[Biomechanics of mini-implants : analysis of the adverse effects of four clinical situations and proposed resolutions].

Abstract

The biomechanical adverse effects generated by our treatments must be considered among the failures of mini-implants, certainly excellent means of anchorage. The aim of this article was to illustrate and comment on mechanical adverse effects and to propose solutions. Four common clinical situations in vestibular technique are analyzed, decomposed three-dimensionally and solved. Maxillary incisor intrusion in direct traction (mini-implant between lateral incisors and canines in direct anchorage) can lead to a disto-labial rotation of the supporting teeth and an incisor flaring. Maxillary incisivo-canine retraction (mini-implant between 5 and 6 in direct anchorage) leads to a canine rotation, a clockwise rotation of the occlusal plane and a version of the adjacent teeth. The maxillary molar two-steps distalization (mini-implant between 5 and 6 with metal ligation to the canine) causes a rotation of the adjacent to the spring teeth, an incisor flaring and a molar disto-version. The protraction of a mandibular molar (mini-implant between 3 and 4 in direct anchorage) causes a disto-labial rotation, a lingual torque and a mesio-version of the molar as well as an incisor flaring and a clockwise rotation of the occlusal plan. The compensation bends on the adjacent teeth, the choice of the location and the type of mini-implant, the use of a power arms to get closer to the center of resistance are among the means of resolution. If mini-implants anchorage allows a significant quantitative effect, adverse effects should be considered individually with a three-dimensional biomechanical analysis.