Simulated risk of root and neurovascular bundle damage during miniscrew insertion in the anterior palate without radiological data

模拟在无放射学数据的情况下,前腭植入微型螺钉时牙根和神经血管束损伤的风险

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Abstract

OBJECTIVE: This study aimed to explore the risk of potential root and nerve damage in planning the insertion of paramedian miniscrews without radiological information. STUDY DESIGN: The study included CBCT and intra-oral scan (IOS) records of 60 subjects (28 males, 32 females) featuring normal transverse palate dimension (Group A = 30 subjects, mean age 20.5 ± 4.7) and skeletal maxillary constriction (Group B = 30 subjects, mean age 21.9 ± 5.1). Two miniscrews (Spider Screws Regular Plus Konic - HDC Srl, Vicenza, Italy), featuring 2 mm in diameter and 9 mm in length were virtually inserted using only the.stl IOS file following established clinical guidelines (T-Zone). Specific linear measurements were registered to calculate the distance between the miniscrews and both incisors' roots and the naso-palatine duct after integrating CBCT images; same measurements were performed after adjusting the position with the aid of CBCT. All data were analyzed for comparison between both procedures and groups. RESULTS: Safe distances were recorded between miniscrews and incisors' roots in both groups (p > 0.05). The distances from the nasopalatine duct were significantly closer (and in few cases risky) in group B and required significant adjustment using CBCT (p < 0.05). CONCLUSION: The present findings would discourage planning or inserting miniscrews in the paramedian region without radiological information (CBCT) in subjects with skeletal maxillary constricted.

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