Comparison between two orthodontic skeletal anchorage devices: osseointegrated implants and miniscrews - Medical-Legal Considerations

The object of this article is to describe potential medical-legal problems concerning the use of miniscrews as orthodontic skeletal anchorage. The miniscrews, which are already used in rigid fixation, do not need either a healing period before loading, or complete osseo-integration as do implants. Their particular shape allows high primary stability and they can be placed in the sub-periosteal region. The dimensions of these miniscrews are minute, with dimensions of only 4-5 mm in length. They penetrate only slightly deeper than the cortical layer and therefore notably reduce the risk of lesions to roots, nerves, or maxillary sinus, when compared to other skeletal anchorage systems such as implants. The use of the miniscrew in oral surgery or periodontology does not need specific insurance coverage in contrast to the insertion of implants. Accordingly, orthodontic therapy completed by the dentist with orthopaedic microscrews as anchorage could also be included in a general civil insurance policy for orthodontics.