title: Root trauma and tooth loss through the application of pre-drilled transgingival fixation screws.
abstract: Transgingival fixation screws are used for intermaxillary fixation in different situations. The aim of this study was to evaluate the risk of root trauma and tooth loss using pre-drilled transgingival fixation screws.
  
  
  METHODS
  521 patients with mean age 26.9 (SD 9.9) years who had orthognathic surgery or trauma to the maxilla or mandible were selected for the study. Postoperative orthopantomographs (OPT) taken before and after screw removal were examined. The location of the screws and dental-root "hits" were recorded.
  
  
  RESULTS
  1663 screws were inserted either to the maxilla or to the mandible. 285 teeth (17.1%) showed radiologically proven contact between the dental roots and the screws or the dental roots were hit by the screw (screw inserted with more than the screws radius into the root). In three cases (0.2%) teeth were lost due to apical or periradicular inflammation, four teeth (0.2%) had to be root filled and five teeth (0.3%) were persistent painful at the follow-up examination before miniplate removal 10.3 (SD 8.1) months post-surgery.
  
  
  CONCLUSIONS
  Dental problems occurred in 0.7% at the screw insertions sites. The use of transgingival fixation screws showed a low risk of tooth loss. Root defects healed without any incident. However surgeons must be aware of possible consequences to provide a safe treatment.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hochtaunus Hospital Bad Homburg, Bad Homburg, Germany. michael.schulte-geers@web.de
authors.forename: Michael
authors.initials: M
authors.lastname: Schulte-Geers
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kater
authors.forename: Robin
authors.initials: R
authors.lastname: Seeberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws / Q000009:adverse effects*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008338:Mandibular Injuries / Q000601:surgery; D008437:Maxilla / Q000293:injuries / Q000601:surgery; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures / Q000295:instrumentation; D010485:Periapical Periodontitis / Q000209:etiology; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D012390:Root Canal Therapy; D016388:Tooth Loss / Q000209:etiology*; D014092:Tooth Root / Q000293:injuries*; D014098:Toothache / Q000209:etiology; D055815:Young Adult