D Michelogiannakis1, F Javed1, H Vastardis2. 1. Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA. 2. Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece. vastard@dent.uoa.gr.
Abstract
AIM: To review currently available evidence regarding the use of mini-screw implant (MSI)-supported pontics for the transitional management of missing permanent maxillary lateral incisors in children and adolescents. METHODS: Indexed databases were searched until October 2019. The following inclusion criteria were imposed: (a) children and adolescents with missing permanent maxillary lateral incisor/s; (b) temporary replacement of missing permanent maxillary lateral incisors with MSI-supported pontics; (c) clinical and radiographic assessment of the outcome [MSI stability and/or alveolar bone (ALB) development]; and (d) follow-up after pontic placement. Commentaries, letters to the Editor, reviews, and studies in adult patients and/or patients with systemic/genetic diseases, with no follow-up, and without clinical and radiographic assessment of the outcome were excluded. RESULTS: Six out of 225 initially-identified studies were included. All studies were case-reports/series. A variability was observed among studies-assessed regarding the treatment protocol such as in the MSI dimensions, loading time and pontic retention protocol. Results from the included studies indicate that the MSI-supported pontics remained stable, with no infraocclusion and angular bony defect formation, ALB levels and bone density were maintained, and there was vertical ALB development during the follow-up period which ranged up to 99 months. Reported complications included MSI loss due to mobility, crown repair/replacement due to discoloration, and gingival impingement. CONCLUSIONS: The limited evidence shows that MSI-supported pontics are useful transitional restorations for missing permanent maxillary lateral incisors in children and adolescents; however, further well-designed clinical trials are needed in this regard.
AIM: To review currently available evidence regarding the use of mini-screw implant (MSI)-supported pontics for the transitional management of missing permanent maxillary lateral incisors in children and adolescents. METHODS: Indexed databases were searched until October 2019. The following inclusion criteria were imposed: (a) children and adolescents with missing permanent maxillary lateral incisor/s; (b) temporary replacement of missing permanent maxillary lateral incisors with MSI-supported pontics; (c) clinical and radiographic assessment of the outcome [MSI stability and/or alveolar bone (ALB) development]; and (d) follow-up after pontic placement. Commentaries, letters to the Editor, reviews, and studies in adult patients and/or patients with systemic/genetic diseases, with no follow-up, and without clinical and radiographic assessment of the outcome were excluded. RESULTS: Six out of 225 initially-identified studies were included. All studies were case-reports/series. A variability was observed among studies-assessed regarding the treatment protocol such as in the MSI dimensions, loading time and pontic retention protocol. Results from the included studies indicate that the MSI-supported pontics remained stable, with no infraocclusion and angular bony defect formation, ALB levels and bone density were maintained, and there was vertical ALB development during the follow-up period which ranged up to 99 months. Reported complications included MSI loss due to mobility, crown repair/replacement due to discoloration, and gingival impingement. CONCLUSIONS: The limited evidence shows that MSI-supported pontics are useful transitional restorations for missing permanent maxillary lateral incisors in children and adolescents; however, further well-designed clinical trials are needed in this regard.