Dokument: Stability of Hybrid Hyrax Appliances with Angle-Stable Mini-Implants – an In Vitro Study
| Titel: | Stability of Hybrid Hyrax Appliances with Angle-Stable Mini-Implants – an In Vitro Study | |||||||
| Weiterer Titel: | Stabilität von Hybrid Hyrax Apparaturen mit winkelstabilen Mini-Implantaten - eine in vitro Studie | |||||||
| URL für Lesezeichen: | https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=72981 | |||||||
| URN (NBN): | urn:nbn:de:hbz:061-20260429-150214-0 | |||||||
| Kollektion: | Dissertationen | |||||||
| Sprache: | Englisch | |||||||
| Dokumententyp: | Wissenschaftliche Abschlussarbeiten » Dissertation | |||||||
| Medientyp: | Text | |||||||
| Autor: | Grützner, Geraldine Isabelle Caroline [Autor] | |||||||
| Dateien: |
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| Beitragende: | Prof. Dr. med. dent. Drescher, Dieter [Gutachter] Prof. Dr. Dr. Handschel, Jörg [Gutachter] | |||||||
| Stichwörter: | Kieferorthopädie | |||||||
| Dewey Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften » 610 Medizin und Gesundheit | |||||||
| Beschreibungen: | Hybrid-Hyrax-Apparaturen werden bei Gaumenerweiterungen (RPE) mit skelettaler Verankerung eingesetzt. Diese Studie untersucht Benefit-DIRECT-Mini-Implantate (DG; Direktgruppe) mit winkelstabilen Gewinden (Appliance-First-Workflow) bei maximalen Kräften, die in der Anfangsphase der RPE auftreten. In einem in-vitro Experiment mit 25 Maximalbelastungsversuchen wurden Benefit Standard Mini-Implantate (KG; Kontrollgruppe, PSM Medical Solution) mit Benefit DIRECT Mini-Implantaten (DG; DIRECT Gruppe) verglichen. Die Mini-Implantate, 9 mm lang und 2 mm im Durchmesser, wurden in Kunstknochen (Sawbone, 40 pcf, 15 mm x 10 mm x 10 mm) in einen Schraubstock eingespannt, einer starr, der andere beweglich. In jedem Kunstknochen wurde nach Vorbohrung ein Mini-Implantat mittig inseriert, das andere im Abstand von 8 mm. DG wurden polyaxial in verschiedenen Winkeln 0°, 5°, 10°, 15° Grad (DG0°, DG5°, DG10°, DG15°) durch das Abutment der BMX Expansionsschraube (BMX; PSM Medical Solution) eingesetzt, CG in 0° Winkel und mit Fixationsschraube verbunden. Die Mini-Implantate wurden mit einem elektrischen Schraubendreher (max. 40 Ncm) eingesetzt. Die Dehnschrauben wurden schrittweise aktiviert, bis eine plastische Verformung oder Abkopplung auftrat, wobei die Kräfte elektronisch erfasst wurden. Statistisch signifikante Unterschiede bei den Maximalkräften wurden bezüglich der unterschiedlichen Insertionswinkel bei DG beobachtet. DG war resistenter gegenüber Expansionskräften mit einer durchschnittlichen Maximalkraft von 243 N (DG 0° x̄ = 280 ± 44 N; DG 5° x̄ = 226 ± 26 N; DG 10° x̄ = 226 ± 23 N; DG 15° x̄ = 240 ± 29 N) als CG 0° mit x̄ = 114 ± 21 N). Signifikante Unterschiede bei den Maximalkräften wurden zwischen DG 0°–15° und CG gefunden, aber nicht zwischen DG 0°–15°. DG zeigte eine höhere Verformungsgrenze als CG (DG 0° x̄ = 183 ± 1 N; DG 5° x̄ = 183 ± 1 N; DG 10° x̄ = 203 ±8 N; DG 15° x̄ = 202 N; CG 0° x̄ = 94 ± 2 N). Es gab einen signifikanten Mittelwertsunterschied zwischen DG 10° und DG 15° sowie zwischen DG 0° und DG 5°.
Diese Studie zeigt, dass Mini-Implantat gestützte RPE (MARPE) vor allem bei winkelstabilen Mini-Implantaten wie den DIRECT Vorteile gegenüber herkömmlichen RPE-Verfahren bietet. DG 0° erzielte höhere Maximalkräfte, während DG 10° und DG 15° die höchsten Verformungsgrenzen aufwiesen. Dies spricht für die Nutzung von DIRECT-Mini-Implantaten für MARPE. Schlüsselwörter: Kieferorthopädie, Mini-Implantate, Hybrid-Hyrax, RPE, MARPE, winkelstabile Implantate; Gaumenerweiterungstechnik; MaterialprüfungHybrid hyrax appliances are increasingly used in orthodontics for skeletally and dentally supported rapid palatal expansion (RPE). Mini-implants with matching abutments have to withstand high forces during skeletal expansion. Novel angular-stable mini-implants enable an appliance-first workflow, allowing the appliance to be inserted first, then the mini-implants. The study aimed to compare the load capacity of mini-implants with different coupling types under typical maxillary expansion forces. In an in vitro setup, Benefit Standard mini-implants (CG; control group; PSM Medical Solution) were compared with Benefit DIRECT mini-implants (DG; direct group) comprising a head with an angle-stable thread. Both 9 mm long, 2 mm diameter mini-implants underwent a loading test. Two artificial bones (Sawbone, 40 pcf, 15 mm x 10 mm x 10 mm) were clamped in a vise, one fixed, one movable in one direction. After pre-drilling, a mini-implant was inserted in an artificial bone block using a CAD/CAM printed insertion guide, centered and 8 mm apart, with an electric screwdriver applying a maximum torque of 40 N/cm (NSK iSD900). Benefit DIRECT mini-implants were placed at 0, 5, 10, or 15 degrees (DG 0°, DG 5°, DG 10°, DG 15°) through the corresponding abutments of the BMX expansion screw abutments (Benefit Maxillary Expander, PSM Medical Solution). The control group, Standard Benefit mini-implants, were inserted orthogonally and connected to a BMX with a fixation screw. During 22 BMX activations, forces on the coupling and mini-implants and activation displacement were electronically recorded. Activation stopped upon plastic deformation or decoupling. Statistically significant different maximum forces were observed regarding different insertion angles of DG. DG were more resistant to expansion forces with a total mean maximum force of 243 N (DG 0° x̄ = 280 ± 44 N; DG 5° x̄ = 226 ± 26 N; DG 10° x̄ = 226 ± 23 N; DG 15° x̄ = 240 ± 29 N) than CG 0° with x̄ = 114 ± 21 N). Significant maximum forces were found between DG 0-15 and CG, but not between DG 0-15. DG yielded a higher mean deformation limit than CG (DG 0° x̄ = 183 ± 1 N; DG 5° x̄ = 183 ± 1 N; DG 10° x̄ = 203 ±8 N; DG 15° x̄ = 202 N; CG 0° x̄ = 94 ± 2 N). The mean of DG 10° and DG 15° was significantly different from DG 0° and DG 5°. This research supports the advantages of mini-implant-assisted RPE (MARPE), especially with angle-stable mini-implants, over traditional RPE. The DG withstood greater forces, with DG 0° tolerating the highest forces, and DG 10° and DG 15° showing the highest deformation. This in vitro study supports the suitability of DIRECT mini-implants for MARPE. Keywords: orthodontics, mini-implants, hybrid hyrax, RPE, MARPE, angle-stable implants; palatal expansion technique; materials testing | |||||||
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| Fachbereich / Einrichtung: | Medizinische Fakultät | |||||||
| Dokument erstellt am: | 29.04.2026 | |||||||
| Dateien geändert am: | 29.04.2026 | |||||||
| Promotionsantrag am: | 29.09.2025 | |||||||
| Datum der Promotion: | 02.04.2026 |
