Accuracy of orthodontic mini-implants placed at the anterior palate by tooth-borne or gingiva-borne guide support: a cadaveric study

  • Stephan Christian MöhlhenrichEmail author
  • Maximilian Brandt
  • Kristian Kniha
  • Andreas Prescher
  • Frank Hölzle
  • Ali Modabber
  • Michael Wolf
  • Florian Peters
Original Article



The aim of this cadaveric study was to measure the transfer accuracy of orthodontic mini-implant placement at the anterior palate depending on tooth-borne or gingiva-borne guide support.

Materials and methods

Forty orthodontic mini-implants were placed paramedian in the anterior palate of 20 cadaver heads using tooth-borne (TBG) or gingiva-borne guides (GBG). Placement was planned after superimposition of lateral cephalograms and corresponding plaster models. After mini-implant placement, digital impressions were taken with scanbodies. For the measurement of both linear and angle deviations, virtual planning models and postoperative oral scans were compared using automatic surface registration based on an iterative closest point algorithm.


Statistical differences between TBG and GBG were detected for lateral deviations 0.88 mm (SD 0.46) versus 1.65 mm (SD 1.03) (p = .004) and sagittal angular deviations 3.67° (SD 2.25) versus 6.46° (SD 5.5) (p = .043). No differences were found for vertical deviations 2.34 mm (SD 0.74) versus 2.14 mm (SD 0.73) (p = .40) and transverse angular deviations 3.60° (SD 2.89) versus 4.06° (SD 3.04) (p = .62).


The use of surgical guides based on silicone provides sufficient control of orthodontic mini-implant placement and is comparable to CAD/CAM templates. However, when compared with guided dental implantology, the planned mini-implant position is more inaccurate. However, accuracy can be significantly increased by guide extension involving the teeth. Clinical investigations have to prove if the accuracy is sufficient for receiving an orthodontic appliance.

Clinical relevance

The use of lateral cephalograms and plaster models for silicone guide construction leads to lower radiation exposure and provides sufficient accuracy for palatal orthodontic mini-implant placement.


Orthodontics Mini-implant Orthodontic implants Transfer accuracy Surgical guides Surgical templates Temporary anchorage device (TAD) 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with living human participants or animals. Institutional approval was given.

Informed consent

Not required.

Sources of support

The orthodontic mini-implants were provided free of charge by OrthoLox, Promedia Medizintechnik A Ahnfeldt GmbH, Siegen, Germany.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Stephan Christian Möhlhenrich
    • 1
    Email author
  • Maximilian Brandt
    • 1
  • Kristian Kniha
    • 2
  • Andreas Prescher
    • 3
  • Frank Hölzle
    • 2
  • Ali Modabber
    • 2
  • Michael Wolf
    • 1
  • Florian Peters
    • 2
  1. 1.Department of OrthodonticsUniversity Hospital of RWTH AachenAachenGermany
  2. 2.Department of Oral and Maxillofacial SurgeryUniversity Hospital of RWTH AachenAachenGermany
  3. 3.Medical Faculty of RWTH AachenInstitute of Molecular and Cellular AnatomyAachenGermany

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