Preparation for Zygomatic Mini-implant Placement to Correct Class II Malocclusion (Fig.1,2)

  1. #15 blade, surgical basic, needle holder and scissors, 4-0 Plain Gut suture
  2. E16 and 400 handpieces (irrigation)
  3. 2 of 10 mm mini-implants with a hole so that ligature wire can go through; Ancor Pro mini implant kit
  4. Stainless wire box
  5. White Ortho box: closed coil springs, Crimpable Power Hooks (right and left, Fig.3 <), crimping forceps
  6. Incision is made 4-5 mm above the mucogingival junction, over the maxillary 1st molar (Fig.3 *)
  7. Rationale: the Zygomatic mini implant (Fig.4 *) will be placed higher than the existing one (<)

Postop follow up at 1 week (Fig.5,6), 2 months (Fig.7,8) and 3 months (Fig.9,10).  Granulation tissue forms around the entrance of closed coil spring with tenderness 2 months postop (Fig.7,8).  Pain persists especially on the left.  Tension of coiled spring associated with zygomatic implants is low; new coiled springs are added for the posterior implants (Fig.9,10).  Later the left spring associated with the left zygomatic implant fractures.

Six months post zygomatic implants, the profile, anterior overbite and overjet and the right posterior interdigitation are within normal limit (Fig.11), whereas the left one not (Fig.12).  The lower midline appears to be deviated to the left.  Elastics are used for correction (Fig.11,13,14).  A second option is to reduce the number of closed springs on the right and increase the one on the left.

Assistants, Ortho Cases, Mini-implant Preparation, Professionals Implant & Ortho 2

Xin Wei, DDS, PhD, MS 1st edition 05/03/2016, last revision 04/12/2017