128 EN-MASSE RETRACTION USING ORTHODONTIC MICRO IMPLANT BASHA ET AL

Comparative Study Between Conventional

En-Masse Retraction (Sliding Mechanics)
and En-Masse Retraction Using
Orthodontic Micro Implant
Asim Ghouse Basha, BDS, MDS,* Ravi Shantaraj, MDS, and Shivalinga B. Mogegowda, MDS

Purpose: The purpose of this was used as anchorage. The retraction

rthodontic anchorage control is

O a fundamental part of orth-

odontic treatment planning and
subsequent treatment delivery. On one
study was to measure and compare
the difference between rate of en-
masse retraction with mini-implant
and molar anchorage.
and postretraction lateral cephalo-
grams were taken. Rate of retraction
and anchor loss were measured by
using pterygoid vertical in maxilla.
hand, research has focused on the ef-
ficient movement of teeth to minimize Patients and Method: A compar- Results: Four implants became
anchorage loss by improvement in ative study consisting of 14 patients loose during the treatment, which
orthodontic material bracket design (all females) randomized into 2 were subsequently replaced. The sta-
(self-ligating bracket, tip edge) and groups. Seven in group I (nonimplant) bility of surgical steel in this study was
frictionless protocols (segmented arch molar was used as anchor for en- 71.4%. Student t test were used to an-
technique).1 masse retraction of anterior teeth alyze the treatment charges in 2
The maintenance of anchorage dur- (mean age 16 years SD 1.41). In groups. Mean anchor loss in maxilla
ing en-masse retraction using sliding group II (implant), mini-implant was in nonimplant group. No differences in
mechanics is difficult practically in clin- used as anchorage to retract the ante- the mean rate of retraction time were
ical situations. Williams and Hosila2 rior teeth (mean age 17.36 SD noted in both groups.
found that, in patients whose first pre-
molars are extracted, only 66.5% of the
1.35). In both groups, all first premo- Conclusion: Mini-implants pro-
available extraction space was taken up lars were extracted. After leveling and vided absolute anchorage in patients
by retraction of the anterior segment. aligning, surgical steel mini-implant requiring maximum anterior re-
Creekmore3 stated that, as a rule of of 1.3 mm in diameter and 8 mm in traction. No differences in the
thumb when first premolars are ex- length were placed between the roots mean retraction time were noted
tracted, 1 can expect the posterior teeth of second premolar and first molar in between 2 groups. (Implant Dent
to move forward approximately one the maxilla in the implant group. Im- 2010;19:128 136)
third of the space for relief of crowding plants were immediately loaded with 2 Key Words: anchorage, mini-
and incisor retraction. In this scenario, N of force. In nonimplant group molar implants, sliding mechanics
*PG Student, Department of Orthodontics and Dentofacial
Orthopedics, JSS Dental College and Hospital, Mysore,
Karnataka, India.
Associate Professor, Department of Orthodontics and
maximum anchorage of the posterior anchorage such as headgear, face-
Dentofacial Orthopedics, JSS Dental College and Hospital, teeth assumes important in not only al- mask, intermaxillary elastics are used.
Mysore, Karnataka, India.
Professor, Department of Orthodontics and Dentofacial lowing the anterior teeth to be retracted The use of headgear has proved to
Orthopedics, JSS Dental College and Hospital, Mysore,
Karnataka, India. to their greatest extent but also increas- be the best source of anchorage. The
ing the chances of straightening the pro- problems related to patient compliance,4
Reprint requests and correspondence to: Asim
Ghouse Basha, BDS, MDS, Department of
file by reducing the convexity of the undesirable side effects on the maxillary
Orthodontics and Dentofacial Orthopedics, JSS face. complex, and the risk of injuries5 have
Dental College and Hospital, Mysore 570 015, There are many different sources jeopardized success. Because any dental
Karnataka, India, Phone: 91 9945687868, E-mail:
[email protected] of orthodontic anchorage. Segments of anchorage would, to a certain degree,
teeth or the entire arch have been the result in unwanted movement of the an-
ISSN 1056-6163/10/01902-128
Implant Dentistry most common type of orthodontic an- chor teeth, there was a need to use de-
Volume 19 Number 2
Copyright 2010 by Lippincott Williams & Wilkins chorage. But in difficult situations the vices that do not use teeth as anchorage
DOI: 10.1097/ID.0b013e3181cc4aa5 need for extra-dental supplements of units.
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 2 2010 129

With the introduction of dental im- Orthodontics and Dentofacial Ortho-

plants,6 mini-plates, 7 and micro- paedics at JSS Dental College and
screws8 10 as anchorage units, it is now Hospital, Mysore, Karnataka.
possible to obtain absolute anchorage of The study was approved by ethi-
the posterior teeth and close the extrac- cal and review committee of JSS Den-
tion space completely by anterior retrac- tal College and Hospital. All female
tion. The implant as they are in direct patients were selected in this study
contact with the bone, they do not pos- such that growth in these patients is
ses a periodontal ligament. The hypoth- completed early (1316 years, growth Fig. 1. Preretraction intraoral photograph us-
ing mini-implants. Implants placed between
esis is that these implants do not move completion was determined using cer-
2nd premolar and 1st molar.
when the orthodontic/orthopedic force is vical maturity indicators in lateral
applied and therefore can be used as cephalograms),11,16,17 such that growth
absolute anchorage. These implants does not have effect on results.
have gained popularity in difficult cases
where traditional treatment has given Inclusion Criteria
compromised results.
Titanium, being most biocompat- 1. Comprehensive medical and den-
ible was the material of choice in im- tal history ruling out any systemic Fig. 2. SK Surgical mini-implant and driver.
plant logy. Also, its unique property of disease.
integrating with the surrounding bone, 2. Minimum age at the beginning of
a property termed as Osseo integra- treatment of 13 years to minimize
tion, gave first order preference. confounding results due to growth.
In orthodontics, true osseointegra- 3. No congenitally missing teeth ex-
tion is not required, as they are used cept third molars.
only for preserving anchorage for a lim- 4. Midlines matching with no spacing
ited time period. Henceforth, implant with mild or no anterior crowding
systems made of surgical steel can be in maxillary arch.
used. This would be advantageous in 5. Maximum anchorage, with 75% to
economizing the implant cost as well as 100% of space closure of retraction
facilitate its easy removal after the re- of anterior segment in maxillary
quired tooth movement has been arch. Fig. 3. IOPA photograph of mini-implant in
achieved. 6. Therapeutic extraction of first pre- position between 2nd premolar and 1st molar
Today, vast literature is available molars required. roots.
regarding titanium implants regarding 7. Patients with bimaxillary protru-
their types, properties, loading behav- sion with Angles class I malocclu-
ior, use in retraction of teeth (both sion (ANB angle of 2 4 degrees)
single and en-masse). But very little is those requiring maximum anchor-
reported regarding the use of surgical age were selected.
steel implants.79,1115 All patients were treated with pre-
Clinical validity is required before adjusted edgewise appliance system
their use in clinical practice. Hence, it (MBT 0.022 0.028 in). After initial
was felt that there is a need to explore leveling and aligning in group II (im-
the clinical efficiency of mini-implants plant) 0.019 0.025 in stainless steel
in providing absolute anchorage during arch wire with soldered hook distal to
orthodontic tooth movement. lateral incisor were placed in both Fig. 4. Postretraction intraoral photograph
In this study, efficiency of surgical arches (Fig. 1). To ensure that the showing closure of extraction space.
steel implants was evaluated to retract 6 wires were passive, they were left in
anterior teeth, and any anchor loss oc- place for at least 5 weeks before start-
curred during retraction was calculated. ing retraction. Surgical steel mini- NY) These mini-implants were placed
This was compared with conventional implants (1.3 mm in diameter, 8 mm under topical anesthesia. Mini-
mode of retraction where molar was in length; SK Surgical, Pune, India.) implants were self-drilling type. Im-
used as anchor unit. Sliding mechanics (Fig. 2) were placed between the roots plants were immediately loaded with
was used in both groups of patients. of first molar and second premolar in elastomeric chain with force of 2 N.
the upper arch (Fig. 3). The elastomeric chain extended from
PATIENTS AND METHODS Implants were placed with the head of the implant to the soldered
This study was prospective in na- help of Anesthetic spray18 LIGNOX hook (Fig. 1).
ture in a sample of 14 patients under- SPRAY (Lidocaine Topical Aerosol; In other group, after similar set up,
going treatment in the Department of Warren Pharmaceutical, Ossining, molar was used as anchor unit. Conven-
130 EN-MASSE RETRACTION USING ORTHODONTIC MICRO IMPLANT BASHA ET AL

tional methods of anchorage reinforce- DISCUSSION and 2-step retraction, as anchorage loss
ment was used, in this group (group I) Anchorage is a critical component is seen in both methods.11 When using
Trance palatal arch was used. Retraction of en-masse retraction. Orthodontists preadjusted appliances to retract 6
was carried out once patient was on pay special attention to maintain anchor- anterior teeth, for clinicians, this is a
0.019 0.025 wires. Retraction was age to obtain successful treatment out- double-edge sword. The benefits and
considered complete once the extraction comes.19 Many approaches to treatment disadvantages outweigh each other.
space is closed (Fig. 4). mechanics have been developed to effi- The benefits such as minimal wire bend-
Lateral cephalograms were taken ciently retract anterior teeth. In tooth- ing and adequate space for activation
pre- and postretraction in both group borne anchorage cases, complicated have overshadowed the loop mechanics.
of patients. Anchor loss was assessed mechanics or supplementary appliances In sliding mechanics, there is a tendency
by calculating the distance between are needed to control anchorage. for extrusion or tipping of posterior teeth
pterygoid vertical to maxillary molar The retraction of 4 incisors after during anterior retraction. On the con-
in pre- and postlateral cephalogram. canine retraction is accepted as a trary, tipping action built into anterior
Rate of retraction was calculated method to minimize the mesial move- brackets in preadjusted appliances may
by dividing the amount of en-masse ment of the posterior teeth. There is no produce problems of anchorage.
retraction by time taken for retraction. difference between en-masse retraction Previously, extraoral anchorage
(headgear) has been used to reinforce
anchorage,20 but its application depends
Statistical Analysis
on patient compliance and also the head-
The results were calculated using Table 1. Comparison of Anchor Loss
in Implant and Nonimplant Group
gear is usually worn fewer than 12 hours
Student t test using statistical software a day, whereas most orthodontic forces
SPSS. Descriptive statistical analysis Anchor are required to be continuous. Anchorage
was carried out in this study. Signifi- Loss in mm Group I Group II P is supplemented to some extent with the
cance is assessed at 5% level of sig- Range 1.02.30 0 use of intraoral transpalatal arches. Stud-
nificance. Student t test (2 tailed, Mean SD 1.73 0.43 0 ies12,21,22 have shown that even with the
independent) has been used to find the Group I is nonimplant group and group II is implant group. use of transpalatal arch anchor loss occurs.
significance of study parameters on
continuous scale between 2 groups
(intergroup analysis). Table 2. Comparison of Retraction Time Period in Implant and Nonimplant Group
Retraction Time Group I Group II P
Statistical software. The statistical
software namely SPSS 15.0, Stata 8.0, Retraction time period (d) 181.00 32.07 182.43 9.64 0.912
MedCalc 9.0, and Systat 11.0 were (127212) (167198)
used for analysis of the data and Mi- Retraction/mo in mm (right) 1.05 0.17 1.06 0.12 0.917
crosoft word and excel have been used (0.921.42) (0.911.26)
to generate table and graphs. Retraction/mo in mm (left) 1.07 0.13 1.06 0.15 0.923
(0.851.21) (0.851.26)
Results are presented in mean SD (min-max).
RESULTS Group I is nonimplant group and group II is implant group.

The success rate of stability of

stainless steel mini-implants was
71.4% because 4 of 14 mini-implants
were loose during the study, which
were subsequently replaced.

Anchor Loss
Anchor loss was statistically sig-
nificant in nonimplant group 1.73 mm
compare with implant group (Table 1).

Retraction Time
In this study, rate of retraction was
statistically and clinically insignificant.
Both groups took 182 days for retrac-
tion, with nonimplant group taking
0.92 mm per month (0.917) and im- Graph 1. Comparison of retraction time in days. Comparison between implant and nonimplant
plant group taking 0.85 mm per month group. (Group I is nonimplant group and group II is implant group).
(0.923) for retraction (Table 2, Graph 1).
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 2 2010 131

The position of upper incisors has a slightly heavier than elastomeric chain, and patients nursing appointments were
striking effect on the aesthetic appear- which could have deleterious effect on the same in both groups.
ance of the face and on the function of mini-implants, and also maintenance of The second reason that we observed
the stomatognathic system. Retraction oral hygiene is better with elastomeric was that in both groups retraction was
of the incisors as part of orthodontic chain.29 Mini-implants were immedi- carried out on 0.019 0.025 in stainless
therapy represents a fundamental phase ately loaded after placement, with the steel wire; whereas in a previous study,34
23
of treatment. belief that orthodontic force of appropri- the retraction was carried out on
With the advent of skeletal an- ate magnitude can thus be applied 0.016 0.022 in stainless steel wire in
chorage, the boundaries of orthodontic immediately after implant placement 0.022 slot. Because the anterior inclina-
treatment have been redefined. Skele- without decreasing the success rate.30 tion was dictated by the control of force
tal anchorage using dental implants,24 We found this to be the same in our direction, the torquing curve on the
miniplates,25 miniscrews, and 13 mi- study. Lateral cephalogram were taken archwire and retraction of 6 anterior
croscrews 14,26 provide an absolute before and after retraction in both teeth with sliding mechanics, the need
anchorage for tooth movements. Mi- groups of patients to measure the anchor for heavy archwire decreased. Heavy
niscrew or microscrew implants have loss in both groups. archwire are known to produce more
many benefits such as ease of place- The stability of mini-implants made friction than lighter archwires. There-
ment and removal and inexpensive- of surgical steel in our study was 71.4% fore, 0.016 0.022 in archwire in 0.022
ness. Most importantly, because of because 4 of 14 implants failed during in bracket system produced less friction
their small size, they can be placed in retraction, most of the failures were than 0.019 0.022 in archwire and
the intra-arch alveolar bone without within 2 months after placement, and hence facilitated faster tooth movement.
discernable damage to tooth roots. once this time passed, success levels re- There was significant anchorage
Studies with micro-implant posi- mained relatively constant. The sample loss (mean 1.73 mm) in the nonimplant
tioned between the roots of the second in our study was all female patients with group. In previous studies, 1.6 to 4 mm
premolar and first molars have shown mean age of 17 years, study31 have of mesial molar movement was re-
successful retraction of the entire an- shown that implant failures rates are ported. Although retracting canines with
terior segment with nickel-titanium higher in females younger than 18 years. traditional mechanics15 and with ad-
coil springs and elastomeric chains. Mini-implants proved to be an ade- juncts for anchor preservation, up to 2.4
Few studies have measured the an- quately stable source of anchorage for mm of anchorage loss was observed.35,36
chorage loss with implant assisted en- en-masse retraction of maxillary ante- Results could have been more accurate
masse retraction. Hence, this study was rior teeth of the 14 implants used in 7 if the pretreatment axial inclination of
aimed at evaluating the anchorage loss patients 4 implants came loose within incisors in both groups would have been
in patients requiring extraction of 4 first several weeks of placement. Compared identical. In this study, axial inclination
premolars and maximum retraction of with titanium implants, the success rate was not taken into consideration, 1
anterior teeth (bialveolar protrusion) varied from 70%32 to 100%33 with aver- to 2 mm anchorage loss is clinically
with implants made up of surgical steel age 87%. Four lost implants were sub- acceptable, higher amounts can be
and patients treated with conventional sequently replaced. In the implant group detrimental to overall efficiency of
sliding mechanics with conventional for 4 patients, retraction was discontin- treatment, especially when anchor-
methods of anchorage reinforcement. In ued for 2 to 4 weeks because of persis- age demand is critical.
addition, the time taken for space closure tent inflammation around the implant
was compared between these 2 groups. site. Retraction was resumed when the Limitations of Study
The patients all selected in both inflammation was brought under control 1. Study was prospective in nature. It had
groups were females with mean age in by improving oral hygiene. sample size of 14 patients, and the re-
nonimplant group 16.00 1.41 years Contrary to previous reports, we sult obtained from this study should be
and implant group 17.35 3.5 years. found no significant shortening of treat- verified with a larger sample.
The implants were placed as per guide- ment time in patients treated with 2. Only female patients were selected
lines of Park et al.9 The implants were implants.34 There are 2 possible expla- in both groups. Gender-based com-
immediately loaded with initial force of nations for this: In implant group, clo- parison is needed.
2 N. The implants were placed only in sure of extraction space was completely 3. Lateral cephalograms were analyzed
upper arch between the first molars and done by distalization of anterior teeth. In for assessment of anchorage loss.
second premolars, as in maximum re- the nonimplant group due to anchorage Lateral cephalograms have their own
traction cases, upper molars provide less loss, there was simultaneous movement limitations, which affect the results
anchorage than lower molars.27 The im- of anterior and posterior teeth. Treat- of study.
plants were loaded immediately with ment time depends not only on the rate 4. There was no cast and cephalomet-
elastomeric chain. We preferred elasto- of tooth movement but also on other ric comparison.
meric chain as studies28 have shown that variables such as mechanics, patient co- 5. No study was conducted in the
the rate of retraction with elastomeric operation and patient motivation. These mandibular arch. If the implants
chain is similar to NiTi coil spring, also variables were not controlled in our were placed in mandibular arch,
initial force of NiTi coil spring is study. Repeated debonding of brackets then more pronounced profile
132 EN-MASSE RETRACTION USING ORTHODONTIC MICRO IMPLANT BASHA ET AL

change might have been expected, cooperation in wearing headgear. Am J 21. Bobak V, Christiansen RL, Hollister
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5. Holland GN, Wallace DA, Mondino transpalatal arch: A finite element analysis.
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debonding of brackets could have evaluation of titanium mini-plates as an-
contributed to overall outcome of tion system. Eur J Orthod. 2000;22:33-41.
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Orthod. 1994;28:6993-6704.
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25. Umemori M, Sugawara J, Mitani H,
1. Mini-implants placed in the maxil- age. Angle Orthod. 2004;74:703-710.
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Micro-implant anchorage for treatment of bite correction. Am J Orthod Dentofacial
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implants in our study was about Extraction space closure with vacuum- 31:763-767.
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11. Heo W, Nahm DS, Baek SH. En- TM, Vanarsdall RL Jr, Vig KWL, eds. Orth-
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 IMPLANT DENTISTRY / VOLUME 19, NUMBER 2 2010 133

Abstract Translations
GERMAN / DEUTSCH SPANISH / ESPAOL
AUTOR(EN): Asim Ghouse Basha, BDS, MDS, Ravi Shan- AUTOR(ES): Asim Ghouse Basha, BDS, MDS, Ravi Shan-
taraj, MDS, Shivalinga B. Mogegowda, MDS taraj, MDS, Shivalinga B. Mogegowda, MDS
Komparativstudie zwischen einer konventionellen gemein- Estudio comparativo entre la retraccion (mecanica del desl-
schaftlichen Retraktion (gleitende Mechanik) und einer izamiento) en masa convencional y la retraccion en masa
gemeinschaftlichen Retraktion unter Anwendung kieferortho- usando un microimplante ortodontico
padischer Mikroimplantate
ABSTRACTO: Proposito: El proposito de este estudio fue
ZUSAMMENFASSUNG: Zielsetzung: Die vorliegende medir y comparar la diferencia entre la tasa de retraccion en
Studie zielte darauf ab, den Unterschied zwischen der Quote masa con la sujecion molar y del miniimplante. Materiales y
bei einer gemeinschaftlichen Retraktion unter Zuhilfenahme Metodos: Un estudio comparativo que consistio en 14 paci-
von Mini-Implantaten und einer molaren Verankerung zu entes (todas mujeres) aleatorizadas en dos grupos. Siete en el
messen und zu vergleichen. Materialien und Methoden: Die grupo I (sin implante) se uso un molar como sujecion para la
komparative Studie umfasste insgesamt 14 Patienten (alle retraccion en masa de los dientes anteriores (edad media de
weiblichen Geschlechts), die nach dem Zufallsprinzip in zwei 16 anos, desviacion estandar de 1.41). En el grupo II (con
Gruppen unterteilt wurden. Bei 7 Patienten der Gruppe I implante) se uso el miniimplante como sujecion para la
(ohne Implantatverwendung) wurde der Mahlzahn als Ver- retraccion de los dientes anteriores (edad media 17.36 des-
ankerung fur eine gemeinschaftliche Retraktion der vorderen viacion estandar 1.35). En ambos grupos, se extrajeron
Zahne benutzt (Durchschnittsalter 16 Jahre SD 1.41). Bei todos los primeros premolares. Luego de nivelar y alinear, se
Gruppe II (mit Implantateinsatz) wurde ein Mini-Implantat colocaron miniimplantes quirurgicos de acero de 1.3 mm de
als Verankerung verwendet, um die Retraktion der vorderen diametro y 8 mm de largo entre las races del segundo
Zahne durchzufuhren (durchschnittliches Alter 17.36 SD premolar y el primer molar en el maxilar del grupo con
1.35). In beiden Gruppen wurden den Patienten alle ersten implante. Los implantes se cargaron inmediatamente con 2 N
Pramolaren gezogen. Nach Anpassung und Ausrichtung wur- de fuerza. En el grupo sin implante, el molar se uso como
den die Mini-Implantate aus Stahl mit einem Durchmesser sujecion. Se tomaron cefalogramas laterales de la retraccion y
von 1.3 mm und einer Lange von 8 mm zwischen die Wur- la post-retraccion. Se medio la tasa de retraccion y la perdida
zeln des zweiten Pramolaren und des ersten Molaren im de la sujecion usando un pterigoide vertical en el maxilar.
Oberkiefer der Patienten der Implantat-Versuchsgruppe Resultados: Cuatro implantes se aflojaron durante el trata-
eingepflanzt. Die Implantate wurden sofort mit einer Kraft miento y fueron posteriormente reemplazados. La estabilidad
von 2 N belastet. In der Versuchsgruppe ohne Implantatver- del acero quirurgico en este estudio fue del 71.4%. La prueba
wendung wurde der Molar als Verankerung verwendet. Zu t de Student se uso para analizar los cambios en el trata-
Retraktion und Post-Retraktion wurden laterale Schadel- miento de los 2 grupos. La perdida media de sujecion en el
bildaufnahmen angefertigt. Der Anteil an Retraktion und maxilar en el grupo sin implante. No se notaron diferencias
Ankerverlust wurden am vertikalen Vidianus im Oberkiefer en la tasa media del tiempo de retraccion de ambos grupos.
gemessen. Ergebnisse: 4 Implantate lockerten sich wahrend der Conclusiones: Los miniimplantes proporcionaron una suje-
cion absoluta en pacientes que requieren una retraccion an-
Behandlung. Diese wurden entsprechend ersetzt. Die Stabilitat
terior maxima. No hay diferencias en la media del tiempo de
des chirurgischen Stahls in dieser Studie belief sich auf 71.4%.
retraccion entre los 2 grupos.
Der Studenten-T-Test wurde angewendet, um die Behandlung-
skosten in den beiden Gruppen zu ermitteln und zu untersuchen. PALABRAS CLAVES: sujecion, miniimplantes, mecanica
Im Oberkiefer der Versuchsgruppe ohne Implantateinsatz ergab del deslizamiento
sich ein durchschnittlicher Verankerungsverlust. Es gab keine
Unterschiede in der durchschnittlichen Quote an Retraktionszeit
zwischen den beiden Gruppen. Schlussfolgerungen: Mini- PORTUGUESE / PORTUGUS
Implantate sorgten fur eine absolut zuverlassige Verankerung
bei Patienten, die sich einer maximalen vorderen Retraktionsbe- AUTOR(ES): Asim Ghouse Basha, Bacharel em Cirurgia
handlung unterziehen mussten. Es gab keine Unterschiede in der Dentaria, Mestre em Cirurgia Dentaria, Ravi Shantaraj,
durchschnittlichen Quote an Retraktionszeit zwischen den bei- Mestre em Cirurgia Dentaria, Shivalinga B. Mogegowda,
den Gruppen. Mestre em Cirurgia Dentaria
Estudo comparativo entre retracao em massa convencional
SCHLUSSELWORTER: Verankerung, Mini-Implantate, (mecanica de deslize) e retracao em massa usando micro-
Schiebemechanik implante ortodontico
134 EN-MASSE RETRACTION USING ORTHODONTIC MICRO IMPLANT BASHA ET AL

RESUMO: Objetivo: O objetivo deste estudo era medir e     (
comparar a diferenca entre a taxa de retracao em massa com  16    1,41).
ancoragem em mini-implante e molar. Materiais e Metodos:   II (   ) 
Estudo comparativo compreendendo 14 pacientes (todas mul-      
heres) distribudos aleatoriamente em dois grupos de 7. No - ( 
grupo I (nao-implante) o molar foi usado como ancora para 17,36   1,35).  
retracao em masse de dentes anteriores (idade media 16 anos      . "
SD 1.41). No grupo II (implante) o mini-implante foi    ( )
usado como ancoragem para retrair os dentes anteriores       
(idade media 17.36 SD 1.35). Em ambos os grupos todos      
os primeiros pre-molares foram extrados. Depois de nivelar   ,   -
e alinhar, o mini-implante de aco cirurgico de 1.3 mm de ,    
diametro e 8 mm de extensao foi colocado entre as razes do -  1,3    8 .
segundo pre-molar e primeiro pre-molar na maxila no grupo #    2
de implante. Os implantes foram imediatamente carregados $.  ,    , 
com 2 N de forca. No grupo de nao-implante, o molar foi    .  
usado como ancoragem. Foram tirados cefalogramas laterais     . 
de retracao e pos-retracao. A taxa de retracao e a perda de      
ancora foram medidas usando pterigoide vertical na maxilla.  -
Resultados: 4 implantes se soltaram durante o tratamento, os ( )   
quais foram subsequentemente substitudos. A estabilidade . 
.     4
do aco cirurgico neste estudo foi de 71.4%. Testes T de ,    .
Student foram usados para analisar as cargas de tratamento     
em 2 grupos. Perda media de ancora na maxila no grupo de   71,4%.   -
nao-implante. Nenhuma diferenca na taxa media de tempo de       
retracao foi observada em ambos os grupos. Conclusoes: t- .  ,   
Mini-implantes proporcionaram absoluta ancoragem em pa- ,     
cientes que exigiam maxima retracao anterior. Nenhuma dife-  .     
renca no tempo de retracao media foi observada entre os 2   ,    
grupos. .

. (- 
  ,  
PALAVRAS-CHAVE: Ancoragem, Mini-implantes, Mecanica    .  
de deslize       , 
   .

RUSSIAN / $("" 
: , -,

 

: Asim Ghouse Basha, 
 , 
 , Ravi Shantaraj, 
 , Shivalinga B. Moge-
TURKISH / TURKCE
gowda,    YAZARLAR: Asim Ghouse Basha, BDS, MDS, Ravi Shan-

  
     taraj, MDS, Shivalinga B. Mogegowda, MDS

   (   )  Konvansiyonel Toptan Geri Cekme (Sliding Mekanik Re-

  
   !
 traksiyon) ve Ortodontik Mikro Implant Kullanan Toptan
   !  Geri Cekme Yontemlerinin Karslastrmas

"#$%".
.    OZET: Amac: Bu calsmann amac, mini implantl ve molar
      ankrajl toptan (en-masse) geri cekme (retraksiyon) yontem-
     - leri arasndaki fark olcmek ve karslastrmakt. Gerec ve
       Yontem: 14 hastadan (hepsi kadn) olusan calsmada olgular
. 
.    iki gruba randomize edildi. Grup Ideki (implantsz) 7 has-
  14  (  tann az disi, on dislerin hep birlikte geri cekilmesi icin
),      ankraj olarak kullanld (ortalama yas: 16 yl SD 1.41).
  . 7    Grup IIde (implant grubu) on dislerin retraksiyonu icin bir
 I (   );  - mini implant ankraj amacyla kullanld (ortalama yas: 17.36
    !   yl SD [plusmn 1.35). Her iki grupta da tum birinci premolar
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 2 2010 135

disleri cekildi. Duzelme ve hizalanmadan sonra, implant oldugu goruldu. Student t testi, 2 gruptaki tedavi degisik-
grubunda 1.3 mm capnda ve 8 mm uzunlugunda cerrahi liklerinin analizinde kullanld. Implantsz grupta maksillada
celikten olusmus bir mini implant, maksillada ikinci premolar ortalama ankraj kayb. Her iki grupta ortalama retraksiyon
ile birinci az disinin koklerinin arasna yerlestirildi. Implant- suresinde farkllk bulunmad. Sonuc: Azami on retraksiyon
lara derhal 2 N duzeyinde bir guc uyguland. Implantsz gereken hastalarda mini implantlar kesin ankraj saglad. Iki
grupta az disi ankraj olarak kullanld. Retraksiyon ve retrak- grup arasnda ortalama retraksiyon suresi acsndan bir fark-
siyon sonras lateral sefalogramlar cekildi. Geri cekme hz llk bulunmad.
ve ankraj kayb, maksillada pterygoid dikey kullanlarak ol-
culdu. Bulgular: Tedavi srasnda gevseyen 4 implant degi- ANAHTAR KELIMELER: Ankraj, Mini Implantlar, Sliding
stirildi. Bu calsmada cerrahi celigin stabilitesinin %71.4 mekanigi

JAPANESE /
136 EN-MASSE RETRACTION USING ORTHODONTIC MICRO IMPLANT BASHA ET AL

CHINESE /

KOREAN /