Skeletal anchorage for everybody? A questionnaire study on frequency of use and clinical indications in daily practice

The purpose of this survey was to determine how commonly, and in what clinical situations, German-based orthodontists use skeletal anchorage devices in daily clinical practice. In early 2013, a set of questionnaires on the subject of skeletal anchorage devices was mailed to 2459 members of the German Orthodontic Society (Deutsche Gesellschaft fur Kieferorthopadie, DGKFO). The questions dealt separately with miniscrews (MSCs) and osseointegrated palatal implants (OPIs). The addressees were asked whether or not, as well as how frequently and in what clinical situations, they used these MSCs and/or OPIs, what their experience was, and to elaborate on their reasons for using or not using these devices. The rate of returned questionnaires was 48 %. To correctly interpret our data, it should be kept in mind that an unknown number of respondents did not distinguish between OPIs and palatally inserted MSCs. Overall, 62 % indicated that they did use MSCs and/or OPIs, although most of them (> 50 %) infrequently (a parts per thousand currency signaEuro parts per thousand 2 new patients/3 months). Only a parts per thousand currency signaEuro parts per thousand 2 % were frequent users (> 2 new patients/week). While most users (> 70 %) indicated that their experience was mostly good, only a parts per thousand currency signaEuro parts per thousand 50 % considered the devices easy and trouble-free to use in daily clinical practice. The median percentage of insertion procedures conducted by the respondents themselves was 2 % for MSCs and 0 % for OPIs. Many of the non-users indicated that their treatment concept did not include suitable clinical indications (a parts per thousand yenaEuro parts per thousand 50 %), expressed skepticism about the success rates (56 % of MSC and 21 % of OPI non-users), or thought that the insertion procedures involved were too complex or time-consuming (33 % of MSC and 56 % of OPI non-users). A total of 62 % of German-based orthodontists participating in this survey indicated using skeletal anchorage devices, although most of them infrequently. Major reasons for non-use were lack of clinical indications, skepticism about the success rate of MSCs, and overly complex or time-consuming procedures of surgical OPI insertion.