TY - JOUR
T1 - Interradicular sites and cortical bone thickness for miniscrew insertion
T2 - A systematic review with meta-analysis
AU - Tepedino, Michele
AU - Cattaneo, Paolo M
AU - Niu, Xiaowen
AU - Cornelis, Marie A
N1 - Copyright © 2020 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - INTRODUCTION: Safe zone maps are useful for the clinician to plan miniscrew insertion and possibly reduce radiation exposure. This study aimed to investigate the available evidence regarding the presence of sufficient interradicular space and adequate cortical bone thickness in patients with a complete permanent dentition, in the vestibular and palatal or lingual interradicular sites, mesial to the second molar.METHODS: PubMed, Scopus, Web of Science, Cochrane Library, and OpenGrey databases were searched up to January 2019 for observational studies involving patients with fully erupted second molars that investigated the amount of interradicular space and/or the cortical thickness of the alveolar processes using 3-dimensional data sets. A custom tool was prepared and used to assess the risk of bias in individual studies. A meta-analysis was performed when at least 4 different studies evaluated 1 identical parameter homogeneously. Publication bias was assessed with the Egger linear regression test.RESULTS: Twenty-seven observational articles were included in the qualitative synthesis. Only 11 articles were at low risk of bias. Fifteen articles were included in the meta-analysis. The results were graphically reported in "safe-zone" maps.CONCLUSIONS: In the maxilla, the most suitable insertion sites are those from mesial to the first molar to distal to the first premolar, and between the canine and the lateral incisor, all at 6 mm from the cementoenamel junction. In those areas, the cortical bone has adequate thickness, not requiring predrilling. In the mandible, the preferable vestibular interradicular spaces are those between first and second molars and between first and second premolars, both at 5 mm from the cementoenamel junction, and predrilling is suggested in these areas.TRIAL REGISTRATION NUMBER: PROSPERO CRD42016042081.
AB - INTRODUCTION: Safe zone maps are useful for the clinician to plan miniscrew insertion and possibly reduce radiation exposure. This study aimed to investigate the available evidence regarding the presence of sufficient interradicular space and adequate cortical bone thickness in patients with a complete permanent dentition, in the vestibular and palatal or lingual interradicular sites, mesial to the second molar.METHODS: PubMed, Scopus, Web of Science, Cochrane Library, and OpenGrey databases were searched up to January 2019 for observational studies involving patients with fully erupted second molars that investigated the amount of interradicular space and/or the cortical thickness of the alveolar processes using 3-dimensional data sets. A custom tool was prepared and used to assess the risk of bias in individual studies. A meta-analysis was performed when at least 4 different studies evaluated 1 identical parameter homogeneously. Publication bias was assessed with the Egger linear regression test.RESULTS: Twenty-seven observational articles were included in the qualitative synthesis. Only 11 articles were at low risk of bias. Fifteen articles were included in the meta-analysis. The results were graphically reported in "safe-zone" maps.CONCLUSIONS: In the maxilla, the most suitable insertion sites are those from mesial to the first molar to distal to the first premolar, and between the canine and the lateral incisor, all at 6 mm from the cementoenamel junction. In those areas, the cortical bone has adequate thickness, not requiring predrilling. In the mandible, the preferable vestibular interradicular spaces are those between first and second molars and between first and second premolars, both at 5 mm from the cementoenamel junction, and predrilling is suggested in these areas.TRIAL REGISTRATION NUMBER: PROSPERO CRD42016042081.
KW - Cone-Beam Computed Tomography
KW - Cortical Bone/diagnostic imaging
KW - Humans
KW - Mandible/diagnostic imaging
KW - Maxilla/diagnostic imaging
KW - Tooth Root/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85092777638&partnerID=8YFLogxK
U2 - 10.1016/j.ajodo.2020.05.011
DO - 10.1016/j.ajodo.2020.05.011
M3 - Review
C2 - 33077369
SN - 0889-5406
VL - 158
SP - 783
EP - 798
JO - American Journal of Orthodontics and Dentofacial Orthopedics
JF - American Journal of Orthodontics and Dentofacial Orthopedics
IS - 6
M1 - e20
ER -