Präprothetische Intrusion elongierter oberer Molaren mittels „Mini-Mausefalle“

Zusammenfassung

Elongierte obere Molaren müssen vor einer prothetischen Rehabilitation der Unterkiefer-Molarenregion in vielen Fällen zunächst intrudiert werden. Dies stellt jedoch eine große Herausforderung an die Verankerung dar. In diesem Artikel wird die Verwendung der „Mini-Mausefalle“ beschrieben, die sich auf (Mini-) Implantaten im anterioren Gaumen abstützt. Um die Apparatur klein und effizient zu gestalten, kann die Intrusionsmechanik auch ohne einen Transpalatinalbogen eingesetzt werden. Bei nicht optimal ausgerichteter Kraftwirkungslinie kann es jedoch ohne TPA zu Kippungen der zu intrudierenden Zähne kommen.

Abstract

In many cases, elongated upper molars must be intruded prior to prosthetic rehabilitation of the mandibular molar region. However, this poses a great challenge for the anchorage. This article describes the use of the “mini mousetrap”, which rests on (mini) implants in the anterior palate. In order to make the appliance small and efficient, the intrusion mechanism can also be used without a transpalatal arch. If the line of force is not optimally aligned, however, the teeth to be intruded may tilt without TPA.

Schlüsselwörter

Molarenintrusion - Verankerung - Mini-Implantate

Key words

Molar intrusion - anchorage - mini implants

• Literatur

• 1 Kravitz ND, Kusnoto B, Tsay PT. et al. Intrusion of overerupted upper first molar using two orthodontic miniscrews. A case report. Angle Orthod 2007; 77: 915-922
• 2 Kravitz ND, Kusnoto B, Tsay TP. et al. The use of temporary anchorage devices for molar intrusion. J Am Dent Assoc 2007; 138: 56-64
• 3 Yao CC, Lee JJ, Chen HY. et al. Maxillary molar intrusion with fixed appliances and mini-implant anchorage studied in three dimensions. Angle Orthod 2005; 75: 754-760
• 4 Sherwood KH, Burch JG, Thompson WJ. Closing anterior open bites by intruding molars with titanium miniplate anchorage. Am J Orthod Dentofacial Orthop 2002; 122: 593-600
• 5 Lin JC, Liou EJ, Yeh CL. Intrusion of overerupted maxillary molars with miniscrew anchorage. J Clin Orthod; 2006; 40: 378-383; quiz 358
• 6 Wilmes B. Fields of Application of Mini-Implants. In Ludwig B, Baumgaertel S, Bowman J. (Hrsg.) Innovative Anchorage Concepts Mini-Implants in Orthodontics. Berlin, New York: Quintessenz; 2008;
• 7 Lee M, Shuman J. Maxillary molar intrusion with a single miniscrew and a transpalatal arch. J Clin Orthod 46: 48-51
• 8 Ludwig B, Glasl B, Kinzinger GS. et al. Anatomical guidelines for miniscrew insertion: Vestibular interradicular sites. J Clin Orthod 45: 165-173
• 9 Poggio PM, Incorvati C, Velo S. et al. “Safe zones”: a guide for miniscrew positioning in the maxillary and mandibular arch. Angle Orthod 2006; 76: 191-197
• 10 Kim SH, Yoon HG, Choi YS. et al. Evaluation of interdental space of the maxillary posterior area for orthodontic mini-implants with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2009; 135: 635-641
• 11 Ludwig B, Glasl B, Bowman SJ. et al. Anatomical guidelines for miniscrew insertion: palatal sites. J Clin Orthod 45: 433-441; quiz 467
• 12 Wiechmann D, Meyer U, Buchter A. Success rate of mini- and micro-implants used for orthodontic anchorage: a prospective clinical study. Clin Oral Implants Res 2007; 18: 263-267
• 13 Miyawaki S, Koyama I, Inoue M. et al. Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage. Am J Orthod Dentofacial Orthop 2003; 124: 373-378
• 14 Chen YH, Chang HH, Chen YJ. et al. Root contact during insertion of miniscrews for orthodontic anchorage increases the failure rate: an animal study. Clin Oral Implants Res 2008; 19: 99-106
• 15 Ludwig B, Glasl B, Kinzinger GS. et al. Anatomical Guidelines for Miniscrew Insertion: Vestibular Interradicular Sites. J Clin Orthod 2011; 45: 165-173
• 16 Wilmes B, Panayotidis A, Drescher D. Fracture resistance of orthodontic mini-implants: a biomechanical in vitro study. Eur J Orthod 33: 396-401
• 17 Fritz U, Ehmer A, Diedrich P. Clinical suitability of titanium microscrews for orthodontic anchorage-preliminary experiences. J Orofac Orthop 2004; 65: 410-418
• 18 Tsaousidis G, Bauss O. Influence of insertion site on the failure rates of orthodontic miniscrews. J Orofac Orthop 2008; 69: 349-356
• 19 Kadioglu O, Buyukyilmaz T, Zachrisson BU. et al. Contact damage to root surfaces of premolars touching miniscrews during orthodontic treatment. Am J Orthod Dentofacial Orthop 2008; 134: 353-360
• 20 Maino BG, Weiland F, Attanasi A. et al. Root damage and repair after contact with miniscrews. J Clin Orthod 2007; 41: 762-766; quiz 750
• 21 Gracco A, Tracey S, Baciliero U. Miniscrew insertion and the maxillary sinus: an endoscopic evaluation. J Clin Orthod 44: 439-443
• 22 Wilmes B, Ottenstreuer S, Su YY. et al. Impact of implant design on primary stability of orthodontic mini-implants. J Orofac Orthop 2008; 69: 42-50
• 23 Wilmes B, Drescher D. Impact of bone quality, implant type, and implantation site preparation on insertion torques of mini-implants used for orthodontic anchorage. Int J Oral Maxillofac Surg 2011; 40: 697-703
• 24 Wilmes B, Nienkemper M, Ludwig B. et al. Upper-molar intrusion using anterior palatal anchorage and the Mousetrap appliance. J Clin Orthod 2013; 47: 314-320
• 25 Wilmes B, Vasudavan S, Stocker B. et al. Closure of an open bite using the ‘Mousetrapʼ appliance: a 3-year follow-up. Aust Orthod J 2015; 31: 208-215
• 26 Wilmes B, Ludwig B, Vasudavan S. et al. The T-Zone: Median vs. Paramedian Insertion of Palatal Mini-Implants. J Clin Orthod. 2016; 50: 543-551
• 27 Wilmes B, Drescher D. A miniscrew system with interchangeable abutments. J Clin Orthod 2008; 42: 574-580 quiz 595
• 28 Wilmes B, Drescher D, Nienkemper M. A miniplate system for improved stability of skeletal anchorage. J Clin Orthod 2009; 43: 494-501