Assessment of interradicular areas and cortical bone thickness for orthodontic mini-implant placement: a cone-beam computed tomography study.

BACKGROUND

Mini-implant has become an accepted and reliable method for providing absolute anchorage in orthodontics. It is known that incorrect implant positioning can increase the failure rates and damage the adjacent tooth roots. This study aimed to assess the interradicular areas and cortical bone thickness for orthodontic mini-implant placement using cone beam computed tomography (CBCT).

METHODS

CBCT scans of 100 subjects (42 males, 58 females; mean age of 16.32 ± 5.72 years) were selected consecutively from the records archive of the Department of Orthodontics and Dentofacial Orthopedics, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A convenience sampling method was employed for selecting the sample. For each interradicular space in the maxilla and the mandible from the central incisor to the second molar; the mesiodistal distance, buccopalatal/lingual thickness, and cortical bone thickness were measured at three different depths from the cementoenamel junction (CEJ), that is at 2 mm, 4 mm, and 6 mm. Descriptive analysis was used to obtain the mean and standard deviation of all the studied measurements. Analysis of variance was used to compare the interradicular dimensions and cortical bone thickness in different regions and at various heights.

RESULTS

There were differences in the interradicular dimensions and cortical bone thickness in different regions and at various heights in both the maxilla and mandible. In the maxilla, the highest mesiodistal distances (3.48 mm, 6 mm apical to CEJ) were between the first molar and second premolar and the highest buccopalatal thickness (14.26 mm, 6 mm apical to CEJ) and buccal cortical thickness (1.92 mm, 4 mm apical to CEJ) existed between the first and second molars and highest palatal cortical thickness (1.77 mm, 6 mm apical to CEJ) were between the first and second premolars. In the mandible, the highest mesiodistal distance (4.74 mm, 6 mm apical to CEJ), buccolingual thickness (13.60 mm, 6 mm apical to CEJ), buccal cortical thickness (3.05 mm, 4 mm apical to CEJ), and lingual cortical thickness (2.59 mm, 4 mm apical to CEJ) were between the first and second molars.

CONCLUSIONS

Mesiodistal distance, buccopalatal/lingual thickness, and cortical bone thickness differ in different regions and at various heights in both the maxilla and mandible. Hence, these factors must be considered while assessing the optimal sites for mini-implant placement. The safest interradicular areas in the maxilla were between the first molar and the second premolar, whereas between the first and second molars in the mandible, at 6 mm apical to CEJ.