Navigazione dinamica per l’inserimento di miniviti nella volta palatina: uno studio pilota

OBJECTIVES The use of dynamic navigation for orthodontic miniscrew inser- tion is not sufficiently discussed in the literature. This pilot prospective study aimed to assess the accuracy of Dynamic Navigation systems in placing miniscrew in the palatine vault by evaluating the discrep- ancy between planned and actu- al miniscrew positions in minis- crew placement. MATERIALS AND METHODS 23 subjects were included in the study, 15 males and 8 females (mean age: 14 years; min 11- max 17 years) and 46 minis- crews were inserted. CBCTs were performed on each subject both before and after the minis- crew insertion, the intra-oral scanning was performed before the miniscrew insertion to over- lap the STL file to the DICOM file. The Navident system (ClaroNav Technology Inc., Toronto, Canada) was used for miniscrew planning and placement. Four variables were assessed to compare the vir- tual planned miniscrew site with the actual miniscrew position: en- try 3D, apex 3D, apex depth, and angular deviation. A descriptive statistical analysis was performed. RESULTS The mean entry point 3D deviation was 2.55 mm (range: 0.83-5.2 mm; SD 1.12); the mean apex point 3D deviation was 3.10 mm (range: 0.44-5.85 mm; SD 1.49); the mean apex vertical point devi- ation was 0.87 mm (range: 0.01- 3.05 mm; SD 0.80); the mean an- gular deviation was 8.50° (range: 0°-28.4°; SD 6.68).CONCLUSIONS It is possible to conclude that the accuracy of dynamic navigation for miniscrew insertion is clinically acceptable, demonstrating a sat- isfying vertical control but, on the other side, a low accuracy in an- gular deviation. CLINICAL SIGNIFICANCE The conclusions of this study are crucial for clinicians, especially considering how angular devia- tion can complicate the con- struction of orthopedic-ortho- dontic devices. The results of this study provide a guidance for practitioners during mini-screw insertion, enabling them to enhance operational practices and ensure safe and precise insertion. This information should be care- fully considered and used as a constant warning during proce- dures to adopt appropriate pre- ventive measures to minimize the risk of damage to surrounding anatomical structures. Through continuous real-time monitoring, effective insertion can be ensured, allowing patients to fully benefit from orthodontic therapies with miniscrews. This study represents a signifi- cant contribution to the advance- ment of orthodontic practice, promising excellent results and tangible benefits for the involved patients.