JPFA-95; No.

of Pages 8

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Available online at www.sciencedirect.com

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Comparative evaluation of intrusive effects of

miniscrew, Connecticut intrusion arch, and utility
intrusion arch – An in vivo study

Ashutosh Kaushik, Maninder Singh Sidhu, Seema Grover *, Sandeep Kumar

Department of Orthodontics and Dentofacial Orthopedics, S.G.T. Dental College, Hospital and Research Institute,
Budhera, Gurgaon, Haryana 122505, India

article info abstract

Keywords: Objectives: This study compared the skeletal and dental changes obtained by incisor intru-
Utility arch sion using three methods: utility intrusion arch (UIA), Connecticut intrusion arch (CIA), and
Connecticut arch miniscrews.
Deep bite Materials and methods: A total of thirty-eight patients with age range of 14–25 years were
Miniscrews included which were divided into three groups: Group I (n = 13), UIA; Group II (n = 13), CIA;
and Group III (n = 12), miniscrew. All the groups were further subdivided into maxillary and
mandibular arch. Intrusion force of 60 g and 40 g was used for maxillary and mandibular
arch respectively for standardization. Intrusion was concluded after 5–6 months or when
correction was achieved. Pre-treatment and post-treatment skeletal and dental changes
were compared sing lateral cephalograms.
Results: The results suggested that all three methods were effective means of intrusion, but
true intrusion measured from center of resistance was maximum in miniscrew group. No
anchorage loss and change in axial inclination of incisors was observed in miniscrew group
as compared to UIA and CIA group. Overbite decreased in all groups but more significantly in
miniscrew group.
Conclusions: Miniscrew intrusion was considered the preferred method of true intrusion to
correct deep bite.
# 2016 Pierre Fauchard Academy (India Section). Published by Elsevier, a division of Reed
Elsevier India, Pvt. Ltd. All rights reserved.

on a variety of factors such as incisor display, smile line, and

1. Introduction
vertical dimension. The decision must be based on patient's
age, etiology of the anomaly, skeletal and dental morphology,
Deep bite is one of the most common findings in cases of surrounding muscular and periodontal tissues, existence of
malocclusion. Deep bite by definition means increased the deep bite in the rest position, length of lips, OP, ideal
overbite and is measured as vertical overlap of the incisors incisor position, and the lower facial height.
perpendicular to the occlusal plane (OP). It is typically An excessive deep bite is associated with incisor wear,
corrected by intrusion of the anterior teeth or extrusion of palatal impingement, and compromised esthetics1 and po-
the posterior teeth or both. The treatment of choice depends tentially detrimental effects on temporomandibular joint

* Corresponding author. Tel.: +91 9810636828.

E-mail address: seemaortho@gmail.com (S. Grover).
http://dx.doi.org/10.1016/j.jpfa.2016.01.001
0970-2199/# 2016 Pierre Fauchard Academy (India Section). Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd. All rights
reserved.

Please cite this article in press as: Kaushik A, et al. Comparative evaluation of intrusive effects of miniscrew, Connecticut intrusion arch,
and utility intrusion arch – An in vivo study, J Pierre Fauchard Acad (India Sect). (2016), http://dx.doi.org/10.1016/j.jpfa.2016.01.001
JPFA-95; No. of Pages 8

2 journal of pierre fauchard academy (india section) xxx (2016) xxx–xxx

function and periodontal health. Deep overbite correction is (n = 13), with maxillary arch (n = 7) and mandibular arch (n = 6),
often a major component of orthodontic treatment. The where intrusion was achieved by UIA. Group II consisted of 13
treatment for patients with normal vertical development patients (n = 13), with maxillary arch (n = 7) and mandibular
and gummy smiles involves maxillary incisor intrusion. arch (n = 6), where intrusion was achieved by CIA. Group III
Intrusion is also the treatment of choice for adult patients consisted of 12 patients (n = 12), with maxillary arch (n = 7) and
who have significant bone loss around the incisors. mandibular arch (n = 5), where intrusion was achieved by
Intrusion of incisors is an ideal option to correct deep bites miniscrews.
because it maintains the vertical dimension of the patient. In all the three groups, intrusion was carried out in either
Successful intrusion mechanics include force magnitude maxillary incisors, mandibular incisors, or both as dictated by
constancy, use of single point application, control of direction the clinical situation. The intrusive force of 60 g and 40 g was
of force and selection of proper point of force application, and used in maxillary and mandibular arch respectively for
control of reactive units avoiding extrusive mechanics, which standardization. The force was measured by dontrix gauge.
should be carefully planned and delivered. Conventional Intrusion was concluded after 5–6 months or when the
methods of incisor intrusion usually involve 2
4 appliances correction was achieved. For the assessment of true intrusion,
such as utility arches, 3-piece intrusion arches, or reverse the evaluation was made from the center of resistance of
curved arches. An intrusive force is applied to the incisors incisor rather than the incisor apex or the crown tip, as it may
using tip-back bends at the molars. Engaging the utility arch lead to the perception of intrusion due to the inclination
will produce approximately 15 g of force on each incisor, a changes achieved during the intrusion.
force level considered ideal for lower incisor intrusion. All patients were evaluated every 3 weeks. A logbook was
Nanda's Connecticut intrusion arch2 (CIA) is fabricated maintained to keep record of all patients at every visit. The
from a nickel titanium alloy to provide the advantages of force chosen in the present study for intrusion was 15 g per
shape memory, springback, and light, continuous force maxillary incisor and 10 g per mandibular incisor and same
distribution. When arch is activated, a simple force system force was maintained for all three groups at each visit.
results, consisting of a vertical force in the anterior region and
a moment in the posterior region. 2.1. Group I (utility arch group)
The introduction of skeletal anchorage (miniscrews) as a
source of stationary anchorage to orthodontic forces has made Custom made utility arches were made from
most complex tooth movements simple.3 Mini implants have 0.016 in.
0.022 in. blue elgiloy wire (RMO). The UIAs were
been used to intrude incisors since 1983, when Creekmore and constructed according to the specifications given by Ricketts.6
Eklund reported using a metal implant to correct a deep Before the placement of the utility arch, a 458 tip back to molar
overbite.4,5 It has been shown that miniscrews can be loaded to section was given, directly ligated into the anterior bracket
forces up to 500 g and yet stay intact until the end of the slots and the arch was cinched back.
treatment. It has been shown that true intrusion can be
achieved with simple mechanics via miniscrews with only 2.2. Group II (CIA group)
minimal protrusion of the anterior teeth.
In this study, we aimed to compare dental and skeletal The CIA is a proprietary trademark of Ortho Organizer, San
changes obtained by incisor intrusion obtained with the aid of Marcos, CA 92069, a pre-fabricated intrusion arch. The CIA was
utility arch, CIA, and miniscrews. fabricated from 0.01600
0.02200 dimension nickel titanium
alloy to provide advantages of shape memory, springback, and
light continuous force distribution. The maxillary and man-
2. Materials and method dibular versions have anterior dimensions of 34 mm and
28 mm respectively.2 The intrusion arch was directly ligated
The sample size consisting of 38 subjects in the age group into the anterior bracket slots and cinched back.
between 14 and 25 years was selected from patients coming to
the department of orthodontics who were recommended 2.3. Group III (miniscrews group)
orthodontic treatment. The inclusion criteria for the study
were: patients having deep bite of at least 4 mm, with minimal Two miniscrews (Biomaterials®, Korea), 1.3 mm in diameter
crowding and no existing history of periodontal disease. The and 8 mm in length were placed between the roots of lateral
exclusion criteria were teeth with incomplete apexification, incisor and canine under local anesthesia. Standard periapical
history of trauma, signs of root resorption prior to orthodontic radiographs were taken to check the position of the screws in
treatment, history of root canal treatment, and previous relation to neighboring roots. The screws were loaded after at
orthodontic treatment. least 1 week of placement with medium superelastic nickel
In this study, comparison of intrusive effects of utility titanium closed coil springs of appropriate length and an
intrusion arch (UIA), CIA, and miniscrews were evaluated for intrusion force of 50–80 g was applied. Control appointments
deep bite correction using lateral cephalograms. Fixed ortho- were kept every 4 weeks and the force was checked at every
dontic treatment was started in all the patients utilizing appointment. Records were taken before the application of the
MBTTM Versatile+ Appliance System prescription with mechanics and after completion of intrusion. All the patients
0.022
0.028 slot. were radiographed by using digital lateral cephalograms.
The patients were divided randomly into three groups based To avoid the perception of false intrusion, the center of
on treatment mechanics: Group I consisted of 13 patients resistance of maxillary central incisor was taken as point

Please cite this article in press as: Kaushik A, et al. Comparative evaluation of intrusive effects of miniscrew, Connecticut intrusion arch,
and utility intrusion arch – An in vivo study, J Pierre Fauchard Acad (India Sect). (2016), http://dx.doi.org/10.1016/j.jpfa.2016.01.001
JPFA-95; No. of Pages 8

journal of pierre fauchard academy (india section) xxx (2016) xxx–xxx 3

Fig. 1 – Cephalometric parameters: (1) sella-nasion distance, Fig. 2 – Cephalometric parameters: (1) U1-VR, (2) U1-PTV, (3)
(2) anterior facial height, (3) upper facial height, (4) lower U1-PP, (4) U1-SN, (5) U1-L1, (6) U1Cr-PP, (7) L1-MP, (8)
facial height, (5) posterior facial height, (6) SNA, (7) SNB, (8) overjet, and (9) overbit.
ANB, (9) MP–FH, and (10) MP–SN.

located at one third of distance of root length apical to alveolar software SPSS version 16.0. For comparison of pre-treatment
crest. The center of resistance (Cr) of the maxillary incisor was and post-treatment parameters, results were analyzed in
selected as a measurement point instead of the Cr of the subgroup, using paired t-test. To compare intergroup changes,
anterior segment because it is easier to locate and more one-way ANOVA was used followed by post-hoc test (post-hoc
reproducible. Lateral cephalometric parameters were evaluat- analysis, bonferroni). For comparison of subgroups along with
ed for hard and soft tissues changes that occurred by intrusion interaction effect, two-way ANOVA was used.
in all the patients.
To measure linear cephalometric parameters, following
3. Results
planes were used as reference planes for accurate measure-
ments:
In all patients, intrusion was carried out after minimal leveling
1. Pterygoid vertical (PTV): the PTV drawn perpendicular to and aligning. Pre-intrusion and post-intrusion lateral head
sella-nasion plane passing through posterior superior of cephalograms were taken and analyzed. Following were the
Pterygomaxillary Fissure. results obtained after evaluating skeletal and dental param-
2. Vertical reference plane (VR): drawn perpendicular to eters in maxilla and mandible. Table 1 represents pre- and
constructed horizontal plane (78 to SN plane) from point post-treatment cephalometric skeletal and dental parameters
of intersection of anterior wall of sella turcica and anterior in maxillary and mandibular arch.
clinoid process. There was statistically insignificant correlation in ceph-
alometric skeletal parameters in maxillary arch on
Sella-nasion (SN), Frankfort horizontal (FH), mandibular intragroup comparison in utility arch, Connecticut arch,
plane (MP), palatal plane (PP), and occlusal plane (OP) were also and miniscrew group (Table 2). Only Connecticut arch group
used as reference planes in this study. The cephalometric hard showed significant increase in posterior facial height (1.33,
tissue skeletal linear and angular parameters measured were: p ≤ 0.05) and MP angle (1.10, p ≥ 0.05). In dental parameters,
(1) sella-nasion distance, (2) anterior facial height, (3) upper maxillary incisor to vertical reference (U1-VR) was signifi-
facial height, (4) lower facial height, (5) posterior facial height, cantly increased for CIA group (1.26, p = 0.022) and UIA
(6) SNA, (7) SNB, (8) ANB, (9) MP–FH, and (10) MP–SN (Fig. 1). The group (2.42, p ≤ 0.05). Similarly, U1-PTV was significantly
cephalometric hard tissue dental angular and linear param- increased for CIA group (1.54, p ≤ 0.05) and UIA group (1.44,
eters measured were (1) U1-VR, (2) U1-PTV, (3) U1-PP, (4) U1-SN, p ≤ 0.001).
(5) U1-L1, (6) U1Cr-PP, (7) L1-MP, (8) overjet, and (9) overbite U1 CR-PP (Cr to PP) was decreased by 2.46, p ≤ 0.001 in MS
(Fig. 2). group, 1.84, p ≤ 0.001 in CIA group, and 1.99, p ≤ 0.001 in UIA
Cephalometric superimpositions of utility arch group (Group group, all of which were statistically significant. L1-MP (8) was
I), Connecticut arch group (Group II), and miniscrew group are increased in all the three groups but the change was significant
shown in Fig. 3a–c; Fig. 4a–c, and Fig. 5a–c respectively. in UIA group (3.833, p ≤ 0.05). Overbite was reduced in all the
The data were entered into Microsoft Excel 2007 (Microsoft, groups which was statistically significant, with 4.14 in MS
Redmond, Wash). The data were analyzed using Statistical group, 3.20 in CIA group, and 2.99 in UIA with p ≤ 0.001 in

Please cite this article in press as: Kaushik A, et al. Comparative evaluation of intrusive effects of miniscrew, Connecticut intrusion arch,
and utility intrusion arch – An in vivo study, J Pierre Fauchard Acad (India Sect). (2016), http://dx.doi.org/10.1016/j.jpfa.2016.01.001
JPFA-95; No. of Pages 8

4 journal of pierre fauchard academy (india section) xxx (2016) xxx–xxx

Fig. 3 – Intrusion in utility arch group (Group I). (a) Pre-treatment, (b) post-intrusion and (c) superimposition of pre-treatment
and post-intrusion.

Fig. 4 – Intrusion in Connecticut intrusion arch group (Group II). (a) Pre-intrusion, (b) post-intrusion and (c) superimposition of
pre-treatment and post-intrusion.

all the groups. In mandible, only in MS group, MP angle significant when UIA vs MS groups and CIA vs MS groups
decreased whereas it slightly increased in CIA and UIA groups were compared with each other.
(Table 2).
Table 3 describes the intergroup comparison of all 3 groups
4. Discussion
in maxillary arch and no significant cephalometric skeletal
and dental changes were observed except upper incisor to SN
was significant when UIA and CIA were compared and also Recently, the focus of the orthodontic literature has been on
among UIA and MS groups. Also L1-MP correlation was the incisor display during smiling after treatment of deep

Please cite this article in press as: Kaushik A, et al. Comparative evaluation of intrusive effects of miniscrew, Connecticut intrusion arch,
and utility intrusion arch – An in vivo study, J Pierre Fauchard Acad (India Sect). (2016), http://dx.doi.org/10.1016/j.jpfa.2016.01.001
JPFA-95; No. of Pages 8

journal of pierre fauchard academy (india section) xxx (2016) xxx–xxx 5

Fig. 5 – Intrusion in mini implant group (Group III). (a) Pre-treatment, (b) post-intrusion and (c) superimposition of pre-
treatment and post-intrusion.

Table 1 – Comparison of pre- and post-treatment cephalometric skeletal and dental parameters for maxillary and
mandibular arch in utility intrusion arch (Group I), Connecticut intrusion arch (Group II), and miniscrew (Group III).
S. No Cephalometric Group I (UIA) (n = 7) Group II (CIA) (n = 7) Group III (MS) (n = 7)
parameters
Pre- Post- Pre- Post- Pre- Post-
treatment treatment treatment treatment treatment treatment

Mean SD Mean SD Mean SD Mean SD Mean SD Mean SD

1 Sella-nasion (mm) 58.51 1.51 58.68 1.52 56.33 1.85 56.43 1.99 58.50 3.15 58.43 3.21
2 AFH (mm) 91.07 4.06 94.67 7.08 89.14 1.88 92.67 4.12 96.28 6.29 95.41 6.62
3 UFH (mm) 72.60 7.40 42.93 2.55 74.20 6.46 40.76 3.07 40.75 1.92 40.71 2.06
4 LFH (mm) 50.54 5.08 54.50 8.47 51.16 2.95 51.91 3.17 52.34 5.12 53.14 5.52
5 PFH (mm) 61.05 6.23 61.64 6.33 62.44 3.11 63.77 3.54 61.16 1.81 62.01 1.34
6 SNA (8) 81.79 2.71 81.64 1.84 82.57 1.99 83.29 2.56 82.00 3.42 82.07 2.86
7 SNB (8) 76.86 3.29 77.36 2.78 76.86 1.86 78.00 2.52 76.71 2.93 76.64 2.84
8 ANB (8) 4.93 2.21 4.29 2.50 5.71 1.25 5.29 0.95 5.29 1.80 5.43 1.51
9 MP–FH (8) 24.29 4.19 24.83 4.53 22.57 1.99 23.67 2.27 18.57 5.88 17.43 5.68
10 MP–SN (8) 32.00 5.92 33.31 6.18 29.71 3.40 30.91 2.80 25.43 6.50 25.00 4.90
11 U1-VR (mm) 57.58 6.18 60.00 5.88 56.58 4.72 57.84 4.47 61.47 7.70 60.29 6.52
12 U1-PTV (mm) 40.16 5.10 41.60 4.91 40.61 7.48 42.15 7.05 44.29 8.50 44.43 7.76
13 U1-PP (mm) 25.70 4.67 23.54 4.35 26.54 1.90 24.10 1.89 27.56 4.25 25.14 3.90
14 Overjet (mm) 4.08 2.67 3.51 1.91 4.00 1.92 3.11 0.94 6.15 2.07 5.07 3.06
15 Overbite (mm) 5.64 1.30 2.65 0.66 5.64 1.18 2.44 0.47 6.64 0.95 2.50 1.38
16 U1 CR To PP (mm) 8.42 2.86 6.44 2.67 9.24 2.94 7.4 2.70 9.89 1.63 7.43 2.13
14 L1-MP (8) 97.50 7.61 100.17 8.04 100.33 7.89 103.33 10.44 98.80 9.28 101.80 9.42

bite.7–9 The patients selected for this study were those where maxilla and mandible was essential due to differences in
incisor intrusion was the preferred choice of treatment. various factors which affects intrusion, such as bone density of
However, no overcorrection was carried out and bite opening maxilla and mandible differs significantly. Also, the surface
was to be achieved by intrusion of not only maxillary incisors area of anterior teeth is different. Hence, the optimal force
but also of the mandibular incisors. level for intrusion is different for maxilla and mandible.
The sample in this study was divided randomly into three Therefore, the sample was subdivided into maxillary and
treatment groups. Depending upon the clinical situation, the mandibular arches within each intrusion modality group.
intrusion of maxillary and mandibular incisors was carried For UIA, an intrusive force was applied to the incisors using
out. For each method of intrusion, division of sample into tip-back bends at the molars. This tip back bend was

Please cite this article in press as: Kaushik A, et al. Comparative evaluation of intrusive effects of miniscrew, Connecticut intrusion arch,
and utility intrusion arch – An in vivo study, J Pierre Fauchard Acad (India Sect). (2016), http://dx.doi.org/10.1016/j.jpfa.2016.01.001
JPFA-95; No. of Pages 8

6 journal of pierre fauchard academy (india section) xxx (2016) xxx–xxx

Table 2 – Intragroup comparison of pre- and post-treatment changes in cephalometric skeletal and dental parameters in
utility intrusion arch (Group I), Connecticut intrusion arch (Group II), and miniscrew (Group III) for maxillary arch and
mandibular arch.
S. No Variable Group I (UIA) Group II (CIA) Group III (MS)

T2–T1 T2–T1 T2–T1

Mean SD p Mean SD p Mean SD p

1 Sella-nasion (mm) 0.17 0.72 0.557 0.10 0.27 0.36 0.07 0.19 0.36
2 AFH (mm) 2.67 3.29 0.075 0.38 1.42 0.51 0.84 0.95 0.16
3 UFH (mm) 1.17 1.47 0.079 0.17 1.28 00.74 0.04 0.43 0.83
4 LFH (mm) 3.97 6.68 0.167 0.75 1.67 0.28 0.80 0.64 0.12
5 PFH (mm) 0.58 1.36 0.302 1.33 1.09 0.02* 0.85 0.67 0.11
6 SNA (8) 0.14 1.11 0.744 0.71 1.38 0.22 0.07 1.10 0.87
7 SNB (8) 0.50 0.96 0.216 1.14 1.57 0.10 0.07 0.84 0.83
8 ANB (8) 0.64 0.85 0.093 0.43 0.53 0.08 0.14 0.38 0.36
9 MP–FH (8) 0.54 1.41 0.349 1.10 0.74 0.44 1.14 2.54 0.28
10 MP–SN (8) 1.31 2.49 0.212 1.20 0.90 0.013* 0.43 2.64 0.682
11 PP–occlusal plane (8) 0.64 4.33 0.708 1.14 2.79 0.32 1.64 1.44 0.02*
12 U1-VR (mm) 2.42 0.77 0.00*** 1.26 1.09 0.022* 1.19 2.98 0.333
13 U1-PTV (mm) 1.44 0.52 0.00*** 1.54 1.18 0.013* 0.14 2.41 0.697
14 U1-PP (mm) 2.15 0.51 0.00*** 2.44 0.54 0.00*** 2.41 0.63 0.00***
15 Overjet (mm) 0.57 0.95 0.165 0.89 1.46 0.16 1.08 1.76 0.16
16 Overbite (mm) 2.99 1.26 0.001*** 3.20 0.77 0.00*** 4.14 1.20 0.00***
17 U1 CR to PP (mm) 1.98 0.61 .001*** 1.84 0.36 0.00*** 2.46 1.11 0.00***
18 U1-SN (8) 4.29 2.14 0.711 5.71 4.39 0.13 1.57 5.03 0.44
19 U1-PP (8) 4.00 2.24 0.352 4.71 5.02 0.26 0.57 5.22 0.782
21 L1-MP (8) 3.833 2.483 0.013* 3.000 3.795 0.111 3.000 5.701 0.305
NS – p ≥ 0.05 not significant.
*
p ≤ 0.05.
***
p ≤ 0.001.

Table 3 – Intergroup comparison of pre-treatment and post-treatment changes in cephalometric skeletal and dental
parameters in utility intrusion arch (Group I), Connecticut intrusion arch (Group II), and miniscrew (Group III) for maxillary
arch and mandibular arch.
S. No. Variable Group I vs Group II Group I vs Group III Group II vs Group III
1 Sella-nasion (mm) p = 1.000 p = 1.000 p = 1.000
2 AFH (mm) p = 1.000 p = 0.379 p = 0.182
3 UFH (mm) p = 1.000 p = 0.197 p = 0.131
4 LFH (mm) p = 1.000 p = 0.466 p = 0.449
5 PFH (mm) p = 1.000 p = 1.000 p = 0.636
6 SNA (8) p = 0.991 p = 1.000 p = 0.596
7 SNB (8) p = 0.203 p = 1.000 p = 0.951
8 ANB (8) p = 0.306 p = 0.088 p = 1.000
9 MP–FH (8) p = 0.079 p = 0.257 p = 1.000
10 MP–SN (8) p = 0.525 p = 0.445 p = 1.000
12 U1-PTV (mm) p = 0.339 p = 0.418 p = 1.000
13 Overjet (mm) p = 1.000 p = 1.000 p = 0.318
14 Overbite (mm) p = 0.375 p = 0.196 p = 1.000
15 U1 CR to PP (mm) p = 0.440 p = 0.774 p = 1.000
16 U1-SN (8) p = 0.01** p = 0.043* p = 1.000
17 L1-MP (8) p = 1.000 p = 0.003* p = 0.004**
NS – p ≥ 0.05 not significant.
*
p ≤ 0.05.
**
p ≤ 0.01.

calibrated, by means of dontrix gauge, so that it exerts 60 g of When the vertical skeletal changes (Tweed's MP angle,
force on maxillary incisors and 40 g of force on mandibular Steiner's MP angle) were studied, statistically non-significant
incisors. Bench et al.10 advocated the intrusive force of 15–20 g changes were observed in each treatment modality. The
per lower incisor or 60–80 g for all four lower incisors. MP angle was reduced slightly in miniscrew group, while it was
Ricketts11 advocated the use of 125–160 g of force for upper increased in CIA and utility arch, though was not statistically
incisor intrusion and 60–75 g for lower incisors. significant. Statistically significant increase in MP angle

Please cite this article in press as: Kaushik A, et al. Comparative evaluation of intrusive effects of miniscrew, Connecticut intrusion arch,
and utility intrusion arch – An in vivo study, J Pierre Fauchard Acad (India Sect). (2016), http://dx.doi.org/10.1016/j.jpfa.2016.01.001
JPFA-95; No. of Pages 8

journal of pierre fauchard academy (india section) xxx (2016) xxx–xxx 7

(MP–FH) was observed for mandibular intrusion in the CIA 1. All three methods, i.e. miniscrews, CIA, and UIA, were
(1.58) and UIA (2.25). These observations are in accordance effective methods of intrusion of anterior teeth.
with the study by Varlik et al.12 who reported similar increase 2. True intrusion measured from Cr was maximum in
in Steiner's MP angle (SN–MP) with utility arch intrusion. miniscrew group although there was no significant differ-
Similar increase in Steiner's MP angle (SN–MP) was also ence between the intrusion achieved by utility arch and
observed by Amasyali et al. in their study on CIA and utility Connecticut arch.
arch. 3. There was no anchorage loss in miniscrew group while the
In the current study, the anterior facial height, posterior Cr of maxillary molars was moved mesially which indicated
facial height, and the lower facial height increased in CIA and anchorage loss in CIA and UIA group.
UIA group and not in mini implant group. A more increase was 4. The change of axial inclination of incisors was minimal in
seen for UIA group as compared to CIA group. These findings miniscrew group followed by CIA and UIA.
of CIA and UIA group are in accordance with the previous 5. Overbite decreased in all the three groups but was more
studies.13–16 The probable cause of the increase in the facial significant for miniscrew group.
heights was the slight extrusion of posteriors due to the
anchorage taken from them in UIA and CIA. In mini implant
group, there was no increase in anterior, posterior facial
Conflicts of interest
height and lower facial height. In mini implant group, there
was no taxing of anchorage on posteriors in vertical plane, as
there was no reciprocal force acting on molars in miniscrews The authors have none to declare.
group.
When the intrusion was measured from incisal edge, the
maxillary incisor intrusion was 2.41 mm, 2.44 mm, and references
2.15 mm for miniscrews, CIA, and UIA respectively. For
mandibular incisor, it was 3.84 mm, 2.30 mm, and 2.26 mm
for miniscrews, CIA, and UIA respectively. Overbite reduction 1. Strang RHW. A Textbook of Orthodontia. Philadelphia: Lea &
was 4.14 mm, 3.20 mm, and 2.99 mm for miniscrews, CIA, and Febiger; 1950.
UIA respectively. According to Ng et al.,17 the use of the incisal 2. Nanda R, Marzban R, Kuhlberg A. The Connecticut intrusion
arch. J Clin Orthod. 1998;32:708–715.
edge or root apex for the evaluation of intrusion is not
3. Kokich VG. Managing complex orthodontic problems: the
recommended because these points do not depend on any
use of implants for anchorage. Semin Orthod. 1996;2:
change in inclination. 153–160.
The axial inclination of upper incisors in the present 4. Creekmore TD, Eklund MK. The possibility of skeletal
investigation showed a minimum increase during intrusion anchorage. J Clin Orthod. 1983;17:266–269.
that was not significant for miniscrew group. The Cr of 5. Polat-Ozsoy O, Arman-Ozcirpici A, Veziroglu F. Miniscrews
upper incisors lies 8 mm apical and 5 mm distal to for upper incisor intrusion. Eur J Orthod. 2009;31:
412–416.
lateral incisors.16,18 The point of force application in this
6. Ricketts RM. Bioprogressive therapy as an answer to
study was close to the Cr and amount of force applied was orthodontic needs. Part 1. Am J Orthod. 1976;70:241–268.
within limits. Hence, no moments were generated which 7. Lindauer SJ, Lewis SM, Shroff B. Overbite correction and
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Please cite this article in press as: Kaushik A, et al. Comparative evaluation of intrusive effects of miniscrew, Connecticut intrusion arch,
and utility intrusion arch – An in vivo study, J Pierre Fauchard Acad (India Sect). (2016), http://dx.doi.org/10.1016/j.jpfa.2016.01.001