Korean J Orthod.  2016 Mar;46(2):111-126. 10.4041/kjod.2016.46.2.111.

Prognostic factors associated with the success rates of posterior orthodontic miniscrew implants: A subgroup meta-analysis

• Hong SB
• Kusnoto B
• Kim EJ
• BeGole EA
• Hwang HS
• Lim HJ

• KMID: 2159359
• DOI: http://doi.org/10.4041/kjod.2016.46.2.111

Abstract

OBJECTIVE
To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region.
METHODS
Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed.
RESULTS
Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ≥ 20 years of age, and for long MIs (≥ 8 mm) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74).
CONCLUSIONS
When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.

Keyword

Subgroup meta-analysis; Miniscrew implant; Success rate; Prognostic factor

MeSH Terms

Humans
Jaw
Maxilla
Odds Ratio
Outcome Assessment (Health Care)
Prospective Studies
Retrospective Studies
Risk Factors
Sample Size

Figure

• 

  Figure 1 PRISMA flow diagram of the search strategy for the prognostic factors associated with the success rates of posterior orthodontic miniscrew implants. W, Web of Science; S, Scopus; P, PubMed; M, manual search.

• 

  Figure 2 A, Forest plot of odds ratios (ORs) for success rates between mandible and maxilla. Homogeneous subgroup of prospective studies showed combined OR of 3.67 (95% confidence interval [CI], 2.10-6.44)*, and homogeneous subgroup of retrospective studies showed a combined OR of 2.10 (95% CI, 1.60-2.74)*. B, In the sensitivity analysis for prospective studies regarding jaw, a significantly higher success rate in the maxilla was shown. C, The sensitivity analysis of retrospective studies regarding jaw showed a higher success rate in the maxilla. *Sig nificance.

• 

  Figure 3 Forest plot of odds ratio for success rates. A, Bet ween males and females. The results in both subgroups showed no significant difference in success rates. B, Between age groups. Homogeneous subgroups showed higher success rates in patients aged 20 years and over (≥ 20 years) except subgroup of retrospective studies and studies with small samples. C, Between long miniscrew implants (MIs) (≥8 mm) and short MIs (<8 mm). Long MIs had significantly higher success rates. D, Between large diameter (>1.4 mm) and small diameter (≤1.4 mm) screws. MIs with large diameters had significantly higher success rates.

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