Phase
of low stability
Primary Secondary
stability stability
1 2 3 4 5 6 7 8 9 Weeks
Stability of Mini-implants
How to measure primary stability:
- Insertion Torque
(in vivo / in vitro)
- Periotest
(in vivo / in vitro)
10
0
paramedian 0 2 4 6 Weeks
Restricted
site
Mini-implant Abutments
Pre-drilling in adults
Handpiece
Insertion
Orthodontist could insert
Stability of Mini-implants
Consider angle of insertion!
Mechanics with palatal TADs
Molar distalization
Beneslider Pendulum B
Molar mesialization
T-Bow Mesialslider
Molar Alignment of
Intrusion retained teeth
Beneslider
Beneplate
Benetube
Wilmes B, Drescher, D. Nienkemper M. Beneplate - A miniplate system for
improved stability of skeletal anchorage. J Clin Orthod 2009; 43:494-501
Wilmes B, Drescher D. Application and effectiveness of the Beneslider molar
distalization device. World J Orthod. 11:33134
Combination of distalization mechanics and
conventional braces
lingual braces
Aligners
Beneslider
Beneslider
Beneslider
Beneslider & Aligner
Study: N=51
Wilmes B. Clinical management of the Beneslider and the Pendulum B appliances for
maxillary molar distalization. In: Moschos Papadopoulus: Skeletal anchorage in orthodontic
treatment of Class II malocclusion: Contemporary applications of orthodontic implants,
miniscrew implants and mini plates. Amsterdam. Mosby, Elsevier (in press)
Pendulum B
Upper molar mesialization
T-Bow Mesialslider
Indirect Direct
Anchorage Anchorage
Upper molar mesialization
Goal 1:
No load on the bicuspids/
deciduous molars
No/less tipping of the teeth
Wilmes B. Fields of Application of Mini-Implants. In: Ludwig B, Baumgaertel S, Bowman JS, editor.
Mini-Implants in Orthodontics Innovative Anchorage Concepts. London: Quintessence Publishing
Co Ltd;2008. p. 91-122
Maxillary advancement using a Facemask
Goal 2:
Mesial migration of the dentition
Avoid mesial migration
of the teeth
protraction facemask in the treatment of Class III malocclusions in growing children: a prospective long-
term study. Semin Orthod 1997;3:265-274.
Hybrid-Hyrax
Hyrax Expander
Hybrid-Hyrax / Facemask
Hybrid-Hyrax / Facemask
Hybridhyrax
Mentoplate
Wilmes B, Kau CH, Ludwig B, Drescher D. Early Class III
Treatment with a Hybrid Hyrax-Mentoplate Combination,
J Clin Orthod 2011
Hybridhyrax and Mentoplate
Hybridhyrax and Mentoplate
17 years
Overview early class III treatment
Conv.RPE + Hybrid Hyrax Hybrid Hyrax 4 Bollard
Facemask + Facemask + Mentoplate Plates
2 mini-implants 4 miniplates
Surgery? No 2 mini-implants 1 miniplate
Skeletal
Efficiency?
Molar anchorage
Molar anchorage
Molar intrusion
Molar distalization
Beneslider Pendulum B
Molar mesialization
T-Bow Mesialslider
Molar Alignment of
Intrusion retained teeth
Conclusions: 3. No difference between median and lateral
Conclusions: 4. Just do it !
Courage!
Palatal Mini-implants
wilmes@med.uni-duesseldorf.de
www.uniklinik-duesseldorf.de/kieferorthopaedie