Load-related implant reaction of mini-implants used for orthodontic anchorage

The purpose of this study was to determine the clinical and biomechanical outcome of two different titanium mini-implant systems activated with different load regimens. A total of 200 mini-implants (102 Abso Anchor((R)) and 98 Dual Top((R))) were placed in the mandible of eight Gottinger minipigs. Two implants each were immediately loaded in opposite direction by various forces (100, 300 or 500 cN) through tension coils. Additionally, three different distances between the neck of the implant and the bone rim (1, 2 and 3 mm) were used. The different load protocols were chosen to evaluate the load-related implant performance. The load was provided by superelastic tension coils, which are known to develop a virtually constant force. Non-loaded implants were used as a reference. Following an experimental loading period of 22 and 70 days half of the minipigs were sacrificed, and implant containing bone specimens evaluated for clinical performance and implant stability. Implant loosing was found to be statistically dependent on the tip moment (TM) at the bone rim. Clinical implant loosing were only present when load exceeded 900 cN mm. No movement of implants through the bone was found in the experimental groups, for any applied loads. Over the two experimental periods the non-loaded implants of one type of implant had a higher stability than those of the loaded implants. Dual Top((R)) implants revealed a slightly higher removal torque compared with Abso Anchor((R)) implants. Based on the results of this study, immediate loading of mini-implants can be performed without loss of stability when the load-related biomechanics do not exceed an upper limit of TM at the bone rim.