The skeletal cortical anchorage using titanium microscrew implants

Park, Hyo Sang 대한치과교정학회 1999 대한치과교정학회지 Vol.29 No.6

고정원의 조절은 교정치료에 있어서 매우 중요한 요소로 이를 보강하기 위한 많은 노력이 있어왔다. 골융합성 임프란트의 경우 확실한 고정원으로서 가능성이 인정되고 있고, 또 임상에서 많이 시도되고 있다. 그러나 임프란트를 매식하기 위해서ㅏ는 무치악이 존재해야 하거나 하악구치 후방부위에 식립해야 하는 등 장소의 제약이 있고, 값이 비싸며, 골융합을 위하여 기다리는 시간이 필요하다는 등의 단점으로 인하여 보편화되고 있지는 않다. 최근 몇몇 임상가에 의하여 수술용 titanium microscrew나 miniscrew를 교정치료시의 고정원으로 사용하려는 시도가 있었는데, 이것은 골융합성 임프란트보다 수술이 간단하며, 가격이 저렴하고, 치조골 어느 부위이든지 식립할 수 있다는 장점이 있다. 저자는 titanium microscrew implant를 사용한 skeletal cortical anchorage를 이용하여 통상적인 교정치료 동안 협조도가 고갈된 환자를 치료하였다. 6 개월간의 titanium microscrew로 부터 가해진 교정력에 의하여 상악 전치부는 4mm 후방 치체이동과 압하이동을 얻었다. 통상의 교정치료에서 고정원역할을 하는 상악 구치부도 1.5 mm 후방이동 되었다. titanium microscrew는 치료기간 동안 움직임없이 잘 유지되었다. 비록 과학적으로 밝혀져야 할 임상적인 문제가 있기는 하나, ske,etal cortical anchorage는 확실한 고정원으로서의 역할을 할 수 있을 것으로 생각된다. Anchorage plays an important role in orthodontic treatment. Endosseous implants maybe considered adequate firm anchorage. However, clinicians have hesitated to use endosseous implants as orthodontic anchorage because of limoted implantation space, high cost, and long waiting period before osseointegration occurs. Recently, some clinicians have tried to use titanium miniscrews and microscrews in treatment due to their many advantages such as ease of insertion and removal, low cost, immediate loading, and the ability to palce microscrews in any area of alveolar bone. The author treared a case with skeletal cortical anchorage using titanium microscrew implants. During six months of orthodontic force application from skeletal cortical anchorage, the author could get 4 mm bodily retraction and intrusion of upper anterior teeth. The most outstanding result was a 1.5 mm posterior retraction of the upper posterior teeth. The titanium microscrew implants had remained firm and stable throughout treatment . These results indicate that skeletal cortical anchorage might be a very good option.

Clinical study on success rate of microscrew implants for orthodontic anchorage

Park, Hyo-Sang 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.3

치아아동의 고정원으로 사용되고 있는 miniscrew and microscrew implants의 임상 적용의 유용성을 알아보고자 73명의 환자에 식립된 180개를 대상으로 성공율을 연구하였다. 1년 기간의 전반적인 성공율은 93.3%(180개의 miniscrew and microscrew implants중 168개 성공)이었고, UB군(상조골)은 11개중 모두 성공하여 100%를 보였고, LB군(하악 협측치조골)은 96.6%(58개중 56개 성공), UP군(상악 구개측 치조골)은 11개중 모두 성공하여 100%를 보였고, LR군(하악 ㅎ구치 부위)은 19개중 14개가 성공하여 73.7%의 성공율을 보였다. 이 연구를 통하여 볼 때 miniscrew and microscrew implants는 교정치료의 고정원으로 성공적으로 사용될 수 있을 것으로 생각된다. To provide some guideline for microscrew implants, 73 patients that received a total of 180 mini- or microscrew implants were scrutinized. The overall success rate was 93.3% (168 among 180 mini- or microscrew implants) and the mean period of utilization was 15.8 months. Microscrew implants in the UB group (maxillary buccal area) succeeded at a rate of 94.6% (87 among 92), mini- or microscrew implants the LB group (mandibular buccal area) succeeded 96.6% of the time (56 out of 58), while microscrew implants in the UP group (maxillary palatal area) had a 100% success rate (11 out of 11), and mini- or microscrew implants in the LR group (retromolar area) succeeded in 73.7% of cases (14 among 19). This study might indicate that microscrew implants can be used successfully as orthodontic anchorage in daily orthodontic practice.

Histologic and biomechanical characteristics of orthodontic self-drilling and self-tapping microscrew implants

Park, Hyo-Sang,Yen, Shue,Jeoung, Seong-Hwa 대한치과교정학회 2006 대한치과교정학회지 Vol.36 No.4

Objective: The purpose of this study was to compare the histological and biomechanical characteristics of self-tapping and self-drilling microscrew implants. Methods: 112 microscrew implants (56 self-drilling and 56 self-tapping) were placed into the tibia of 28 rabbits. The implants were loaded immediately with no force, light (100 gm), or heavy force (200 gm) with nickel-titanium coil springs. The animals were sacrificed at 3- and 5-weeks after placement and histologic and histomorphometric analysis were performed under a microscope. Results: All microscrew implants stayed firm throughout the experiment. There was no significant difference between self-drilling and self-tapping microscrew implants both in peak insertion and removal torques. Histologic examinations showed there were more defects in the self-tapping than the self-drilling microscrew implants, and newly formed immature bone was increased at the interface in the self-tapping 5-week group. There was proliferation of bone towards the outer surface of the implant and/or toward the marrow space in the self-drilling group. Histologically, self-drilling microscrew implants provided more bone contact initially but the two methods became similar at 5 weeks. Conclusion: These results indicate the two methods can be used for microscrew implant placement, but when using self-tapping microscrew implants, it seems better to use light force in the early stages. 이 연구의 목적은 교정용 고정원으로 사용된 self-drilling과 self-tapping microscrew implants를 조직학적 및 생역적으로 비교하는 것이다. 28 마리의 가토에 112개의 microscrew implants (56개의 self-drilling microscrew implants 와 56개의 self-tapping microscrew implants)를 식립하였다. Self-tapping microscrew implants는 0.9 mm 드릴로서 홈을 형성한 후 식립하였고 self-drilling microscrew implants는 홈을 형성하지 않고 바로 식립하였다. 교정력은 식립 직후 바로 NiTi coil spring을 연결하여 가하였으며 일부는 교정력을 가하지 않았고 일부는 100 gm정도의 약한 교정력을 일부는 200 gm정도의 강한 교정력을 가하였다. 실험동물은 3주 혹은 5주에 희생하였으며 72개의 비탈회 표본을 만들어 전반적인 조직학적 관찰과 조직 계측을 시행하였다. 토크 게이지로 최대 식립 토크와 최대 제거 토크를 측정하였다. 모든 microscrew implants는 실험기간 동안 안정되게 유지되었고 최대 제거 토크의 측정에는 self-drilling과 self-tapping microscrew implants 사이에 통계학적으로 유이한 차이가 없었다. 조직 관찰에서 self-tapping microscrew implants에서 골 임프란트 계면에 골결손이 더 많았고 5주에서는 새로이 형성된 미성숙 골이 더 많았다. Self-drilling microscrew implants에서 골표면 혹은 골내막으로의 골 형성이 많이 관찰되었으나 5주에서는 흡수되는 양상을 보였다. 3주에서는 self-drilling microscrew implants가 더 많은 골접촉을 보였으나 5주에서는 두 군사이에 차이가 관찰되지 않았다. 이 결과는 두 방법이 모두 microscrew implant의 식립에 사용될 수 있음을 시사하나 self-tapping microscrew implants의 경우 초기에는 약한 힘을 가하는 것이 좋을 것으로 생각된다.

Titanium Microscrew Implant의 고정원으로서의 이용

박효상,김종배 啓明大學校 醫科大學 1999 계명의대학술지 Vol.18 No.4

The purpose of this is to evaluate the efficacy of the skeletal cortical anchorage using titanium microscrew implants, and to describe the clinical considerations. Author examined 14 patients, who had been treated orthodontically by skeletal cortical anchorage. The 23 of 28 titanium microscrew implants, implanted on the upper and lower alveolar bones, had remained firm and stable for 5 months orthodontic force application. The cause of 5 failed microscrew implants was excessive force during manipulation. So, if the problem concerning excessive force solve, the success rate will increase. The most outstanding results were 1-2 mm posterior movement of the posterior teeth during months orthodontic force application in 6 superimposed cases, which were usually act as anchorage during conventional orthodontic treatment. Conclusively the skeletal cortical anchorage using titanium microscrew implants night be excellent method of anchorage control in maximum anchorage case in the orthodontic treatment.

난소 적출 백서에 식립된 마이크로스크류에 교정력 부여 시 나타난 초기 경조직 변화에 관한 연구

이대승,이진우,,장문정 대한치과교정학회 2006 대한치과교정학회지 Vol.36 No.2

중년 이후의 여성의 경우 칼슘 섭취가 부족하거나, 인위적인 난소 적출 또는 폐경 등으로 인하여 골밀도가 감소하는 경향이 있다. 이 경우 교정 치료 시, 골내 고정원으로 마이크로스크류를 이용할 수 있는지를 알아보기 위하여, 생후 4개월 된 Sprague-Dawley계 백서를 실험군으로 난소 적출(Ovariectomy Screw, OS)군, 대조군으로 Sham operation 시행한(Sham operation Screw, SS)군의 두 군으로 나누었다. OS군과 SS군 모두 상악 대구치 사이 구개골에 마이크로스크류를 식립하였고, NiTi coil spring을 이용하여, 상악 중절치 2개를 견인하였다. 각 군당 3일, 7일 후 7마리씩 희생시켰다. 희생 3일전 Alizarin red S를 주입하고, 상악골, 장골, 심장혈을 채득한 후, 심장혈을 성분분석하고, 상악골과 장골은 비탈회 레진표본을 제작하여, 편광현미경, 형광현미경으로 관찰하였다. 심장혈을 통한 성분 조사 결과 OS군, SS군 모두 7일째 alkaline phosphatase (ALP)의 농도가 높게 나타나 골개조의 가능성을 보였고, 편광현미경 사진에서 OS, SS군에서 모두 마이크로스크류의 압박측, 긴장측, 치아의 긴장측에서 3일 보다 7일에서 기존골에 비하여 골밀도가 낮은 영역이 적었고, 치아의 압박측에서는 골밀도가 낮은 영역이 증가하였다. 형광현미경 관찰결과는 3일째 보다 7일째에 더 Alizarin red S로 침착된 골이 나타난 것으로 보아, 새로운 골의 형성이 있었음을 나타내었다. 골다공증이 유도된 백서에서 계속된 골의 흡수보다는 골개조의 가능성이 증가하고, 신생골의 형성이 증가함을 확인할 수 있었고, 이는 골다공증에서도 마이크로스크류의 식립으로 고정원 확보가 가능한 것으로 생각한다. Most elderly women experience a decrease in their bone density due to a deficiency of calcium intake, ovariectomy, or menopause. This study evaluated the usability of the microscrew as a skeletal anchorage system in these orthodontic treatment cases, using rats as a research group. The 4 month old sprague-dawley species rats were divided into two groups, the OS (Ovariectomy Screw), and the SS (Sham operation Screw) group. In both the OS and SS groups, microscrews were implanted into the palatal bone between the upper molar teeth and two upper incisors were retracted using NiTi coil spring with 75g of force. After 3days, the again after 7days, 7rats in each group were sacrificed. Three days before they were sacrificed, Alizarin red S was intraperitoneally injected, and their maxillary bone, tibia and blood from their hearts were taken. The components of the extracted blood were biochemically analyzed and non-decalcified grinding resin sections for maxillary bone and tibia were made. The sections were examined with a polarization microscope, and fluorescent microscope. Smaller concentrations of Ca and P, the inorganic substances closely related to bone density, were found in the extracted blood of the OS group. Both OS and SS groups showed a possibility of bone remodeling with a high concentration of ALP after 7days. An increase in bone density on the tension and compression sides of the microscrew and the tension side of the tooth or both OS and SS groups was confirmed with a polarization microscope. However, the bone density of the pressure side of the tooth and apical side was decreased. More deposits of Alizarin red S in the bone after 7 days rather than 3 days seen with a fluorescent microscope suggested the existence of new bone formation.

큰 하악 평면각을 가진 골격성 II급 성장기 환자의 마이크로스크루 지지형 트윈 블록 장치 치료

이원강 대한치과교정학회 2022 대한치과교정학회 임상저널 Vol.12 No.4

This case report describes an orthopedic and orthodontic treatment of a young female patient who had skeletal Class II malocclusion with mandibular deficiency and vertical growth tendency. Favorable anterior growth of the mandible was acquired by using Twin-block appliance. In application of the Twin-block, it was modified using microscrew to reduce the side effects, like lower incisor proclination and upper incisor reclination, which reduces the potential of achieving maximum skeletal effects. The aim of this case report is to present an idea when using the Twin-block appliance. By this method, the proclination of the lower incisors and the reclination of the maxillary anterior teeth could be prevented. Moreover, the vertical growth of the maxillary dentition could be inhibited by using intraoral elastics between the microscrews and buttons on the Twin-block. This idea may be useful in the treatment of the growing skeletal Class II patients with deficient mandible.

Qualitative and quantitative evaluation of root injury risk potentially burdening insertion of miniscrew implants

Antoszewska, Joanna,Trzesniewska, Paulina,Kawala, Beata,Ludwig, Bjorn,Park, Hyo-Sang The Korean Association Of Orthodontists 2011 대한치과교정학회지 Vol.41 No.2

Objective: Microscrew implants (MSls) offer many advantages, but some complications are known to occur during their insertion. One of the most commonly reported complications is root injury. Our aim was to identify factors associated with root injury and to evaluate their qualitative and quantitative values. Methods: Thirty-five orthodontists placed MSls (AbsoAnchor$AbsoAnchor^{(R)}$, Dentos Co. Ltd, Daegu, Korea) in the upper jaw of typodonts, labially between the second premolar and the first molar, in low and high vertical positions. Root contacts were counted, and distances between MSI apices and roots were measured. Fear level of the orthodontists was surveyed before and after the experiment. Wilcoxon's test, chi-square test, and Mann-Whitney test were used for statistical analysis. Results: Overall root contact rate of MSI insertion was 23.57%. The root contact rate was significantly higher in MSls inserted at $90^{\circ}$ (45.71%) than at $30^{\circ}$ (1.43%). The distance between the dental root and MSI also increased significantly in MSls inserted at $30^{\circ}$. Mean fear level before MSI insertion (4.6) significantly decreased after insertion (3.2); the causative factors were risk of injury to dental root and maxillary sinus or mandibular canal. Conclusions: Root injury is relatively rare, and oblique angulation reduces the risk of root and MSI contact.

Qualitative and quantitative evaluation of root injury risk potentially burdening insertion of miniscrew implants

Joanna Antoszewska,Paulina Trze?niewska,Beata Kawala,Bjorn Ludwig,Hyo-Sang Park 대한치과교정학회 2011 대한치과교정학회지 Vol.41 No.2

Objective: Microscrew implants (MSIs) offer many advantages, but some complications are known to occur during their insertion. One of the most commonly reported complications is root injury. Our aim was to identify factors associated with root injury and to evaluate their qualitative and quantitative values. Methods: Thirty-five orthodontists placed MSIs (AbsoAnchor<SUP>ⓡ</SUP>, Dentos Co. Ltd, Daegu, Korea) in the upper jaw of typodonts, labially between the second premolar and the first molar, in low and high vertical positions. Root contacts were counted, and distances between MSI apices and roots were measured. Fear level of the orthodontists was surveyed before and after the experiment. Wilcoxon’s test, chi-square test, and Mann-Whitney test were used for statistical analysis. Results: Overall root contact rate of MSI insertion was 23.57%. The root contact rate was significantly higher in MSIs inserted at 90° (45.71%) than at 30° (1.43%). The distance between the dental root and MSI also increased significantly in MSIs inserted at 30°. Mean fear level before MSI insertion (4.6) significantly decreased after insertion (3.2); the causative factors were risk of injury to dental root and maxillary sinus or mandibular canal. Conclusions: Root injury is relatively rare, and oblique angulation reduces the risk of root and MSI contact.

M0.8 마이크로 스크류의 유한요소해석기반 공정설계

송정한(J.H. Song),이혜진(H.J. Lee),이낙규(N.K. Lee),이근안(G.A Lee),이형욱(H.W. Lee) 한국생산제조학회 2011 한국생산제조시스템학회 학술발표대회 논문집 Vol.2011 No.4

본 연구에서는 , 1.0 inch HDD 요소부품의 체결에 사용되는 직경 800 um에 200um의 피치를 갖는 마이크로 스크류의 성형을 위하여 전조공정에 대한 유한요소 해석을 통하여 공정분석을 수행하였으며, 실제 설계 가이드라인과 형상비교를 통하여 성형가능성을 검토하였다. 그 결과 유한요소 해석을 통하여 얻은 스크류의 형상이 JIS 기준에 만족하는 것으로 나타났으며 이를 통하여 1.0 inch HDD 체결용 마이크로 스크류의 성형이 가능함을 확인할 수 있었다.

간접 골성고정원(indirect skeletal anchorage)을 이용한 상악구치 압하

전윤식(Youn-Sic Chun),장연주(Yeon-Joo Chang) 대한치과의사협회 2004 대한치과의사협회지 Vol.42 No.1