There is no unequivocal scientific consensus for the temporary anchorage device (TAD) positioning in the infrazygomatic crest area (IZC). The two principal aims of this systematic review were to assess bone availability in the IZC and to establish both the target site and the need for cone-beam computed tomography (CBCT) prior to miniscrew placement. The study was performed following PRISMA guidelines (PROSPERO: CRD42023411650). The inclusion criteria were: at least 10 patients, three-dimensional radiological examination, and IZC assessment for the TAD placement. ROBINS-I tool and Newcastle-Ottawa Scale were used for quality evaluation. No funding was obtained. The study was based on the information coming from: PubMed, Google Scholar, Web of Science Core Collection, MDPI, Wiley, and Cochrane Libraries. The last search was carried out on 1 August 2023. Fourteen studies were identified for analysis. A narrative synthesis was performed to synthesize the findings of the different studies. Unfortunately, it is not possible to establish the generally recommended target site for IZC TAD placement. The reasons for this are the following: heterogeneity of available studies, inconsistent results, and significant risk of bias. The high variability of bone measurements and the lack of reliable predictors of bone availability justify the use of CBCT for TAD trajectory planning. There is a need for more high-quality studies aiming three-dimensional bone analysis of the IZC. 

Should Cone-Beam Computed Tomography Be Performed Prior to Orthodontic Miniscrew Placement in the Infrazygomatic Crest Area?—A Systematic Review

Abstract Background The insertion positions of mini-implant in infrazygomatic crest has been reported, but due to the anatomical variation, the precise location of this site is not clear yet. This study used cone-beam computed tomography (CBCT) to analyze the position and angle of mini-implants successfully inserted in the infrazygomatic crest, with the goal of providing reference data for clinical practice. Methods CBCT was used to image 40 mini-implants and their surrounding tissues in adult orthodontic patients who successfully underwent mini-implant insertion in the infrazygomatic crest. The insertion positions and angles of mini-implants were measured, and the thicknesses of buccal and palatal bone adjacent to the mini-implants were also recorded. Then, we proposed the position and implantation angle for infrazygomatic crest insertion. According to the position and angle, the cortical bone thickness and distance to the root of another 54 randomly selected infrazygomatic crests were recorded to verify its feasibility. Results In the coordinate system, the implantation position of the 40 successful mini-implants was (-0.4 ± 2, 8.2 ± 2.5) and the implantation angle between the long axis of the mini-implant and horizontal reference plane was 56.4° ± 7.7°. The bone thicknesses on buccal and palatal sides of infrazygomatic crest adjacent to mini-implants were 4.1 ± 2.5 mm and 7.2 ± 3.2 mm, respectively, and the cortical bone thickness was 2.4 ± 0.6 mm. Among 54 infrazygomatic crests, 75.9% of them met the safety and stability requirements. When the implantation height was increased by 1, 2, and 3 mm, the proportions of implants that met requirements for success were 81.5%, 90.7%, and 94.4%, respectively. But, the proportions of eligible implants were limited at implantation angle increases of 5° and 10°. Conclusions Using the long axis of the maxillary first permanent molar (U6) as the vertical reference line, mini-implants could be safely inserted in the infrazygomatic crest at a distal distance of 0.4 mm and height of 8.2 mm from the central cementum-enamel junction of U6, with an implantation angle of 56.4°. The success rate increased when the implant height increased, but the proportion of eligible implantation was limited with the increase of implantation angle. 

/pdf/clinical-analysis-of-successful-insertion-of-orthodontic-2t6hkv1i.pdf

Clinical analysis of successful insertion of orthodontic mini-implants in infrazygomatic crest

To investigate the difference and distribution of bone depth at different three-dimensional simulated paths to help optimize the insertion path for miniscrew placement in the infrazygomatic crest.Cone beam computed tomography scans of 80 adults (38 males and 42 females; mean age, 27.0 years) were assessed. For each subject, bone depth of 81 simulated insertion paths at different insertion points and three-dimensional angulations was measured in 160 infrazygomatic crests; the differences were evaluated using the adjusted Friedman test. The bone deficiency ratio for each path was calculated. Distributions of measurements were analyzed and reported as specially designed colormaps.Bone depth increased, and bone deficiency ratio reduced mesially to distally (P < 0.001), apically to coronally (P < 0.01), and at a greater gingival and distal inclination (P < 0.05). The maximum bone depth (10.72 mm) was observed 13 mm above the maxillary occlusal plane in the mesiobuccal root of the maxillary second molar. The minimum bone depth (3.4 mm) was observed 17 mm above the maxillary occlusal plane in the distobuccal root of the maxillary first molar. No bone deficiency was detected at the paths of 13 mm above the maxillary occlusal plane at a gingival inclination of 70° and distal inclination of 30° in the mesiobuccal root of the maxillary second molar. The highest bone deficiency ratio is present 17 mm above the maxillary occlusal plane at a gingival inclination of 60° and a distal inclination of 0° in the distobuccal root of the maxillary first molar (89/160).Insertion paths located at 13 mm above the maxillary occlusal plane in the mesiobuccal root of the maxillary second molar were optimal. A gingival inclination of 70° and a distal inclination of 30° could be beneficial. The distobuccal root of the maxillary first molar region or above the 17 mm insertion plane may not be recommended. 

An evaluation of bone depth at different three-dimensional paths in infrazygomatic crest region for miniscrew insertion: A cone beam computed tomography study

Pharmacogenetics of Antidepressants: Overview of Dosing Strategies in Major Depressive Disorder Saja SAİD Gül ÖZBEY Therapeutic Use of Cannabinoids: Clinical Overview and Recent Updates Beril ALTUN The Xanthine Oxidase Inhibitory Activities of Natural-Based Compounds Targeting Gout Nurcan DEDEOĞLU The Relationship of Dementia and Diabetes Mehtap TUGRAK SAKARYA Rational Use of Drugs Dilan ÖZMEN ÖZGÜN Endocrine Therapy in Breast Cancer: Recent Advances in the Drugs Used Dilek AKSOY Strategies to Increase Solubility and Bioavailability of Drugs İrem ÇİNAR Emrah ÖZAKAR Rukiye SEVİNÇ ÖZAKAR Vesıcular Drug Delivery Systems Muhammet Enes ÖZMUTLU Rukiye SEVİNÇ ÖZAKAR Emrah ÖZAKAR Definition of Pharmacovigilance and Its Historical Development in the World and Türkiye Berna ÖZTÜRK KARAGÖZ 

pdf/current-research-in-pharmacy-and-pharmaceutical-sciences-ii-19hfh22t9a.pdf

Current Research in Pharmacy and Pharmaceutical Sciences II

This study aimed to determine the asymmetry degree between the left and right sides of 57 Class I skeletal pattern adult patients through cephalometric analysis performed in cone-beam computed tomography (CBCT) in the multiplanar reconstruction (MPR) to measured six cephalometric variables. Two angular (FMA, SN.GoGn) and four linear (Co-A, Co-Gn, Co-Go, Go-Me). Sex dimorphism and absolute asymmetry degree was evaluated with t-test. Left and right asymmetry degree was obtained by absolute values assessment and categorized by slight (0 to 2mm), moderate (2 to 5 mm), and severe (>5mm). There was no statistically significant difference between the left and right sides. Absolute asymmetry values showed no significant differences between males and females. The prevalence of slight, moderate, and severe asymmetries was 78.42%, 18.55%, and 3.03% for males and 76.74%, 13.58%, 9.68% for females, associated with mandibular variables. The second study aimed to measure the infrazygomatic crest (IZC) thickness from the distal aspect from second premolars to mesial aspect of second maxillary molars to determine safe regions for Temporary Anchorage Devices (TADs) placement. The influence of sides and sex were also examined. CBCT images of 50 adults (25 males, 25 females) were measured. The IZC thickness was measured bilaterally at the coronal planes of maxillary second premolar labial cusp(2PMBC), first molar mesial and distal labial cusps (1MMBC, 1MDBC), and second molar mesial root (2MMBC) at four different heights. A significantly increasing thickness of the IZC from anterior to posterior and from apical to the bottom regions was observed. The IZC thickness was not influenced by sex nor by the side. These findings might be clinically helpful in TADs planning placement in the IZC. Tomography, Cephalometry.

Asymmetry and infrazygomatic crest assessment by cone-beam computed tomography

Bone depth and thickness of different infrazygomatic crest miniscrew insertion paths between the first and second maxillary molars for distal tooth movement: A 3-dimensional assessment.

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Bone depth and thickness of different infrazygomatic crest miniscrew insertion paths between the first and second maxillary molars for distal tooth movement: A 3-dimensional assessment.