|Year : 2015 | Volume
| Issue : 1 | Page : 26-28
A simple and efficient grid for accurate orthodontic implant placement
Dilip N Kumar, Krishna B. R Gopal, Naveen Shamnur, K Mithun
Department of Orthodontics, College of Dental Sciences, Davangere, Karnataka, India
|Date of Web Publication||21-Jan-2015|
Dilip N Kumar
Department of Orthodontics, College of Dental Sciences, Davangere, Karnataka
Source of Support: None, Conflict of Interest: None
Mini implant has been the major tool in anchorage management in present era. Accurate positioning of mini implant is critical due to the anatomical limitation and biomechanical utility of the implant. Currently several grids and guides are in use for the same purpose. The objective of the present article is to describe the fabrication of a simple grid for accurate positioning of orthodontic implants with minimal armaterium.
Keywords: Grids, implants, orthodontics
|How to cite this article:|
Kumar DN, Gopal KB, Shamnur N, Mithun K. A simple and efficient grid for accurate orthodontic implant placement. Dent Med Res 2015;3:26-8
| Introduction|| |
Very early in our history, orthodontists realized that the anchorage management is a critical issue in orthodontic treatment and plays an important role in the success or failure of orthodontic treatment. Since then they have used teeth, intraoral appliances and extra oral appliances to maximize the desired tooth movement and to minimize the unnecessary tooth movement. 
Advances in orthodontic materials have provided us the advantage of using orthodontic mini-implants as an effective device to control anchorage. Orthodonticmini-implants have become the most commonly used fixation device for anchorage control.
Site selection and accurate positioning of orthodontic mini-implants are very critical for following reasons:
- To avoid the risk of root perforation and damage to the adjacent structures
- For the stability of the implants
- For effectiveness of the implants.
Several guides and grids have been designed for accurate positioning of orthodontic mini-implants, ,, but this is a unique one which is fabricated by the author using a regular orthodontic wire which is very convenient and simple. The purpose of present article is to describe the fabrication of a simple grid for accurate positioning of orthodontic implants with minimal armaterium requirement.
The metal grid for orthodontic mini-implant is fabricated using 0.6 mm round stainless steel wire [Figure 1]a. Bend the wire to form a four column and row grid. Each cell of the grid measures 1.5 mm × 1.5 mm [Figure 1]b.
Adapt the fabricated grid on the cast relating it to the desired site of implant placement. Anocclusal blockis made using impression compound or self-cure acrylic material so that it holds the metal grid in its proper position [Figure 2]a and b.
|Figure 2: (a) Grid adapted to the model (b) Occlusal block holding the grid|
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Once the occlusal block with metal grid is ready, it is then transferred into the patient's mouth and a periapical radiographis taken to confirm the site of implant placement. Desired cell of the grid for accurate position of implant is selected on periapical radiograph [Figure 3]a and b.
|Figure 3: (a) Grid transferred to patients mouth (b) Radiographic view of the grid and surrounding structures|
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After administration of local anesthesia, a self-drilling and self-tapping implant is positioned through the selected cell of the metal grid and driven to its final position [Figure 4]a and b. After the placement of the implant, gently remove the grid. The flexibility of the metal grid provides easy removal of grid with implant in its position.
|Figure 4: (a) Implant placed in desired cell (b) Radiographic view showing final placement of implant|
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| Discussion|| |
With the increase in use of orthodontic mini-implants for anchorage control, varieties of devices and methods have been proposed for accurate implant positioning. The grid presented here is simple to fabricate and requires less materials as well as minimal lab procedures. The grid is universal as it can be used in both maxillary and mandibular arch as well as in anterior or posterior region.
The flexibility of the 0.6 mm stainless steel wire provides added advantage of adopting the grid in maxillary and mandibular arches as well as anterior and posterior region. Flexibility of the wire also allows easy removal of grid after implant placement. The grid can be detached from the occlusal block and reused in other patients after proper sterilization.
| Conclusion|| |
The grid is simple in design, easy to fabricate, economical, efficient, and provides accurate point of implant insertion and can be used with different types of orthodontic implants.
| References|| |
Cope JB. Temporary anchorage devices in orthodontics: A paradigm shift. Semin Orthod 2005;11:3-9.
Kravitz ND, Kusnoto B, Hohlt WF. A simplified stent for anterior miniscrew insertion. J Clin Orthod 2007;41:224-6.
Reddy KB, Kumar MP, Kumar MN. A Grid for guiding miniscrew placement. J Clin Orthod 2008;42:531-2.
Rachala MR, Aileni KR, Bukhari SA, Nagam SR. Tray-Grid guide for accurate mini-implant insertion. J Indian Orthod Soc 2012;46:109-12.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]