title: Replacing a failed mini-implant with a miniplate to prevent interruption during orthodontic treatment.
abstract: BACKGROUND
  When mini-implants fail during orthodontic treatment, there is a need to have a backup plan to either replace the failed implant in the adjacent interradicular area or wait for the bone to heal before replacing the mini-implant. We propose a novel way to overcome this problem by replacement with a miniplate so as not to interrupt treatment or prolong treatment time.
  
  
  METHODS
  The indications, advantages, efficacy, and procedures for switching from a mini-implant to a miniplate are discussed. Two patients who required replacement of failed mini-implants are presented. In the first patient, because of the proximity of the buccal vestibule to the mini-implant, it was decided to replace the failed mini-implant by an I-shaped C-tube miniplate. In the second patient, radiolucencies were found around the failed mini-implants, making the adjacent alveolar bone unavailable for immediate placement of another mini-implant. In addition, the maxillary sinus pneumatization was expanded deeply into the interradicular spaces; this further mandated an alternative placement site. One failed mini-implant was examined under a scanning electron microscope for bone attachment.
  
  
  RESULTS
  Treatment was completed in both patients after replacement with miniplates without interrupting the treatment mechanics or prolonging the treatments. Examination under the scanning electron microscope showed partial bone growth into the coating pores and titanium substrate interface even after thorough cleaning and sterilization.
  
  
  CONCLUSIONS
  Replacement with a miniplate is a viable solution for failed mini-implants during orthodontic treatment. The results from microscopic evaluation of the failed mini-implant suggest that stringent guidelines are needed for recycling used mini-implants.
authors.affiliation: Department of Orthodontics, Kyung Hee University, School of Dentistry, Seoul, Korea.
authors.forename: Jin-Hwa
authors.initials: JH
authors.lastname: Lee
authors.forename: Hyeran
authors.initials: H
authors.lastname: Choo
authors.forename: Seong-Hun
authors.initials: SH
authors.lastname: Kim
authors.forename: Kyu-Rhim
authors.initials: KR
authors.lastname: Chung
authors.forename: Lucille A
authors.initials: LA
authors.lastname: Giannuzzi
authors.forename: Peter
authors.initials: P
authors.lastname: Ngan
mesh_terms: D000293:Adolescent; D000539:Alveolar Process / Q000473:pathology; D001696:Biomechanical Phenomena; D001860:Bone Plates; D015921:Dental Implants; D004868:Equipment Failure; D017743:Equipment Reuse; D005260:Female; D006801:Humans; D008310:Malocclusion / Q000628:therapy; D008437:Maxilla / Q000473:pathology; D008443:Maxillary Sinus / Q000473:pathology; D008855:Microscopy, Electron, Scanning; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D016382:Orthodontic Appliance Design; D016348:Osseointegration / Q000502:physiology; D013314:Stress, Mechanical; D013499:Surface Properties; D014087:Tooth Movement Techniques / Q000295:instrumentation
chemical_list: D015921:Dental Implants