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Sorry, out of stock. Description Key Features Most comprehensive reference book covering a wide array of clinical concepts Covers numerous well-documented clinical cases along with illustrations providing an excellent tool for the orthodontists to serve their patients better Includes unique chapters like Digital imaging in orthodontics,Interdisciplinary orthodontics, Excellence in finishing, Functional goals in orthodontics, and Managing an orthodontic practice Truly international standard book with a dynamic group of leading world-class clinicians, researchers, teachers and authors delivering cutting-edge information Includes more the high-quality illustrations.
About the Book: Clinical Orthodontics: Current Concepts, Goals and Mechanics This book is targeted for every Orthodontic professional -postgraduate students residents , practicing orthodontists andacademicians and is a contemporary reference for all undergraduatelevel dentistry students. The contents of the book have been basedon its theme: Current concepts: dealing with the unique approach to diagnosis,treatment planning, treatment sequencing and execution of treatmentin diverse clinical situations Goals: redefining orthodontic treatment goals in accordance withthe current understanding of the science Mechanics: highlighting newer methods, unbiased treatmentapproach, and refined mechanics to produce high-qualityresults.
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Guaranteed service. International Shipping available. Other Books By Author. New Book Releases. Contact Us. Monday to Saturday 9. E-Gift Coupon , click here. Insights Insights, Account, Orders. About SapnaOnline. Why Shop at SapnaOnline. Create New Account. My Order History. My Wishlist. Clinicians should apply slow and gentle force during insertion to avoid fracture of the miniscrew. The recommended insertion torque value is 5—10 N cm [ 61 ].
Clinical Orthodontics: Current Concepts, Goals and Mechanics, 2e $Do…
Insertion torque values are associated with the success of the procedure. If the self-tapping method is used, the following factors also affect the success rate: flap or flapless surgery, sterilization, pilot hole preparation depth and diameter, cooling technique, drill speed and pressure, direction of placement and placement procedure steady or wiggling [ 6 , 8 , 16 , 18 , 27 , 30 , 43 , 47 ].
The stability of the miniscrew should be checked after placement. If any mobility is detected, the implant needs to be removed. If primary stability is not achieved upon insertion, the miniscrew implant may loosen during orthodontic treatment [ 26 ].
Patients should be informed that they might have pain for 1—2 days and that they can take anti-inflammatory agents if required. Most patients do not have noticeable discomfort or inflammation. Patients need to be instructed in oral hygiene techniques [ 35 ] and should be advised that they can brush their teeth as usual.
Clinical Orthodontics: Current Concepts, Goals and Mechanics
A compressed water spray such as Waterpik [ 12 ] and daily use of mouth rinses will be useful. Caution should be taken not to apply excessive force to the miniscrew while brushing and during mastication. The timing of loading depends largely on the miniscrew type [ 62 - 65 ]. For osseointegrated miniscrews, loading can commence 2—3 months after placement. However, miniscrews that do not require osseointegration are often used, and they can be loaded immediately [ 61 ].
The maximum force-load that a miniscrew can withstand remains controversial [ 66 ]. Dalstra et al. Many studies have reported miniscrew stability with loading forces of g or less [ 68 , 69 ]. In their study, Buchter et a1. Kim et al. The results indicated that miniscrews were fixed evenly in three dimensions and were not more resistant to any particular direction of load. Cortical thickness, miniscrew characteristics, force magnitude, direction and loading period are reported to be factors related to miniscrew stability [ 16 , 64 - 66 , 71 ].
However, one study found that the duration of loading did not influence the success rate of the miniscrews [ 70 ].
To prevent the miniscrew from loosening, the moments created during force application that may tend to unscrew the miniscrew have to be taken into consideration. To control these moments, clinicians have to carefully evaluate the force system applied to the miniscrew. If the application of such undesirable moments to the screw cannot be avoided, indirect anchorage is recommended [ 1 , 8 ].
Although the miniscrews may initially be stable, they may not remain stationary when subjected to orthodontic forces [ 72 , 73 ]. Liou et al. Liu et al. The researchers observed that both the molars and the miniscrews were displaced in the direction of force application and drifted mesially, but not by the same amount.
The molars drifted mesially 0. This result implied that the miniscrews might have come into contact with the roots following treatment. The different mesial-drift ratios of the molars and the miniscrews may be a critical factor in the loosening of miniscrews [ 74 ].
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As a precaution, the researchers [ 73 ] advised placing the miniscrews mesially for long-term stability. The conventional periodontal pressure—tension theory cannot explain the miniscrew displacement process. The Frost mechanostat theory instead identifies complex bone biomechanics [ 75 , 76 ]. The bone remodelling process at the bone—screw interface and the mechanism of screw displacement are correlated to the stress—strain field in the surrounding bone as a result of dynamic loading [ 77 , 78 ].
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Complications may be related to factors such as the clinician, the patient and the miniscrews themselves [ 79 ]. Once clinicians become accustomed to using miniscrews, their success rates increase [ 12 ]. Operators need to develop their skills to avoid damaging adjacent anatomical structures and the root of the tooth while placing the miniscrew.
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