Review
Background
Methods
Focused question
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Patients: for which subgroups of patients with a need for en masse retraction of the upper incisors/canines
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Intervention: do orthodontic mini implants have a benefit over conventional devices?
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Control: compared to forgoing orthodontic mini implants (compared to conventional treatment)
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Outcome: with regard to treatment efficacy (anchorage control), treatment duration, potential harms (inflammation, implant loss)
Search strategy
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Search terms PubMed/MEDLINE (including MeSH terms)
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(“en-masse retraction” OR “incisor retraction” OR “front retraction” OR “orthodontic gap closure” OR or “orthodontic space closure” OR “extraction therapy” [mh])AND (“mini implants” OR “micro screws” OR “micro implants” OR “skeletal anchorage” OR “palatal implant” OR “skeletal” OR “skeletal anchorage” OR “implant” OR “bone screw” OR “temporary anchorage device” OR “TAD” OR “Bone screws”[mh] OR “intraosseous screw” OR “dental implants”[mh])
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AND (“anchorage loss” OR “anchorage quality” OR “quality of life” OR “benefit” or “harm” OR “efficacy” OR “side effects” OR “effect” OR “orthodontic anchorage procedures”[mh] OR “treatment outcome”[mh])
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Search terms EMBASE (including EMTREE terms)
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(“en-masse retraction” OR “incisor retraction” OR “front retraction” OR “orthodontic gap closure” OR “orthodontic space closure” OR “extraction therapy” [EMTREE]) AND (“mini implants” OR “micro screws” OR “micro implants” OR “skeletal anchorage” OR “palatal implant” OR “skeletal” OR “skeletal anchorage” OR “implant”[EMTREE] OR “bone screw”[EMTREE] OR “tooth implant”[EMTREE] “temporary anchorage device” OR “TAD” OR “Bone screws” OR “intraosseous screw” OR “dental implants”) AND (“anchorage loss” OR “anchorage quality” or “quality of life” OR “benefit” OR “harm” OR “efficacy” OR “side effects” OR “effect” OR “orthodontic anchorage”[EMTREE] OR “treatment outcome”)
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Hand search
Study selection
Data extraction and method of analysis
Quality assessment of selected studies
Dealing with missing data and zero values
Data synthesis
Results
Description of studies
Study selection
Reference | Reason for exclusion |
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Barros et al. (2017) [3] | Anchorage loss at first molar not specified |
Borsos et al. (2012) [7] | No en masse retraction (two step canine and front retraction) |
Dai et al. (2009) [10] | Chinese language |
Durrani et al. (2017) [13] | Anchorage loss a first molar not specified |
El-Beialy et al. (2009) [14] | Anchorage loss a first molar not specified |
Garfinkle et al. (2008) [16] | Anchorage loss at first molar not specified |
Heo et al. (2007) [18] | No mini implants used for anchorage |
Herman et al. (2006) [19] | Anchorage loss a first molar not specified |
Janson et al. (2013) [22] | Anchorage loss a first molar not specified |
Jee et al. (2014) [23] | Use of mini implants and mini-plates |
Kuroda et al. (2009) [27] | T0 ceph before leveling (anchorage loss not specified during en masse retraction only) |
Liu et al. (2011) [29] | Anchorage loss at first molar not specified |
Ma et al. (2015) [30] | Full-text unavailable (requested but no response from authors) |
Miyazawa et al. (2010) [33] | Anchorage loss at first molar not specified |
Monga et al. (2016) [35] | Retrospective study |
Park et al. (2004) [38] | Case report |
Park et al. (2007) [40] | Case report |
Park et al. (2008) [41] | Retrospective study |
Santiago et al. (2009) [43] | No en masse retraction, anchorage loss at first molar not specified |
Shi et al. (2008) [44] | Extraction of premolars or molars |
Thiruvenkatachari et al. (2006) [46] | Canine retraction only |
Turkoz et al. (2011) [47] | No premolars extracted |
Upadhyay et al. (2012) [51] | No premolar extraction |
Gollner et al. (2009) [17] | No premolar extraction |
Wehrbein et al. (1996a) [55] | Case report |
Wehrbein et al. (1996b) [56] | Case report |
Xu et al. (2008) [59] | Language not meeting inclusion criteria |
Xun et al. (2004) [61] | Language not meeting inclusion criteria |
Yao et al. (2008) [62] | Retrospective study, mini-plates, and mini implants used |
Reference | Number of patients | Type of study (RCT/CCT/other) | Control intervention | Type of implant (length, material) | Number of implants | Location of implant | Mode of anchorage (direct/indirect) |
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Al-Sibaie and Hajeer [1] | 56 (28 implant, 28 non implant) | RCT | TPA | Self-drilling titanium mini implants (1.6 mm diameter and 7 mm length; Tuttlingen, Germany) | 2 | Between the maxillary second premolar and first molar | Direct |
Basha et al. [4] | 14 (7 implant, 7 non implant) | RCT | TPA | Surgical steel mini implants (1.3 mm diameter, 8 mm length; SK Surgical, Pune, India.) | 2 | Placed between the roots of second premolar and first molar in the maxilla | Direct |
Benson et al. [5] | 51 (23 implant; 24 non implant) | RCT | Headgear | Ortho implant, (6 mm length, Straumann, Waldenburg, Switzerland) | 1 | Midpalatal | Indirect |
Chopra et al. [9] | 50 (25 implant; 25 non implant) | RCT | Nance button; lingual arch | Self-drilling titanium ortho implants | 4 | Buccal alveolar bone between the second premolars and first molars in all the four quadrants | Indirect |
Davoody et al. [11] | 46 (23 implant, 23 non-implant group) | RCT | Intrusion arch and mushroom loops | 1.8–2 mm in width, 8–9 mm in length | 4 | Placed between maxillary second premolars and first molars in all four quadrants | Direct |
Liu et al. [28] | 34 | RCT | TPA | Self-tapping titanium mini-screw implants (8 mm length, 1.2 mm diameter, Cibei, Ningbo, China) | 2 | Between the roots of the first molar and the second premolar | Direct |
Upadhyay et al. [49] | 30 (15 implant, 15 non-implant) | RCT | Treatment in control group not specified: Nance holding arch, extraoral traction, banding of the second molars, and differential moments | Custom made at our institute by modifying conventional surgical screws, measuring 1.3 mm in diameter and 8 mm in length | 2 | Placed between the maxillary second premolar and first molar, preferably between the attached and movable mucosae | Direct |
Upadhyay et al. [48] | 23 | Other (cohort study) | No control group | Titanium mini implants (1.3 mm in diameter and 8 mm in length) | 2 | Placed between the roots of the first molar and the second premolar in both upper quadrants | Direct |
Upadhyay et al. [50] | 40 (20 implant, 20 non implant) | RCT | Conventional methods such as headgears, transpalatal arches, banding of second molars, application of differential moments | Titanium mini implants (1.3 mm diameter, 8 mm length) | 4 | Between the roots of the first molar and second premolar in all four quadrants | Direct |
Victor et al. [52] | 20 (10 implant, 10 non-implant) | RCT | NiTi closed coil spring | Absoanchor—SH 1312-08; (1.3 mm diameter, 8 mm length) | 4 | Placed between the roots of second premolar and first molar in the upper arch, the screw insertion was angulated at 40° and 8 mm gingival to the archwire | Direct |
Wehrbein et al. [54] | 9 | Other (cohort study) | No control group | Orthosystem (diameter 3.3 mm, lengths are 4 and 6 mm) | 1 | Midpalatal | Indirect |
Wilmes et al. [57] | 20 (10 in implant group of which 5 patients had additional transversal reinforcement and 5 did not, 10 in non-implant group) | CCT | TPA | 2.0 × 10 mm, Dual Top™, Jeil Medical Corporation, Seoul, South Korea, or 2.0 × 11 mm, BENEFIT, Mondeal Medical Systems, Mühlheim a.d. Donau, Germany | 1 | Placed in the anterior palate | Indirect |