PARADIGM SHIFT WITH MINISCREWS: INNOVATIVE ORTHODONTIC ANCHORAGE
The advent of temporary anchorage devices (TAD) or miniscrews has created a dramatic paradigm shift within the specialty of orthodontics. Miniscrews have significantly altered the way that orthodontics is treatment-planned and provided the world over. These miniature “anchoring posts” improve predictability, effectiveness, and efficiency of orthodontic biomechanics; thereby, expanding our capabilities for many types of orthodontic tooth movement. Miniscrews offer options for treatments that were either extremely unpredictable or nearly impossible to achieve with conventional means. Although miniscrews are not needed for most patients’ orthodontic care, using them in specific situations can be a substantial advantage as sometimes headgear, extractions, or surgery may be avoided.
Miniscrews are a miniature screw implant, fabricated from bone-friendly titanium alloy, placed into the alveolar bone between the roots of teeth or in the roof of the mouth. Putting in these tiny screws is a rather quick process that requires some numbing of the gum tissue followed by a 30-60 second insertion. Once we are finished using them to enhance our orthodontics, they are removed in only a manner of seconds. Excellent oral hygiene is a must as these devices must be kept clean, but even then, some miniscrews simply get loose, are removed, and subsequently replaced.
We have a somewhat unique perspective on miniscrews as we’ve been involved since before introduction of this technology in the U.S. with the filing of a patent in 2001 for a miniscrew-supported appliance; now know as the Horseshoe Jet. We have also had the experience of working with 13 different miniscrew manufacturers from around the world. We have also placed more than 1300 of these devices as of 2010.
Dr. Bowman has also published numerous articles and three textbook chapters on the application and use of miniscrew anchors. He has been invited to lecture and teach these procedures around the world, including the Annual Session of the American Association of Orthodontists, Greater New York Dental Meeting, and the World Federation of Orthodontists meeting. He has also created a variety of appliances, devices, and methods for use with miniscrews such as the Horseshoe Jet, Ulysses Spring, TAD Bite Opening Auxiliary, Propeller Arms, etc.
Quintessence Books published “Mini-implants in Orthodontics: Innovative Anchorage Concepts,” a textbook co-edited and written by Dr. Bowman in collaboration with Dr’s. Björn Ludwig from Germany and Sebastien Baumgaertel, a professor at Case Western Reserve University. Dr. Berte Melsen from Aarhus University in Denmark and one of the original innovators in miniscrews, remarked that “this is the best textbook available on the topic.” In the Book Review published in the Journal of Clinical Orthodontics, Dr. Orhan Tuncay wrote, “I believe this is the best book available on the subject . . . it is highly recommended as a required textbook for teaching mini-implants . . . ” The book is available in English, German, Spanish and Portuguese.