ISSN : 0376-4672
The mini-screw is widely used in orthodontic treatment for anchorage reinforcement. In mild skeletal Class III patient, retraction of mandibular dentition using mini-screw has been accepted as a reliable and stable treatment approach. In addition, the mini-screw placed in the retromolar area could be used for the uprighting of the lower molar. However, the placement of the mini-screw on the retromolar trigone or anterior ramus region need to be careful because of the possible risk of the “slippage” or “displacement”. Once the mini-screw is displaced to the fascial space such as pterygomandibular space, submandibular space or lateral pharyngeal space, it is difficult to remove. In this case report, we present a mini-screw removal case via an intraoral approach that was displaced into the pterygomandibular space while placing the orthodontic mini-screw on the anterior margin of mandibular ramus.
1. Chen C-H, Chang C-S, Hsieh C-H, Tseng Y-C, Shen Y-S, Huang I-Y, et al. The use of microimplants in orthodontic anchorage. J Oral Maxillofac Surg. 2006 Aug;64(8):1209–13.
2. Papadopoulos MA, Tarawneh F. The use of miniscrew implants for temporary skeletal anchorage in orthodontics: A comprehensive review. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2007;103(5):6–15.
3. Alkadhimi A, Al-Awadhi EA. Miniscrews for orthodontic anchorage: a review of available systems. J Orthod. 2018;45(2):102–14.
4. Nucera R, Bellocchio AM, Oteri G, Farah AJ, Rosalia L, Giancarlo C, et al. Bone and cortical bone characteristics of mandibular retromolar trigone and anterior ramus region for miniscrew insertion in adults. Am J Orthod Dentofac Orthop [Internet]. 2019;155(3):330–8. Available from: https://doi.org/10.1016/j.ajodo.2018.04.025
5. Chang CH, Lin JS, Eugene Roberts W. Ramus screws: the ultimate solution for lower impacted molars. Semin Orthod. 2018;24(1):135–54.
6. Kuroda S, Sugawara Y, Deguchi T, Kyung HM, Takano-Yamamoto T. Clinical use of miniscrew implants as orthodontic anchorage: Success rates and postoperative discomfort. Am J Orthod Dentofac Orthop. 2007;131(1):9–15.
7. Elshebiny T, Palomo JM, Baumgaertel S. Anatomic assessment of the mandibular buccal shelf for miniscrew insertion in white patients. Am J Orthod Dentofac Orthop [Internet]. 2018;153(4):505–11. Available from: https://doi.org/10.1016/j.ajodo.2017.08.014
8. Ribeiro ALR, Silva WB, Menezes SAF, Kataoka MSS, Alves-Junior SM, Pinheiro JJV. Life-threatening expansive sublingual hematoma: A stab wound with lingual artery injury. J Craniofac Surg. 2014;25(1):61–5.
9. Kravitz ND, Kusnoto B. Risks and complications of orthodontic miniscrews. Am J Orthod Dentofac Orthop. 2007;131(4 SUPPL.):43–51.
