Aim: Treatment options in orthodontics have been expanded by skeletal anchorage via mini-implants over the last few years. Sufficient primary stability is imperative to minimize implant loss rate. The aim of this study was to quantitatively analyze the factors influencing primary stability: bone quality, implant-design, diameter, and depth of pilot drilling.
Material and methods: Thirty-six pelvic bone segments (ilium) of country pigs were dissected and embedded in resin. To determine the primary stability, we measured the insertion torque of five different mini-implant types (tomas-pin [Dentaurum, Ispringen, Germany] 08 and 10 mm, and Dual Top [Jeil Medical Corporation, Seoul, Korea] 1.6 x 8 and 10 mm plus 2 x 10 mm). Twenty-five or 30 implants were inserted into each pelvic bone segment following preparation of the implant sites using pilot drill diameters of 1.0, 1.1, 1.2 and 1.3 mm and pilot drill depths of 1, 2, 3, 6 and 10 mm. Five implants were inserted for reference purposes to establish comparability. Thicknesses of bone compacta were measured via micro-computer tomography.
Results: Insertion torques of orthodontic mini-implants and therefore primary stability varied greatly, depending on bone quality, implant-design, and preparation of implant site. Compared with the tomas-pin, the Dual Top screw showed significantly greater primary stability. Torque moments beyond 230 Nmm caused fractures of 9 Dual Top screws.
Conclusion: Compacta thickness, implant design and implant site preparation have a strong impact on the primary stability of mini-implants for orthodontic anchorage. Depending on the insertion site and local bone quality, the clinician should choose an optimum combination of implant and pilot-drilling diameter and depth.