Why do we need to "drive nails" to correct teeth? Does it hurt? Find out in one article!

In ancient times, people would turn pale at the mention of tigers. Today, people turn pale at the mention of nails. The nails here refer to the implant support nails used in orthodontic treatment, which are commonly known as bone nails. Many people come to the hospital to decide on an orthodontic plan with excitement. When they learn that their orthodontic treatment requires bone nails, their faces suddenly change, and they become hesitant and very scared.

So, why do we need anchor nails for orthodontic treatment? What is the function of this "little nail"?

1. What is a bone screw?

Implant anchorage nails, also known as temporary anchorage devices (TADs), generally have a diameter of 1.4mm~2.0mm.

Since the end of the 20th century, TADs have been widely used in orthodontic clinics due to their small implant trauma and flexible implant parts. The application of TADs has simplified a lot of orthodontic treatments and also achieved satisfactory results for some of the complex skeletal malocclusions in the past.

Image source: Big Doctor Little Nursing

In what situations are bone screws needed?

In theory, support nails are suitable for all situations that require support control. The following types are commonly used in clinical practice:

1. Strong anchorage for retracting anterior teeth

The doctor implants an implant anchorage pin in the posterior tooth area so that the posterior teeth are not subjected to the force of mesial movement during the space closing process, thereby achieving maximum anterior tooth retraction and improving protrusion.

2. Lower the front teeth to improve the gummy smile

Implant anchorage pins are placed in the upper front teeth area to depress the upper front teeth. As the front teeth are depressed, the gums will move upward, thereby improving the gummy smile.

3. Push the molars backwards

By implanting implants in the posterior tooth area, the molars can be moved distally, providing space for aligning the teeth and adjusting the inter-jaw relationship.

4. Lower the molars

For many patients with long-term missing teeth, the opposing teeth will gradually elongate, making them impossible to repair. At this time, the prosthodontist will refer the patient to the orthodontist, hoping to gain space for repair through orthodontic intrusion. The use of implant anchorage pins makes molar intrusion simpler and more efficient.

2. Does implanting nails cause serious trauma? Will it be painful?

The diameter of the implant support nail is generally 1.4~2.0mm. It is implanted into the alveolar bone between the tooth roots through local anesthesia. The implantation process only takes a few minutes. The implantation of support nails in most parts will not cause local bleeding and the trauma is minimal .

Generally speaking, there will be local swelling and pain for half a day to a day after the operation, which is relatively mild.

3. Will bone screwing damage tooth roots and nerves?

The implant anchorage pin is implanted in the alveolar bone between the roots of two teeth. During the implantation process, the doctor will adjust the direction according to the feel of the implantation to avoid touching the tooth root. Some patients need to implant in a narrow alveolar bone interval, and the anchorage pin is close to the tooth root, which will cause discomfort in biting after the operation.

As for whether the nerves will be damaged, implants in most areas will not touch the nerves and will definitely not damage the nerves; implants in the mandibular premolar area require reading the film to determine the location of the mental nerve, and then avoid it during the operation . Therefore, the probability of bone screws damaging tooth roots and nerves is very low.

4. Will the bone screws become loose?

After the implant support nail is implanted, it mainly relies on mechanical retention, and there is a certain probability of loosening, about 10% ; if the bone condition is not good, the possibility of loosening increases.

At the same time, the anchor pins and the surrounding gingival mucosa need to be cleaned during use. Redness, swelling and inflammation of the surrounding mucosa will also increase the probability of loosening.

If loosening occurs, the doctor needs to change the implant site or wait until the bone in the same site heals before implanting it again.

5. How long will the bone screws need to be used?

Implant anchorage nails are generally implanted about one month before use and will not be removed during the entire use cycle. According to the function of the anchorage nails and the movement of the teeth, they basically need to be used in the mouth for more than half a year.

When removing the bone nails, no anesthesia was even needed. The doctor took them out in no time. So, you don’t have to feel terrified when you hear about having nails put in your mouth.

Author: Han Gaofeng

Review | Liao Chongshan, attending physician of the Department of Orthodontics, Tongji University Affiliated Stomatological Hospital, young member of the Chinese Orthodontics Professional Committee, editor-in-chief of the Journal of Dental Companionship, PhD of the University of Hong Kong

Source: Big Doctor and Little Nursing