Radiolucent Lesions Associated with Stainless Steel Mini-Implants During Routine Examination with Cone Beam Computed Tomography-An Observational Study

Authors

  • A. Sumathi Felicita Professor, Department of Orthodontics, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India. Author https://orcid.org/0000-0003-2002-0140
  • T.N. Uma Maheswari Professor, Department of Oral Medicine, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India. Author https://orcid.org/0000-0002-2366-2336

DOI:

https://doi.org/10.15517/8mqydn95

Keywords:

Mini-implant; Radiolucent lesion; CBCT.

Abstract

The aim of this study was to determine the prevalence of radiolucent lesions around mini-implants used for orthodontic anchorage due routine evaluation with cone beam computed tomography. Twenty two mini-implants were examined prior to and after orthodontic treatment in young adults requiring absolute anchorage. All mini-implants were placed in the maxillary arch between the second premolar and first permanent molar. CBCT taken immediately after mini-implant placement (T1) and towards the end of treatment (T2) were checked for the presence of radiolucency around the mini-implants. A radiolucent lesion was recorded when it was present in any one of the planes, either the tangential or cross-sectional view of the panoramic window or the coronal or sagittal view of the multiplanar window. The presence/absence of radiolucency was checked individually at T1 and T2 and also compared between T1 and T2. Descriptive statistics with frequency distribution and percentage was done.  31.82% of mini-implants showed a small radiolucency at its tip at T1 and T2. 13.64% of mini-implants showed a linear radiolucency along the length of the mini-implant at T1 and T2. Two mini-implants had periapical lesion at the time of mini-implant at T1 which exaggerated and increased in size at T2 while two mini-implants had a tiny periapical lesion at T1 which resolved at T2. Three mini-implants had radiolucent lesions around the tip of the mini-implant at T1 which changed to a linear radiolucency along the length of the mini-implant at T2 and vice versa.  45.45% of all the mini-implants evaluated showed the presence of radiolucency around it at T1 and 50% of all the mini-implants evaluated showed radiolucency at T2.

Downloads

Download data is not yet available.

References

Kumar V., Ludlow J.B., Mol A., Cevidanes L. Comparison of conventional and cone beam CT synthesized cephalograms.Dentomaxillofac Radiol 2007; 36: 263-269.

Nalc¸aci R., Oztu¨rk F., So¨ku¨cu¨ O. A comparison of two dimensional radiography and three-dimensional computed tomography in angular cephalometric measurements. Dentomaxillofac Radiol 2010; 39: 100-106.

Chien P.C., Parks E.T., Eraso F., Hartsfield J.K., Roberts W.E., Ofner S. Comparison of reliability in anatomical landmark identification using two-dimensional digital cephalometrics and three-dimensional cone beam computed tomography in vivo. Dentomaxillofac Radiol 2009; 38: 262-273

Chidiac J.J., Shofer F.S., Al-Kutoub A., Laster L.L., Ghafari J. Comparison of CT scanograms and cephalometric radiographs in craniofacial imaging. Orthod Craniofac Res 2002; 5: 104-113.

Greiner M., Greiner A., Hirschfelder U. Variance of landmarks in digital evaluations: comparison between CT-based and conventional digital lateral cephalometric radiographs. J Orofac Orthop 2007; 68: 290-298.

Madhur Upadhyay, Sumit Yadav, K. Nagaraj, Ravindra Nanda. Dentoskeletal and Soft Tissue Effects of Mini-Implants in Class II division 1 Patients. Angle Orthod 2009; 79: 240-247.

Felicita A.S. Quantification of intrusive/retraction force and moment generated during en- masse retraction of maxillary anterior teeth using mini-implants: a conceptual approach. Dental Press J Orthod 2017; 22: 47-55.

Nur, M., Bayram, M., Celikoglu, M., Kilkis, D. & Pampu, A. A. Effects of maxillary molar distalization with Zygoma-Gear Appliance. Angle Orthod 2012; 82: 596-602.

Alsafadi A.S., Alabdullah M.M., Saltaji H., Abdo A., Youssef M. Effect of molar intrusion with temporary anchorage devices in patients with anterior open bite: a systematic review. Prog Orthod. 2016; 17: 122-4.

Fayed, M. M. S., Pazera, P. & Katsaros, C. Optimal sites for orthodontic mini-implant placement assessed by cone beam computed tomography. Angle Orthod 2010; 80: 939-951.

Hyo-Sang Park, Seong-Hwa Jeong, and Oh-Won Kwon. Factors affecting the clinical success of screw implants used as orthodontic anchorage. Am J Orthod Dentofacial Orthop 2006; 130: 18-25.

Miyawaki, S. Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage. Am. J. Orthod. Dentofac. Orthop. 2003; 124: 373-378.

Bhoosreddy A.R., Sakhavalkar P.U. Image deteriorating factors in cone beam computed tomography, their classification, and measures to reduce them: A pictorial essay. J Indian Acad Oral Med Radiol 2014; 26: 293-7.

Makins S.R. Artifacts interfering with interpretation of cone beam computed tomography images. Dent Clin North Am. 2014; 58: 485-495.

Sinha A., Mishra A., Srivastava S., Sinha P.M., Chaurasia A. Understanding artifacts in cone beam computed tomography. Int J Maxillofac Imaging. 2016; 2: 51-3.

Felicita, A. S. A simple three-dimensional stent for proper placement of mini-implant. Prog. Orthod 2013; 14: 45-48

Felicita A.S., Wahab T.U.L. Minimum volume of infiltrative anesthetic required for pain-free placement of mini-implants: a split-mouth clinical trial. Quintessence Int. 2023; 54: 16-22.

Peñarrocha-Diago M., Boronat-Lopez A., García-Mira B. Inflammatory implant periapical lesion: etiology, diagnosis, and treatment--presentation of 7 cases. J Oral Maxillofac Surg. 2009; 67: 168-73.

Zhou W., Han C., Li D., Li Y., Song Y., Zhao Y. Endodontic treatment of teeth induces retrograde peri-implantitis. Clin Oral Implants Res. 2009; 20: 1326-32.

Temmerman A., Lefever D., Teughels W., Balshi T.J., Balshi S.F., Quirynen M. Etiology and treatment of periapical lesions around dental implants. Periodontol 2000. 2014; 66: 247-54.

Esposito M., Hirsch J., Lekholm U., Thomsen P. Differential diagnosis and treatment strategies for biologic complications and failing oral implants: a review of the literature. Int J Oral Maxillofac Implants. 1990; 14: 473-90.

Ayangco L., Sheridan P.J. Development and treatment of retrograde peri-implantitis involving a site with a history of failed endodontic and apicoectomy procedures: a series of reports. Int J Oral Maxillofac Implants. 2001; 16: 412-7.

Chaffee N.R., Lowden K., Tiffee J.C., Cooper L.F. Periapical abscess formation and resolution adjacent to dental implants: a clinical report. J Prosthet Dent. 2001; 85: 109-12.

Deguchi T., Takano-Yamamoto T., Kanomi R., Hartsfield J.K. Jr Roberts W.E., Garetto L.P. The use of small titanium screws for orthodontic anchorage. J Dent Res 2003; 82: 377-81.

Adel S.M., Vaid N.R., El-Harouni N., Kassem H., Park J.H., Zaher A.R. Quantifying maxillary anterior tooth movement in digital orthodontics: Does the choice of the superimposition software matter. J World Fed Orthod. 2023; 12: 187-196.

Akca K., Iplikcioglu H. One-year follow-up of an implant with early radiographic signs of loss of osseointegration: case report. Clin Implant Dent Relat Res. 2002; 4: 43-46.

Wanderley V.A., Leite A.F., de Faria Vasconcelos K., Pauwels R., Müller-García F., Becker K., Oliveira M.L., Jacobs R. Impact of metal artefacts on subjective perception of image quality of 13 CBCT devices. Clin Oral Investig. 2022; 26: 4457-4466.

Salari Y., Sakhdari S., Hafezi L., Bidoki F.Z., Mosaddad S.A. The effects of anatomical location and distance from dental implants on the quality and quantity of metal artifacts in cone beam computed tomography scans: a cross-sectional study. Egyptian Journal of Radiology and Nuclear Medicine. 2024 30; 55: 27.

Klintström E., Smedby O., Klintström B., Brismar T.B., Moreno R. Trabecular bone histomorphometric measurements and contrast-to-noise ratio in CBCT. Dentomaxillofac Radiol. 2014; 43: 20140196.

Ni X., Shi Z., Song X., et al. Metal artifacts reduction in kV-CT images with polymetallic dentures and complex metals based on MV-CBCT images in radiotherapy. Sci Rep. 2023; 13: 8970.

Lucas de Paula Lopes Rosado, Izabele Sales Barbosa, Sibele Nascimento de Aquino, Rafael Binato Junqueira, and Francielle Silvestre Verner. Dental students' ability to detect maxillary sinus abnormalities: A comparison between panoramic radiography and cone-beam computed tomography. Imaging Sci Dent. 2019; 49: 191-199.

Luz J., Greutmann D., Wiedemeier D., Rostetter C., Rücker M., Stadlinger B. 3D-evaluation of the maxillary sinus in cone-beam computed tomography. Int J Implant Dent. 2018; 4: 17.

Jia X., Chen X., Huang X. Influence of orthodontic mini-implant penetration of the maxillary sinus in the infrazygomatic crest region. Am J Orthod Dentofacial Orthop. 2018; 153: 656-661.

Alansari R.A., Zawawi K.H., Vaiid N., et al. Is motor-driven insertion of orthodontic miniscrews more advantageous than manual insertion? A micro-CT evaluation of bone miniscrew contact surface area and cortical microcracks in rabbits. Orthod Craniofac Res. 2024; 27: 853-859.

Juan-Antonio Blaya-Tárraga, Juan Cervera-Ballester, David Peñarrocha-Oltra, and Miguel Peñarrocha-Diago. Periapical implant lesion: A systematic review Med Oral Patol Oral Cir Bucal. 2017; 22: e737-e749.

María Peñarrocha-Diago, Laura Maestre-Ferrín, Juan Cervera-Ballester, and David Peñarrocha-Oltra. Implant periapical lesion: Diagnosis and treatment. Med Oral Patol Oral Cir Bucal. 2012; 17: e1023-e1027.

Mosaddad S.A., Talebi S., Keyhan S.O., et al. Dental implant considerations in patients with systemic diseases: An updated comprehensive review. J Oral Rehabil. 2024; 51: 1250-1302.

Juan-Antonio Blaya-Tárraga, Juan Cervera-Ballester, David Peñarrocha-Oltra, and Miguel Peñarrocha-Diago. Periapical implant lesion: A systematic review Med Oral Patol Oral Cir Bucal. 2017; 22: e737-e749.

Kaya S., , Yavuz I., , Uysal I., , Akkus Z. Measuring bone density in healing periapical lesions by using cone beam computed tomography: a clinical investigation. J Endod 2012; 38: 28-31.

Alqahtani A.A., Alam M.K., Alahmari B.S., Srivastava K.C. Effects of low-level laser therapy on orthodontic tooth movement: Evaluation of bone density changes via 3DCBCT. Bangladesh Journal of Medical Science. 2025; 11: 133-43.

María Peñarrocha-Diago, Laura Maestre-Ferrín, Juan Cervera-Ballester, and David Peñarrocha-Oltra. Implant periapical lesion: Diagnosis and treatment. Med Oral Patol Oral Cir Bucal. 2012; 17: e1023-e1027.

Dillenseger J.P., Gros C.I., Sayeh A., Rasamimanana J., Lawniczak F., Leminor J.M., Matern J.F., Constantinesco A., Bornert F., Choquet P. Image quality evaluation of small FOV and large FOV CBCT devices for oral and maxillofacial radiology. Dentomaxillofac Radiol. 2017; 46: 20160285.

Grüning M., Koivisto J., Mah J., Bumann A. Impact of thyroid gland shielding on radiation doses in dental cone beam computed tomography with small and medium fields of view. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 ; 134: 245-253.

Akyalcin S., English J.D., Abramovitch K.M., Rong X.J. Measurement of skin dose from cone-beam computed tomography imaging. Head Face Med. 2013; 9: 9: 28.

Published

2025-12-10