Metal Mouth Message Board

Ok, I've been given an option to have one of these small screws put in my jawbone behind my 2nd molar area so that we can attach an elastic.

Is there anyone here who has had this done?

I've answered your PM Chris, but it's unlikely to be any help because my implant screws are not actually being used yet.

I'll be able to give you more info in a month or so LOL

I did... having the screw put in was by far the easiest part of the whole process...

Here's my original post about it.
viewtopic.php?t=4323&highlight=

I guess what I'm surprized at is that they attached the archwire or elastics almost immediately. How can they do that if it hasn't fused to the bone? It would seem that it would pop out from the pressure.

Chris, from what info I could find on the web, which was mainly abstracts from orthodontic journals courtesy of my ATHENS password these mini-implant screws don't rely on osseointegration (fusing into the bone) the way conventional dental implants do.

The forces applied are not that large. It's only like putting a screw into a wall and then hanging a picture on it. The screws used are normally 10 mm long or so and about 2mm in diameter. A pilot hole is sometimes drilled (other times they just screw them straight in) and then the screw is "screwed" in, making its own thread as it goes. So as long as it's put in straight and there's no wobble when any pilot hole is being drilled, then it shouldn't come out.

Was the risk of hitting the mandibular nerve discussed?

no, but I guess it depends on where they are siting the screw. Maybe mine didn't go near any nerves?
I had an xray done before and after to make sure that the screws hadn't impinged on any tooth roots.

Chris,

Lisa is correct, orthodontic implants (mini-implants) are not given the opportunity to osseointegrate. Dental implants need to "fuse" to the bone before they can be loaded (put into occlusion). Although there is a lot of research and trials into immediate loading. The coatings on the implants are also very different to differentiate the two. Don't you want that little screw removed when you are done with it? Whereas the dental implant needs to be in functional occlusion for life.

Regarding nerve damage, it is highly unlikely. Depending on where you place the screw you may have to consider the anatomy, but that is usually not a concern. Typically mini implants are placed on the bone adjacent to the buccal vestibule. Plus they are often times self tapping so it is just like a home improvement.

Good Luck,
Rory

Here's an interesting article on these mini implants in case someone can read "dentaleeze". Perhaps Rory can put this stuff in laymens terms.

http://www.angle.org/anglonline/?reques ... &page=0539

Just curious, Rory, if many of these are self-tapping, how come orthos want you to see an oral surgeon to put these in.

I think because it's a relatively new technique, that many orthos still don't feel comfortable doing it.
i imagine it would also depend on where the screw is to be sited. The place my ortho wanted mine put was pretty awkward and even the oral surgeon ummed and aahed for a while taking X-rays and doing measurements before he actually started drilling!

Mini implants/screws have been around for 20'ish years so it is not that new of a technique. It has gained popularity in recent years as people have discovered a vast array of uses with creativity.

So Chris, the lowdown on the article is simply a synopsis of a basic use of mini implants. You place the implant into the bone. Then you attach a wire or spring or similar to the screw and the other part to a tooth/teeth/archwire. The screw is simply an anchor and gives another place to anchor and generate force. With traditional orthodontics you typically use the posterior teeth or anterior teeth as an anchor and pull/push/apply force to other teeth using something as a fulcrum or base. The screw can just be placed in many locations depending on your needs.

And most Ortho's don't place them because of liability, lack of interest, lack of training, and lack of sufficient equipment in their office. It is not rocket science and if any Dentist/Ortho/Periodontist/Endodontist/OS wanted to integrate into their practice they could with the proper CE courses. But it is currently mostly performed by Oral Surgeons. I doubt that will change in the future.

Regards,
Rory