The Impact of Drilling Guide Length of a Surgical Guide on Accuracy of Pre-Drilling for Miniscrew Insertion

Abstract

Background: Temporary anchorage devices (TADs) are broadly used in orthodontic treatment. TADs must be placed accurately to avoid collision against tooth roots. To place miniscrews with a higher accuracy, a digitally designed surgical guide was proposed in previous studies. However, to our knowledge, there have been no articles that have assessed the minimal required length to achieve good drilling accuracy. The objective of the present study was to evaluate the accuracy of pre-drilling using computer-aided designed surgical guides with different lengths. Methods: A typodont model was scanned, and surgical guides of 3.0, 4.5, and 6.0 mm were designed. Duplicated typodonts and the surgical guides were printed with a 3D printer. Using these models and surgical guides, pre-drillings were performed. Freehand drilling was also conducted for the control. The drilled models were scanned with micro-computed tomography to evaluate the accuracy. Results: The mean errors at the tip of the drill were 0.44 mm, 0.61 mm, 0.41 mm, and 0.24 mm for the freehand drilling, and 3.0, 4.5, and 6.0 mm for the surgical guide, respectively. Conclusion: The results suggested that a longer surgical guide was recommended to achieve good insertion accuracy for a narrow interradicular space, and that 3.0 mm was enough when an error of 1.0 mm was acceptable for the insertion site.

Keywords

• temporary anchorage device
• TADs
• miniscrews
• CBCT
• pre-drilling
• orthodontic anchor screws