Palatal orthodontic miniscrew insertion using a CAD-CAM surgical guide: description of a technique

The aim of this report was to describe a new computer-guided technique for a controlled site preparation and palatal orthodontic miniscrew insertion using a dedicated software. A surgical guide was designed after planning the appropriate insertion sites on three-dimensional images created by the fusion of cone-beam computed tomography (CBCT) and digital dental model images. Pre- and postoperative CBCT images were compared and the angular, coronal, and apical deviations between the planned and the placed miniscrews were calculated. The mean coronal and apical deviations were 1.38 mm (range: 3.48-0.15 mm; standard deviation (SD): 0.65) and 1.73 mm (range: 5.41-0.10 mm; SD: 1.03), respectively, while the mean angular deviation was 4.60° (range: 15.23-0.54°; SD: 2.54). The present surgical guide allows a controlled and accurate palatal miniscrew placement in three dimensions.