Treatment of maxillary transversal and sagittal deficiency with the use of miniscrews: an update
Morphological features of skeletal class III Malocclusion may comprise mandibular prognathism, maxillary retrognathism or a combination of both. Sagittal orthopaedic forces to protract the maxillary complex were commonly applied to the upper dental arch. This approach incurred well-known side effects such as proclination of the upper front teeth, bite opening, mesial movement of the lateral segments, and constriction of unerupted canines. New skeletal anchorage concepts involving surgical mini-plates or mini-implants have been developed to address these problems. Directing orthopaedic forces directly into the bony structures of the midface promised a significant reduction of dental side effects as well as an enhancement of skeletal response. To further increase orthopaedic treatment effects, some maxillary protraction protocols include rapid maxillary expansion (RME) in order to stimulate the midface sutures. RME can be carried out purely bone-borne or with a combination of dental and skeletal anchorage using mini-implants in the anterior palate (Hybrid-Hyrax). In recent years, the orthodontic specialty continues to make significant advances with the development and incorporation of various digital technologies. The objective of this lecture is to illustrate also the full digital process including custom fabrication of CAD-CAM insertion guides and 3D printing of metallic mini-implant supported appliances.
- To identify the optimum workflows for correction of maxillary deficiency
- To identify optimum insertion sites in the palate