduction
In orthodontics, anchorage is typically achieved by leveraging the movement of malaligned teeth with the support of a single tooth or a group of teeth. With the advancements in orthodontic techniques over recent decades, mini-implants have emerged as a reliable source of anchorage, offering several advantages. Their ease of insertion and removal, small size, and high patient compliance have contributed to their widespread success.
The selection of the optimal mini-implant placement site is determined through clinical and radiographic evaluation. Critical factors such as bone thickness, quality, and quantity at the site of placement play a pivotal role in the stability and effectiveness of orthodontic mini-screws. Various techniques have been developed to simplify the placement process and enhance outcomes. 1
Secondary factors
The angulations of mini-screw to bone.
Degree of mini-screw to bone contact.
Degree of inflammation of the peri-orthodontic mini-screw tissue.
Craniofacial morphology.
Screw dimensions.
Insertion and removal torque.
The miniscrew implantation site is one of the most important elements influencing the stability of mini-screw implants. 4, 5 To precisely insert the miniscrew into interradicular gaps, a screw placement site can be evaluated using a number of ways. 6 Brass wires 7 or metallic markers 8 are simple to position in the interproximal areas, although their relative positions may not always line up across radiographic images. 9
An orthodontic mini implant guide contributes to the overall success of orthodontic treatment by ensuring. 10, 11
Precise placement.
Reducing complications.
Improving predictability.
Enhancing the overall patient experience.
This article describes a new template for orthodontic mini-implant placement that is accurate in determining the implant placement site and is simple to fabricate.
Method of fabrication
The guide is fabricated using 21-gauge stainless steel wire.
Wire is marked at 5mm from one end.
Using universal plier, wire is bent in a u loop fashion and compressed.
A 90˚ bend is given at the end of this u loop.
Leaving 2mm, another 90˚ bend is given for fabrication of following loop.
Multiple loops can be fabricated as per the depth of vestibule.
This template is soldered to base arch wire leaving 4mm from latest U loop.(Figure 2 A,B).
A stiffer base arch wire(19x25 SS) makes minimal movement of the template.
Clinical procedure
The guide is placed in buccal vestibule and inserted in molar tube on one side and premolar bracket on the other(Figure 3 A) An RVG is taken after securing this position(Figure 3 B). Mini-Implant placement site is located by using the template as a measurement guide. We get a precise vertical height for implant placement, the horizontal length is set at 5 mm to facilitate a straightforward estimation of half its length, thereby enhancing the likelihood of successful placement within the interradicular bone Probing is done in the determined location to induce a bleeding point, thus obtaining a site for Mini Implant placement(Figure 3 C,D).
