# Simulated risk of root and neurovascular bundle damage during miniscrew insertion in the anterior palate without radiological data

## TL;DR

This study shows that inserting miniscrews in the palate without X-rays increases the risk of nerve damage in people with narrow upper jaws.

## Contribution

The study demonstrates the necessity of using radiological data for safe miniscrew placement in constricted palates.

## Key findings

- Safe distances between miniscrews and incisors' roots were found in both groups without radiological data.
- Miniscrews were significantly closer to the naso-palatine duct in constricted palates, requiring CBCT adjustments.
- The study discourages miniscrew insertion in constricted palates without CBCT imaging.

## Abstract

This study aimed to explore the risk of potential root and nerve damage in planning the insertion of paramedian miniscrews without radiological information.

The study included CBCT and intra-oral scan (IOS) records of 60 subjects (28 males, 32 females) featuring normal transverse palate dimension (Group A = 30 subjects, mean age 20.5 ± 4.7) and skeletal maxillary constriction (Group B = 30 subjects, mean age 21.9 ± 5.1). Two miniscrews (Spider Screws Regular Plus Konic - HDC Srl, Vicenza, Italy), featuring 2 mm in diameter and 9 mm in length were virtually inserted using only the.stl IOS file following established clinical guidelines (T-Zone). Specific linear measurements were registered to calculate the distance between the miniscrews and both incisors’ roots and the naso-palatine duct after integrating CBCT images; same measurements were performed after adjusting the position with the aid of CBCT. All data were analyzed for comparison between both procedures and groups.

Safe distances were recorded between miniscrews and incisors’ roots in both groups (p > 0.05). The distances from the nasopalatine duct were significantly closer (and in few cases risky) in group B and required significant adjustment using CBCT (p < 0.05).

The present findings would discourage planning or inserting miniscrews in the paramedian region without radiological information (CBCT) in subjects with skeletal maxillary constricted.