Jung-Yul Cha; Hyung-Seog Yu; Chung-Ju Hwang

doi:10.4041/kjod.2010.40.3.167

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The validation of Periotest values for the evaluation of orthodontic mini-implants’ stability

Original Article

Korean J Orthod 2010;40(3):167-175.

Published online: 19 January 2010

DOI: https://doi.org/10.4041/kjod.2010.40.3.167

The validation of Periotest values for the evaluation of orthodontic mini-implants’ stability

Jung-Yul Cha, DDS, MSD, PhD^a, Hyung-Seog Yu, DDS, MSD, PhD^b, Chung-Ju Hwang, DDS, MSD, PhD^b

^aAssitant Professor, Department of Orthodontics, College of Dentistry, Yonsei University.

^bDepartment of Orthodontics, College of Dentistry, Yonsei University.

Corresponding author: Chung-Ju Hwang. Department of Orthodontics, College of Dentistry, Yonsei University, 250, Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea. +82 2 2228 3106; e-mail, hwang@yuhs.ac.

Received 12 December 2008 Revised 9 October 2009 Accepted 12 October 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective:

The aim of this study was to validate the Periotest values for the prediction of orthodontic mini-implants’ stability.

Methods:

Sixty orthodontic mini-implants (7.0 mm x Ø1.45 mm; ACR, Biomaterials Korea, Seoul, Korea) were inserted into the buccal alveolar bone of 5 twelve month-old beagle dogs. Insertion torque (IT) and Periotest values (PTV) were measured at the installation procedure, and removal torque (RT) and PTV were recorded after 12 weeks of orthodontic loading. To correlate PTV with variables, the cortical bone thickness (mm) and bone mineral density (BMD) within the cortical bone and total bone area were calculated with the help of CT scanning.

Results:

The BMD and cortical bone thickness in mandibular alveolus were significantly higher than those of the maxilla (p ＜ 0.05). The PTV values ranged from −3.2 to 4.8 for 12 weeks of loading showing clinically stable mini-implants. PTV at insertion was significantly correlated with IT (−0.51), bone density (−0.48), cortical bone thickness (−0.42) (p ＜ 0.05) in the mandible, but showed no correlation in the maxilla. PTV before removal was significantly correlated with RT (−0.66) (p ＜ 0.01) in the mandible.

Conclusions:

These results show that the periotest is a useful method for the evaluation of mini-implant stability, but it can only be applied to limited areas with thick cortical and high density bone such as the mandible.

Keywords: Periotest, Orthodontic mini-implants, Insertion torque, Mobility

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Fig 1.

Periotest (Siemens, Bensheim, Germany) and clinical application for the mobility test of mini-implants.

Fig 2.

Bone mineral density calibration procedure. The scanned images were reconstructed to a transaxial image for each occlusal plane of the maxilla and mandible, and the average bone mineral density inside of cylindrical area (red box; diameter, 2 mm; depth, 5 mm) was measured by Hounsfield unit using V-implant program (CyberMed, Seoul, Korea).

Table 1.

Range of periotest value (PTV), insertion torque, and removal torque for loading periods of maxilla and mandible

Variables		Mobility(PTV)			Insertiontorque(Ncm) Removaltorque(Ncm)
Period(weeks	0		12		0		12
	Mean	SD	Mean	SD	Mean	SD	Mean	SD
Maxilla Mandible	1.1 −3.2	3.8 3.6	4.8 2.4	4.5 3.8	5.8 17.4	2.6 5.7	2.1 3.6	0.9 1.0

PTV, Periotest value; SD, standard deviation; PTV with − 8 to＋9 indicates clinically firm teeth or implant is well osseo integrated, PTV over＋ 10 indicates implant is no tor not sufficiently osseo integrated (Shulte and Lukas, 1992).

Table 2.

Comparison of bone mineral density (BMD) and cortical bone thickness of implantation site

Variables	BMDcortical (mgHA/cm³)			BMDtotal (mgHA/cm³)			Corticalbonethickness (mm)
	Mean	SD	Sig	Mean	SD	Sig	Mean	SD	Sig
Maxilla	866.9	218.8	∗	581.3	183.6	∗	1.3	0.6	∗
Mandible	1039.6	183.7		741.6	175.3		2.0	0.4

SD, Standard deviation; Sig, significance;

^∗ p <0.05.

Table 3.

Correlation of periotest value (PTV) with each variable at implantation of mini-implant

Position		Variables	Insertiontorque (Ncm)	BMDcortical (mgHA/cm³)	BMDtotal (mgHA/cm³)	Corticalbone thickness(mm)
PTV	Maxilla	Correlationcoefficient	−0.32	−0.07	−0.29	−0.11
		p value	0.14	0.75	0.18	0.63
	Mandible	Correlationcoefficient	−0.51^∗	−0.12	−0.48^∗	−0.42^∗
		p value	0.01	0.55	0.021	0.047

BMD cortical, Bone mineral density of cortical bone; BMD total, bone mineral density of total bone area;

^∗ p <0.05.

Table 4.

Correlation of periotest value (PTV) with each variable at removal of mini-implant

Position	Variables	Removaltorque (Ncm)	BMDcortical (mgHA/cm³)	BMDtotal (mgHA/cm³)	Corticalbone thickness(mm)
PTV Maxilla	Correlationcoefficient	−0.27	−0.22	0.24	0.23
	p value	0.084	0.16	0.12	0.15
Mandible	Correlationcoefficient	−0.66^∗	−0.09	−0.11	0.078
	p value	0.00	0.53	0.46	0.62

BMD cortical, Bone mineral density of cortical bone; BMD total, bone mineral density of total bone area;

^∗ p <0.01.

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