Mechanical and clinical evaluation of the effect of microscrew on root proximity and cortical bone thickness

Abstract

Background/objectives: Primary stability is required for successful use of microscrew. This study investigated correlations among biomechanical, morphological, and clinical values in relationship to root contact and different placement locations.

Materials/methods: Thirty-three microscrews were placed between the molars (n = 18) or in the body of the mandible (n = 15) in three pigs. Insertion torque, Periotest, resonance frequency analysis (RFA), and static and dynamic stiffness were measured. Cone beam computed tomography was performed before and after the insertion of microscrews. Interproximal microscrews were divided into root contacted microscrews (n = 9) and non-root contact microscrews (n = 9). Factorial analysis of variance was conducted, with significance set at P < 0.05.

Results: A significant difference was observed between bodily and root contacted microscrews in Periotest, RFA, static and dynamic stiffness, Tanδ, and bone density (RFA, P = 0.045; all others, P < 0.001). A significant difference was observed between bodily and non-root contact microscrews in Periotest, RFA, and bone density (RFA, P = 0.025; all others, P < 0.001). A significant difference was observed in static (P = 0.01) and dynamic (P = 0.038) stiffness between microscrews with and without contact. Dynamic stiffness (P = 0.02) and Tanδ (P = 0.03) showed significant correlations with Periotest results only in bodily microscrews.

Limitations: Since a pig bone was used, some differences in the quality and quantity of the bone might be observed between humans.

Conclusions/implications: Stiffness values distinguished between microscrews with and without contact. Periotest and RFA results indicated that bodily microscrews were more stable than interproximal microscrews. Periotest and RFA may be useful with large, microscrews and/or in thick cortical bone, but further investigation is required to determine the stability of interproximal microscrews.