Guided Palatal Miniscrews Deviated About 1 mm at the Head and 3 mm at the Tip

Edited by Orthotown staff

Palatal miniscrews placed with surgical guides landed within about 1 mm of their planned position at the head but deviated by more than 3 mm on average at the tip, and denser bone was associated with greater error, according to a prospective clinical study published online Oct. 28 in International Orthodontics.

The study included 23 adults ages 18–25 with anterior open bite who needed intrusion of the maxillary posterior teeth with palatal miniscrew anchorage. A total of 46 self-drilling palatal miniscrews were placed at Mansoura University in Egypt between September 2024 and April 2026.

Investigators planned each placement virtually using CBCT and intraoral scans. After insertion, they scanned the miniscrews with attached scan bodies and superimposed the planned and actual positions to measure linear and angular deviation.

Mean global deviation was 0.94 mm at the miniscrew head and 3.21 mm at the tip, and mean angular discrepancy was 8.6 degrees. Results did not differ significantly between right- and left-side miniscrews, and no harm was observed.

Higher bone density at the insertion site was associated with greater tip deviation (r = 0.379, P = .009), greater vertical tip deviation (r = 0.302, P = .041), and greater angular discrepancy (r = 0.403, P = .005). Cortical bone thickness and planned intrabony insertion depth were not significantly associated with accuracy.

Waleed Mustafa Alshannaq, Ahmed Mohamed Kamel, and Marwa Ali Tawfik of the Department of Orthodontics at Mansoura University conducted the study, which was registered at ClinicalTrials.gov. The authors reported no funding and no competing interests.

The authors concluded that guided palatal miniscrew insertion produced variable transfer deviations. The study was conducted at a single center with 23 patients.

Sources:
International Orthodontics, “Association of bone density, cortical bone thickness, and planned intrabony depth with the accuracy of guided palatal miniscrew insertion in adult patients: A prospective clinical study,” published online Oct. 28, 2026: sciencedirect.com/science/article/pii/S1761722726001257
National Library of Medicine, PubMed, PMID 42950450: pubmed.ncbi.nlm.nih.gov/42950450