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Ask the Experts
Introduction

In the “Ask the experts” feature series, a group of experts is asked to give their opinion on a particularly topical question in less than 250 words. This time we have asked Carlalberta Verna (Switzerland), Brody Hildebrand (USA), Sebastian Kühl (Switzerland) and Hugo De Clerck (Belgium) to give their view on (mini-)implants as anchors for orthodontic treatment.

Carlalberta Verna

The use of osseointegrated implants in orthodontics is not new and is limited to patients at the end of growth as part of an interdisciplinary rehabilitation. The real revolution in orthodontics, however, is the use of so-called TADs, i.e. temporary anchorage devices. The most widely used at the moment are mini-implants, which, being non-osseointegrated, are based on primary stability and can be utilized even in growing patients. The advantage of mini-implants is not limited to cases where maximum anchorage is required in conjunction with decreased patient compliance, and is primarily biomechanical. The spectrum of orthodontic solutions has been greatly expanded by the use of mini-implants, allowing for movements tht would not otherwise be possible. This allows an optimal solution to asymmetries and severe vertical, sagittal and transversal discrepancies, which may even decrease the need for surgical solutions. Their placement is simple and usually well accepted by the patient. Depending on the quality of the bone and the type of mini-implant used, pre-drilling before insertion may not be necessary. Since the success rate depends on factors related to the patients and to the mini-implant selected, thorough planning is obviously needed. Since some stable bone-to-implant contact has been observed, the use of mini-implants has also been recently suggested as a temporary support for pontics in cases of agenesis of lateral incisors pending definitive implant solution.

In summary, the use of skeletal anchorage offered by mini-implants greatly enhances the orthodontic therapeutic solution, and is advantageous for both the patient and the orthodontist.