Fig. 6. Loading of implant off-axially
Fig. 6. Loading of implant off-axially
Fig. 5. Loading of implant axially
Fig. 5. Loading of implant axially
Fig. 4. Installation of strain gauges on surfaces of epoxy resin adjacent to mini implants
Fig. 4. Installation of strain gauges on surfaces of epoxy resin adjacent to mini implants
Fig. 3. Lava Ultimate Restorative crown on the two mini implants.
Fig. 3. Lava Ultimate Restorative crown on the two mini implants.
Fig. 2. Metal crown supported on two mini implants
Fig. 2. Metal crown supported on two mini implants
Fig. 1.
Fig. 1. a Standard, b short-wide, and c single-piece mini implants
Crown
Implant type
Axial
Off-axial
P-value
Mean
SD
...
Axial
Off-axial
P value
Mean
SD
Mean
SD
...
Lava Ultimate
crowns
Metal
crowns
P value
Mean
SD
Mean
...
Load
Crown type
Standard
Short-wide
Double mini
P value
...
Standard
Short-wide
Double mini
P value
Mean
SD
Mean
...
Elfadaly, L.S., Khairallah, L.S. & Al Agroudy, M.A. Peri-implant biomechanical responses to standard, short-wide, and double mini implants replacing missing molar supporting hybrid ceramic or full-metal crowns under axial and off-axial loading: an in vitro study.
Int J Implant Dent 3, 31 (2017). https://doi.org/10.1186/s40729-017-0094-2
Download citation
Received: 14 Februar...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
The authors L.S.Elfadaly, L.S.Kheirallah, and M.A.Alagroudy state that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Fixed Prosthodontics, Cairo University, Giza, Egypt
Lamiaa Said Elfadaly, Lamiaa Sayed Khairallah & Mona Atteya Al Agroudy
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Gracis S, Nicholls J, Chalupnik J, Yuodelis R. Shock-absorbing behavior of five restorative materials used on implants. Int J Prosthodont. 1990;4:282–91.
Skalak R. Biomechanical considerations in osseointegrated prostheses. J Prosthet Dent. 1983;49:843–8.
Misch C. Clinical biomechanics in implant dentistry, Contemporary Implant Dentistry. 3rd ed. 2008. p. 543–56. mosby,inc.
Lundgren D, La...
Himmlova L, Dostalova T, Kacovsky A, Konvickova S. Influence of implant length and diameter on stress distribution: a finite element analysis. J Prosthet Dent. 2004;91(1):20–5.
Shetty S, Puthukkat N, Bhat S, Shenoy K. Short implants: a new dimension in rehabilitation of atrophic maxilla and mandible. Journal of Interdisciplinary Dentistry. 2014;4(2):66.
Misch C, Bidez M. Contemporary implant d...
Barbier L, Vander SJ, Krzesinski G, Schepers E, Van der Perre G. Finite element analysis of non-axial versus axial loading of oral implants in the mandible of the dog. J Oral Rehabil. 1998;25(11):847–58.
Saime S, Murat C, Emine Y. The influence of functional forces on the biomechanics of implant-supported prostheses—a review. J Dent. 2002;30:271–82.
Balshi T, Hernandez R, Pryszlak M, Range...
Mazor Z, Lorean A, Mijiritsky E, Levin L. Replacement of a molar with 2 narrow diameter dental implants. Implant Dent. 2012;21(1):36–8.
Atwood D. Postextraction changes in the adult mandible as illustrated by micrographs of midsagittal sections and serial cephalometric roentgenograms. J Prosthet Dent. 1963;13:810–24.
Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augment...
Within the limitations of this in vitro study, the following conclusions could be drawn:
Implant design, superstructure material, and load direction significantly affect peri-implant microstrains.
The recorded compressive and tensile microstrains for the tested designs were within the physiologic loading range, as they did not exceed the compressive or tensile strength of the bone-implant interf...
Regarding the effect of superstructure material on induced microstrains, generally, different implant designs supporting Lava Ultimate crowns showed higher mean microstrain values(1927.3 ± 1536.6 μɛ), in comparison with those supporting metal crowns (1313.7 ± 973.1 μɛ).Theoretical considerations [44, 45] and in vitro experiments [46,47,48,49] suggest that an occlusal material with ...
Regarding the effect of direction of loading on induced microstrains, it was shown that changing the position of occlusal loading had a considerable effect on the amount of distribution of stresses where axial loading generated even distribution of load around the implant in comparison to off-axial loading where stresses were more pronounced in the area of load application. This might be due to th...
Previous studies have shown that direct correlations exist between microstrain magnitudes and bone stability/instability conditions. This has been summarized by Frost, when bone is loaded below about 2000 microstrains, bone can easily repair what little microdamage occurs. Yet, when pathologic overloading occurs (over 4000 microstrains), stress and strain gradients exceed the physiologic tolerance...
To replace a missing lower molar in compromised ridge, different treatment options were suggested, using either a standard size implant with surgical procedures, short-wide implant, or two mini implants. Concerning the use of mini implant, splinted multiple implants increase the surface area that interfaces with the bone to lessen the per square millimeters of force borne by the bone [11]. The imp...
Results revealed that standard implant showed the statistically significantly highest mean microstrain values (3362.4 ± 757.4 μɛ). Double mini implant showed statistically significantly lower mean microstrain values (801.6 ± 251.4 μɛ), while short-wide implant showed the statistically significantly lowest mean microstrain values (697.6 ± 79.7 μɛ), with a P value
Data were presented as mean and standard deviation (SD) values. Data were explored for normality by checking data distribution and histograms, calculating mean and median values, and finally using Kolmogorov-Smirnov and Shapiro-Wilk tests of normality. Stress data showed non-parametric distribution, so the Kruskal-Wallis test was used to compare between the types of implants. The Mann-Whitney U te...
Each crown was cemented to its corresponding implant-abutment assembly using temporary cement (Cavex Temporary Cement, Cavex, Holland).
Each implant received 4 strain gauges (Kowa strain gages, Japan) placed on the mesial, distal, buccal, and lingual surfaces of the epoxy resin adjacent to the implants. At these selected sites, the thickness of the epoxy resin surrounding each implant was reduced...
In the present study, the following materials were used: titanium root form endosseous implants of standard diameter and length (4-mm platform, 3.8-mm diameter,12-mm length, fixture bevel 0.2 mm, Super Line System, Dentium, USA), short-wide implant (7-mm platform, 5.8-mm diameter, 7-mm length, Super Line System, Dentium, Seoul, Korea) with 1.5-mm machined surface and 5.5-mm threaded surface that ...
There are several factors that affect force magnitudes in peri-implant bone. The application of functional forces induces stresses and strains within the implant prosthesis complex and affect the bone remodeling process around implants [8, 9].
While there are several methods of measuring strain, the most common is with a strain gauge, a device whose electrical resistance varies in proportion to t...
The molars are one of the first teeth to be lost over lifetime; thus, their replacement is frequently needed. Implantation is generally the preferred choice to replace a missing single tooth avoiding vital teeth preparation and bridge fabrication [1].
The mandibular bone loss occurs as knife-edge residual ridge where there is marked narrowing of the labiolingual diameter of the crest of the ridge...
The aim of this study was to evaluate the biomechanical response of the peri-implant bone to standard, short-wide, and double mini implants replacing missing molar supporting either hybrid ceramic crowns (Lava Ultimate restorative) or full-metal crowns under two different loading conditions (axial and off-axial loading) using strain gauge analysis.
Three single-molar implant designs, (1) single, ...
Fig. 6. Loading of implant off-axially
Fig. 6. Loading of implant off-axially
Fig. 5. Loading of implant axially
Fig. 5. Loading of implant axially
Fig. 4. Installation of strain gauges on surfaces of epoxy resin adjacent to mini implants
Fig. 4. Installation of strain gauges on surfaces of epoxy resin adjacent to mini implants
Fig. 3. Lava Ultimate Restorative crown on the two mini implants.
Fig. 3. Lava Ultimate Restorative crown on the two mini implants.
Fig. 2. Metal crown supported on two mini implants
Fig. 2. Metal crown supported on two mini implants
Fig. 1. a Standard, b short-wide, and c single-piece mini implants
Crown
Implant type
Axial
Off-axial
P-value
Mean
SD
...
Axial
Off-axial
P value
Mean
SD
Mean
SD
...
Lava Ultimate
crowns
Metal
crowns
P value
Mean
SD
Mean
...
Load
Crown type
Standard
Short-wide
Double mini
P value
...
Standard
Short-wide
Double mini
P value
Mean
SD
Mean
...
Elfadaly, L.S., Khairallah, L.S. & Al Agroudy, M.A. Peri-implant biomechanical responses to standard, short-wide, and double mini implants replacing missing molar supporting hybrid ceramic or full-metal crowns under axial and off-axial loading: an in vitro study.
Int J Implant Dent 3, 31 (2017). https://doi.org/10.1186/s40729-017-0094-2
Download citation
Received: 14 Februar...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
The authors L.S.Elfadaly, L.S.Kheirallah, and M.A.Alagroudy state that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Fixed Prosthodontics, Cairo University, Giza, Egypt
Lamiaa Said Elfadaly, Lamiaa Sayed Khairallah & Mona Atteya Al Agroudy
You can also search for this author in
PubMed Google Scholar
You can also search for this author in
PubMed Google Scholar
You can also search for this author in
PubMed Google Scholar
LSE have...
Gracis S, Nicholls J, Chalupnik J, Yuodelis R. Shock-absorbing behavior of five restorative materials used on implants. Int J Prosthodont. 1990;4:282–91.
Skalak R. Biomechanical considerations in osseointegrated prostheses. J Prosthet Dent. 1983;49:843–8.
Misch C. Clinical biomechanics in implant dentistry, Contemporary Implant Dentistry. 3rd ed. 2008. p. 543–56. mosby,inc.
Lundgren D, La...
Himmlova L, Dostalova T, Kacovsky A, Konvickova S. Influence of implant length and diameter on stress distribution: a finite element analysis. J Prosthet Dent. 2004;91(1):20–5.
Shetty S, Puthukkat N, Bhat S, Shenoy K. Short implants: a new dimension in rehabilitation of atrophic maxilla and mandible. Journal of Interdisciplinary Dentistry. 2014;4(2):66.
Misch C, Bidez M. Contemporary implant d...
Barbier L, Vander SJ, Krzesinski G, Schepers E, Van der Perre G. Finite element analysis of non-axial versus axial loading of oral implants in the mandible of the dog. J Oral Rehabil. 1998;25(11):847–58.
Saime S, Murat C, Emine Y. The influence of functional forces on the biomechanics of implant-supported prostheses—a review. J Dent. 2002;30:271–82.
Balshi T, Hernandez R, Pryszlak M, Range...
Mazor Z, Lorean A, Mijiritsky E, Levin L. Replacement of a molar with 2 narrow diameter dental implants. Implant Dent. 2012;21(1):36–8.
Atwood D. Postextraction changes in the adult mandible as illustrated by micrographs of midsagittal sections and serial cephalometric roentgenograms. J Prosthet Dent. 1963;13:810–24.
Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augment...
Within the limitations of this in vitro study, the following conclusions could be drawn:
Implant design, superstructure material, and load direction significantly affect peri-implant microstrains.
The recorded compressive and tensile microstrains for the tested designs were within the physiologic loading range, as they did not exceed the compressive or tensile strength of the bone-implant interf...
Regarding the effect of superstructure material on induced microstrains, generally, different implant designs supporting Lava Ultimate crowns showed higher mean microstrain values(1927.3 ± 1536.6 μɛ), in comparison with those supporting metal crowns (1313.7 ± 973.1 μɛ).Theoretical considerations [44, 45] and in vitro experiments [46,47,48,49] suggest that an occlusal material with ...
Regarding the effect of direction of loading on induced microstrains, it was shown that changing the position of occlusal loading had a considerable effect on the amount of distribution of stresses where axial loading generated even distribution of load around the implant in comparison to off-axial loading where stresses were more pronounced in the area of load application. This might be due to th...
Previous studies have shown that direct correlations exist between microstrain magnitudes and bone stability/instability conditions. This has been summarized by Frost, when bone is loaded below about 2000 microstrains, bone can easily repair what little microdamage occurs. Yet, when pathologic overloading occurs (over 4000 microstrains), stress and strain gradients exceed the physiologic tolerance...
To replace a missing lower molar in compromised ridge, different treatment options were suggested, using either a standard size implant with surgical procedures, short-wide implant, or two mini implants. Concerning the use of mini implant, splinted multiple implants increase the surface area that interfaces with the bone to lessen the per square millimeters of force borne by the bone [11]. The imp...
Results revealed that standard implant showed the statistically significantly highest mean microstrain values (3362.4 ± 757.4 μɛ). Double mini implant showed statistically significantly lower mean microstrain values (801.6 ± 251.4 μɛ), while short-wide implant showed the statistically significantly lowest mean microstrain values (697.6 ± 79.7 μɛ), with a P value
Data were presented as mean and standard deviation (SD) values. Data were explored for normality by checking data distribution and histograms, calculating mean and median values, and finally using Kolmogorov-Smirnov and Shapiro-Wilk tests of normality. Stress data showed non-parametric distribution, so the Kruskal-Wallis test was used to compare between the types of implants. The Mann-Whitney U te...
Each crown was cemented to its corresponding implant-abutment assembly using temporary cement (Cavex Temporary Cement, Cavex, Holland).
Each implant received 4 strain gauges (Kowa strain gages, Japan) placed on the mesial, distal, buccal, and lingual surfaces of the epoxy resin adjacent to the implants. At these selected sites, the thickness of the epoxy resin surrounding each implant was reduced...
In the present study, the following materials were used: titanium root form endosseous implants of standard diameter and length (4-mm platform, 3.8-mm diameter,12-mm length, fixture bevel 0.2 mm, Super Line System, Dentium, USA), short-wide implant (7-mm platform, 5.8-mm diameter, 7-mm length, Super Line System, Dentium, Seoul, Korea) with 1.5-mm machined surface and 5.5-mm threaded surface that ...
There are several factors that affect force magnitudes in peri-implant bone. The application of functional forces induces stresses and strains within the implant prosthesis complex and affect the bone remodeling process around implants [8, 9].
While there are several methods of measuring strain, the most common is with a strain gauge, a device whose electrical resistance varies in proportion to t...
The molars are one of the first teeth to be lost over lifetime; thus, their replacement is frequently needed. Implantation is generally the preferred choice to replace a missing single tooth avoiding vital teeth preparation and bridge fabrication [1].
The mandibular bone loss occurs as knife-edge residual ridge where there is marked narrowing of the labiolingual diameter of the crest of the ridge...
The aim of this study was to evaluate the biomechanical response of the peri-implant bone to standard, short-wide, and double mini implants replacing missing molar supporting either hybrid ceramic crowns (Lava Ultimate restorative) or full-metal crowns under two different loading conditions (axial and off-axial loading) using strain gauge analysis.
Three single-molar implant designs, (1) single, ...
Fig. 6. Funnel plot for anchorage loss in the vertical dimension (MD mean difference, SE standard error)
Fig. 6. Funnel plot for anchorage loss in the vertical dimension (MD mean difference, SE standard error)
Fig. 5. Funnel plot for anchorage loss in the horizontal dimension (MD mean difference, SE standard error)
Fig. 5. Funnel plot for anchorage loss in the horizontal dimension (MD mean difference, SE standard error)
Fig. 4. Forest plot for anchorage loss in the vertical dimension
Fig. 4. Forest plot for anchorage loss in the vertical dimension
Fig. 3. Forest plot for anchorage loss in the horizontal dimension
Fig. 3. Forest plot for anchorage loss in the horizontal dimension
Fig. 2. Graphic visualization of the risk of bias judgements
Fig. 2. Graphic visualization of the risk of bias judgements
Fig. 1. PRISMA study flow diagram
Fig. 1. PRISMA study flow diagram
NoneTable 3 Risk of bias judgment according to the Cochrane Collaboration
Reference
Number of patients
Type of study (RCT/CCT/other)
Control intervention
Type of implant (length, material)
...
Reference
Reason for exclusion
Barros et al. (2017) [3]
Anchorage loss at first molar not specified
Borsos et al. (2012) [7]...
Becker, K., Pliska, A., Busch, C. et al. Efficacy of orthodontic mini implants for en masse retraction in the maxilla: a systematic review and meta-analysis.
Int J Implant Dent 4, 35 (2018). https://doi.org/10.1186/s40729-018-0144-4
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Received: 04 May 2018
Accepted: 27 August 2018
Published: 25 October 2018
DOI: https://doi.org/10.1186/s40729-018-0144-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Data extraction template. (CSV 2 kb)
Not applicable
Not applicable
Kathrin Becker, Annika Pliska, Caroline Busch, Benedict Wilmes, Michael Wolf, and Dieter Drescher declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Kathrin Becker.
Michael Wolf and Dieter Drescher contributed equally to this work.
Department of Orthodontics, Universitätsklinikum Düsseldorf, 40225, Düsseldorf, Germany
Kathrin Becker, Annika Pliska, Caroline Busch, Benedict Wilmes & Dieter Drescher
Department of Orthodontics, Universitätsklinikum RWTH Aachen, Aachen, Germany
Michael Wolf
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We acknowledge the work of S. Moscarino, E. Burceck, and J. Bartz who assisted in the abstract screening and hand searching.
The study was self-funded by the authors.
The data extracted for the meta-analysis are available in the Additional file 1.
Xun CL, Zeng XL, Wang X. Clinical application of miniscrew implant for maximum anchorage cases. Zhonghua Kou Qiang Yi Xue Za Zhi. 2004;39(6):505–8.
Yao CC, Lai EH, Chang JZ, Chen I, Chen YJ. Comparison of treatment outcomes between skeletal anchorage and extraoral anchorage in adults with maxillary dentoalveolar protrusion. Am J Orthod Dento Orthoped. 2008;134(5):615–24.
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Upadhyay M, Yadav S, Nagaraj K, Uribe F, Nanda R. Mini-implants vs fixed functional appliances for treatment of young adult Class II female patients: a prospective clinical trial. Angle Orthod. 2012;82(2):294...
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Kawa D, Kunkel M, Heuser L, Jung BA. What is the best position for palatal implants? A CBCT study on bone volume in the growing maxilla. Clin Oral Investig. 2017;21(2):541–9.
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Al-Sibaie S, Hajeer MY. Assessment of changes following en-masse retraction with mini-implants anchorage compared to two-step retraction with conventional anchorage in patients with class II division 1 malocclusion: a randomized controlled trial. Eur J Orthod. 2014;36(3):275–83.
Alharbi F, Almuzian M, Bearn D. Miniscrews failure rate in orthodontics: systematic review and meta-analysis. Eur J O...
The present systematic review and meta-analysis revealed that orthodontic mini implants are associated with a significantly lower anchorage loss at the first upper molars compared to conventional anchorage devices for en-masse retraction in the maxilla. However, the ideal implant location (anterior palate versus alveolar ridge) and the most beneficial concept (direct or indirect anchorage) need t...
Indirect anchorage through implants in the alveolar ridge was associated with mesial molar migration in all studies included in the present review [5, 9, 54, 57]. Nonetheless, anchorage loss with indirect anchorage was significantly lower compared to the conventional devices [5, 9, 57]. It has been suggested that the anchorage loss at indirectly anchored mid-palatal implants may be caused by a sli...
The present systematic review was conducted to address the following focused question: “In patients with a need for en masse retraction of the upper front teeth, what is the efficacy of orthodontic mini implants for anchorage control compared with conventional anchorage devices?”
The literature search revealed that efficacy of anchorage control of orthodontic mini implants in comparison to co...
Meta-analysis was performed on RCTs reporting on anchorage loss at the first molar.
Based on seven studies [1, 4, 11, 28, 49, 50, 52], the weighted mean differences (WMD) [95% CI, p] in horizontal anchorage loss between test and control groups amounted up to − 2.79 mm [− 3.56 to − 2.03 mm, p
The overall success rates of the orthodontic mini implants varied among the studies. A success rate of 95.7% with a loss of 2 from 46 implants was reported by Upadhyay et al. [48], and the implants could be replaced immediately. Two patients developed a peri-implant inflammation which was resolved through improved oral hygiene. A loss of 5 of 72 implants was reported by Upadhyay et al. [49], and i...
In detail, anchorage loss associated with indirect anchorage and a mid-palatal implant amounted to 1.5 ± 2.6 mm versus 3 ± 3.4 mm [5], 0.7 ± 0.4 (right molar) and 1.1 ± 0.3 mm (left molar) [54], 1.73 ± 0.39 mm (horseshoe), and 0.36 ± 0.11 mm (posterior reinforcement) versus 4.21 ± 1.17 mm [57]. An anchorage loss of 0.2 ± 0.35 mm versus 2.0 mm ± ...
The study samples considered for the qualitative synthesis consisted of females exhibiting Angle Class II,1 malocclusion with upper dental protrusion and an overjet of at least 7 mm [48], patients with a dental Class II, a need for extraction of the first upper premolars and front retraction [54], or Class III patients with a need for pre-surgical decompensation through premolar extraction and fr...
The search for the review was undertaken at December 31, 2017. A total of 2046 potentially relevant titles and abstracts were found during the electronic and manual search (676 after duplicate removal) of which 99 titles were considered relevant for abstract screening. During the first stage of study selection, 58 publications were excluded based on the abstract. For the second phase, the complete...
When data were not available in the printed report, we calculated the missing information whenever possible (e.g., by subtracting pre- and post en masse retraction values). In cases where a zero variance (0.00 mm) was presented in the summary tables, these values were changed to 0.01 mm to enable meta-analysis. The corresponding authors of the published studies were contacted when needed.
Heter...
Inclusion of less than five patients
Lack of clinical data on anchorage loss
Measurement of anchorage loss not by superimposition of lateral cephalograms or superimposition of study casts
Previous orthodontic treatment
Treatment in control group not specified
Inclusion of diseased patients, e.g., patients with systemic diseases, periodontal disease, and syndromes
Other treatment than en mass...
AND (“anchorage loss” OR “anchorage quality” OR “quality of life” OR “benefit” or “harm” OR “efficacy” OR “side effects” OR “effect” OR “orthodontic anchorage procedures”[mh] OR “treatment outcome”[mh])
Search terms EMBASE (including EMTREE terms)
(“en-masse retraction” OR “incisor retraction” OR “front retraction” OR “orthodontic gap clo...
This systematic review was structured and conducted according to the preferred reporting items of the PRISMA statement [34].
The focused question serving for literature search was structured according to the PICO (Patients, Intervention, Control, Outcome) format: “In patients with a need for en masse retraction of the upper front teeth, what is the efficacy of orthodontic mini implants for anch...
Extraction of the permanent teeth for retraction of the protruded front teeth is a routine approach in orthodontics. Various techniques such as headgear, Nance button, and transpalatal arches (TPA) have been proposed to achieve sufficient anchorage [5, 8, 9, 12, 28, 31, 45]. Nevertheless, anchorage control turned out to be highly demanding as the conventional approaches were commonly associated wi...
Retraction of the upper incisors/canines requires maximum anchorage. The aim of the present study was to analyze the efficacy of mini implants in comparison to conventional devices in patients with need for en masse retraction of the front teeth in the upper jaw.
An electronic search of PubMed, Web of Science, and EMBASE and hand searching were performed. Relevant articles were assessed, and data...