Effects of cortical bone thickness and trabecular bone density on primary stability of orthodontic mini-implants

Abstract

Background/purpose: Mini-implant screws are now routinely used as anchorage devices in orthodontic treatments. This study used synthetic bone models to investigate how the primary stability of an orthodontic mini-implant (OMI) as measured by resonance frequency (RF) is affected by varying cortical bone thickness and trabecular bone density. Materials and methods: Three synthetic cortical shells (thicknesses of 1, 2, and 3 mm) and three polyurethane foam blocks (densities of 40, 20, and 10 pound/cubic foot) were used to represent jawbones of varying cortical bone thicknesses and varying trabecular bone densities. Twenty-five stainless steel OMIs (2 × 10 mm) were sequentially inserted into artificial bone blocks to depths of 2, 4, and 6 mm. Five experimental groups of bone blocks with OMIs were examined by Implomates® RF analyzer. Statistical and correlation analyses were performed by Kruskal-Wallis test, Wilcoxon rank-sum test, and simple linear regression. Results: As trabecular bone density decreased, RF decreased; as cortical bone thickness decreased, RF also decreased. Simple linear regression analysis showed highly linear correlations between trabecular bone density and RF (R2 > 0.99; P 0.98; P < 0.0001). Conclusion: The stability of an OMI at the time of placement is influenced by both cortical bone thickness and trabecular bone density. Both cortical bone thickness and trabecular bone density have strong linear correlations with RF. Keywords: Mini-implants, Primary stability, Cortical bone thickness, Trabecular bone density, Resonance frequency