Miniscrews in orthodontic treatment: review and analysis of published clinical trials.
BACKGROUND
A systematic review of effects related to patient, screw, surgery, and loading on the stability of miniscrews was conducted.


METHODS
Reports of clinical trials published before September 2007 with at least 30 miniscrews were reviewed. Parameters examined were patient sex and age, location and method of screw placement, screw length and diameter, time, and amount of loading.


RESULTS
Fourteen clinical trials included 452 patients and 1519 screws. The mean overall success rate was 83.8% + or - 7.4%. Patient sex showed no significant differences. In terms of age, 1 of 5 studies with patients over 30 years of age showed a significant difference (P <0.05). Screw diameters of 1 to 1.1 mm yielded significantly lower success rates than those of 1.5 to 2.3 mm. One study reported significantly lower success rates for 6-mm vs 8-mm long miniscrews (72% vs 90%). Screw placement with or without a surgical flap showed contradictory results between studies. Three studies showed significantly higher success rates for maxillary than for mandibular screws. Loading and healing period were not significant in the miniscrews' success rates.


CONCLUSIONS
All 14 articles described success rates sufficient for orthodontic treatment. Placement protocols varied markedly. Screws under 8 mm in length and 1.2 mm in diameter should be avoided. Immediate or early loading up to 200 cN was adequate and showed no significant influence on screw stability.
Crismani
Adriano G
AG
Department of Orthodontics, School of Dentistry, Medical University of Vienna, Vienna, Austria. adriano.crismani@i-med.ac.at
Bertl
Michael H
MH
Celar
Ales G
AG
Bantleon
Hans-Peter
HP
Burstone
Charles J
CJ
D000367:Age Factors; D001863:Bone Screws; D002986:Clinical Trials as Topic; D003758:Dental Implantation, Endosseous / Q000379:methods; D003799:Dental Stress Analysis; D006801:Humans; D008904:Miniaturization; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances; D016896:Treatment Outcome