Guiding jig for accurate placement of temporary anchorage implants

Vimala Gnanasambandam; Sainath Muthiah Chidambaram; Manonmani Arumugam

doi:10.4103/0976-433X.129078

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Year : 2014 | Volume : 5 | Issue : 1 | Page : 65-66

Guiding jig for accurate placement of temporary anchorage implants

Vimala Gnanasambandam¹, Sainath Muthiah Chidambaram¹, Manonmani Arumugam²
¹ Department of Orthodontics and Dentofacial Orthopedics, Government Dental College and Hospital, Chennai, Tamil Nadu, India
² Department of Orthodontics and Dentofacial Orthopedics, Madha Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Web Publication

19-Mar-2014

Correspondence Address:
Vimala Gnanasambandam
Department of Orthodontics and Dentofacial Orthopedics, Tamil Nadu Government Dental College and Hospital, Chennai - 600 003, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/0976-433X.129078

Abstract

Introduction: Temporary anchorage devices are becoming an integral component of fixed orthodontic armamentarium. Success of implants, to a large extent depends on selecting and placing them in an ideal bone space. Locating the exact spot is critical and error of even a millimeter may injure the adjacent root. It is therefore advisable that guidance to locate the spot be utilized especially by a novice to refrain from untoward injury to neighboring anatomical structures. This paper describes about an efficient guiding jig that can be easily fabricated within few minutes of chair side time.

Keywords: Chair side, orthodontic temporary anchorage device (TAD), wire jig

How to cite this article:
Gnanasambandam V, Chidambaram SM, Arumugam M. Guiding jig for accurate placement of temporary anchorage implants. SRM J Res Dent Sci 2014;5:65-6

How to cite this URL:
Gnanasambandam V, Chidambaram SM, Arumugam M. Guiding jig for accurate placement of temporary anchorage implants. SRM J Res Dent Sci [serial online] 2014 [cited 2023 May 28];5:65-6. Available from: https://www.srmjrds.in/text.asp?2014/5/1/65/129078

Introduction

Temporary anchorage devices need to be placed in ideal bone spaces, midway between adjacent roots, with a minimum of 0.5 mm of bone space on either side. ^[1] Radiographs, scans, ^[2] and anatomical guidelines like interdental papilla ^[3] help us in deciding the spot for placing the implant. Yet, when it comes to chair side procedure, the accuracy of transferring the proposed implant spot as decided by radiographs and scans, on to the alveolus becomes a matter of visual assessment and judgment.

The suggested guiding jig provides an easy way to accurately locate the 'exact implant spot'. This wire frame work can be fabricated with ease, within few minutes of chair side time and can be checked for its position immediately with an intraoral periapical (IOPA) view radiograph. The wire used is a regular rectangular wire that is readily available in an orthodontist's clinical chair side armamentarium. Being a stainless steel wire frame work, it can also be sterilized. Intermediate procedures like impressions taking, laboratory work, preparation of transfer trays ^[4] and specially designed screws ^[5] that are not cost and time effective can be avoided. This suggested jig can be fabricated and used at the same appointment.

Fabrication of The Wire JIG

The wire jig is fabricated using a full slot rectangular wire and placed midway between the two teeth, where implant is planned [Figure 1] and [Figure 2]. It has a small 'U' stop loop, a perpendicular leg bearing few semicircular bends. When the minis crew implant is planned at molar region, the small 'U' stop loop is placed mesial to 2 ^nd molar tube or distal to 1 ^st molar tube. The wire is then bent at 90° at a point midway between the two teeth where implant is planned, corresponding to the interdental papilla. On this vertical leg, few opposing semicircles of diameter approximately equal to that of the implant are bent. This wire frame is held in place with a module. An IOPA radiograph is taken to check its position as related to the roots of adjacent roots and to decide the implant spot where there is sufficient bone with a minimum of 0.5 mm on either side of the circle [Figure 3]. Necessary changes if need be, can be incorporated at the 'U' loop region to bring the semicircles at inter radicular area and perpendicular to interdental papilla and checked before fixing the wire jig. The free end of a satisfactory jig can then be cinched. The 'U' stop loop and cinching of free end prevent any mesio - distal movement of the jig. The jig can also be fabricated for any other region - palatal/buccal/anterior/posterior in maxilla or mandible and designed to lie accordingly. In the anterior region where span for placing the 'U' stop is inadequate, the jig is extended to adjacent tooth where the stop can be placed.

As suggested, the success and stability of mini screw implants depend on the quality and quantity of cortical bone in which they are embedded. ^[6] The implant is best placed at the thickest cortical bone area. The appropriate semicircle lying at the maximum cortical thickness area, as suggested and with minimum of 0.5 mm bone space on either side of its circle can be identified using the IOPA. A pilot drill can be made at centre of the identified circle. The implant can then be placed unhindered while the jig is still on. The jig can easily be removed after placement of implant. This jig will especially be useful for beginners in this endeavor.

Figure 1: The design of wire jig. The 19×25 wire has a small adjustable 'U' loop stop, a perpendicular leg with opposing semicircles

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Figure 2: Wire fabrication design. (Scale exaggerated, semicircles of varying sizes to show possibilities of increasing their sizes as per size of implant)

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Figure 3: The position of jig can be checked with an intra oral radiograph and modified if need be

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References

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2.	Sergio EC, Guilherme J, Kelly C, Marcos RD, Jose FC, Arnaldo P.A three dimensional radiographic: Surgical guide for mini-Implant placement. J Clin Orthod 2006;40:548-54.
3.	Chun YS, Lee SK, Wikesjo UM, Lim WH. The interdental gingiva, a visible guide for placement of mini-implants. Orthod Craniofac Res 2009;12:20-4.
4.	Sabarinath VP, Hazarey PV, Narenndra S, Samir J. Precise, simultaneous bracket and miniscrew placement. J Clin Orthod 2009;43:513-4.
5.	Eduardo YS, Boonsiva B. An adjustable surgical guide for miniscrew placement. J Clin Orthod 2005;29:588-90.
6.	Hee JK, Hee SY, Hyun DP, Doo HK, Young CP. Soft-tissue and cortical-bone thickness at orthodontic implant sites. Am J Orthod Dentofacial Orthop 2006;130:177-82.