An Insertion Technique to Minimize the Failure Rate of Mini-Screws for Lower Anterior Teeth Intrusion
Lecture Description
In clinical practice, the need for mandibular anterior teeth intrusion arises more frequently than anticipated. This situation can occur due to several reasons: severe initial deep overbite due to overeruption of the mandibular incisors, bowing effects during mandibular anterior retraction, or counterclockwise rotation of the mandibular occlusal plane during total mandibular distalization, leading to overeruption of the mandibular anterior teeth. Traditional methods such as the use of a utility arch or segmented arch with wire bending are cumbersome to fabricate, cause significant patient discomfort, and are not particularly efficient. Consequently, with the advent of Temporary Anchorage Devices (TADs), various approaches for mandibular anterior intrusion have been attempted. However, these methods have not been widely adopted due to several issues. Firstly, the failure rate of mini-screw insertion is high. This is because the inter-radicular space between the mandibular anterior teeth is narrow, and the bone quality in this region is often poor, making stable mini-screw insertion challenging. To overcome these issues, the use of mini-plates was introduced, but this technique has also not gained widespread acceptance. Because the insertion procedure is complex for orthodontists to perform, and the bulkiness of the mini-plates results in significant patient discomfort. This presentation aims to introduce a method that addresses these problems effectively.