When is an orthodontic mini-implant required as part of orthodontic treatment?

An orthodontic mini-implant may be required when the orthodontist needs additional support to move the teeth in a controlled manner, without undesirably altering the position of other teeth. It is used in complex orthodontic treatments, for example to close gaps between teeth, move molars or correct bite problems.

Not all patients wearing braces need mini-implants. The recommendation depends on the position of the teeth, the specific characteristics of the bite and the objectives of the treatment plan.

In short:

• An orthodontic mini-implant is a temporary device used for anchorage during orthodontic treatment.
• It may be recommended for closing gaps between teeth, moving molars, expanding the jaw or correcting complex bite problems.
• It is usually fitted under local anaesthetic and removed once it is no longer required.
• It is not mandatory for all patients wearing braces.
• The need for one is determined on a case-by-case basis following an orthodontic assessment.

Unlike a conventional dental implant, which replaces the root of a missing tooth and supports a prosthetic restoration, the orthodontic mini-implant serves a temporary purpose. It is removed once it is no longer required for treatment.

Orthodontic mini-implants are particularly recommended when certain tooth movements require additional anchorage, which is difficult to achieve using only braces and the existing teeth.

To close gaps between teeth, including after extractions

In certain orthodontic treatments, the extraction of some teeth may be necessary to create the space required for the other teeth to align.

Closing these gaps involves controlled tooth movement.  

‘To move the teeth into the desired position, we need a fixed anchor point. Sometimes, the support provided by neighbouring teeth is not sufficient. In these situations, orthodontic mini-implants placed in the anchorage area provide us with stable support, which helps us to better control the movements. If we need to move the front teeth without the molars moving forward, an orthodontic mini-implant can be a real help,” explains Dr. Liana Andruseac. “In certain cases, this additional support can also help to shorten some stages of treatment,” adds the doctor.

For the controlled movement of molars and premolars

“Sometimes, we need to move the molars or premolars in the anteroposterior direction (from front to back). These teeth in the lateral areas have long, strong roots, and molars even have two or three roots. To achieve safe, controlled and faster movement, we can use orthodontic mini-implants.”

These movements can be difficult to achieve when neighbouring teeth do not provide stability or when their movement needs to be avoided.  

Orthodontic mini-implants can facilitate the movement of molars and premolars, providing a more secure and stable anchor point.

For palatal expansion

When the upper jaw is too narrow, the dentist may recommend a device to widen it. “If we wish to widen the dental arch at the level of the maxillary bone base (by widening the palate), in adolescents or adults, we use orthodontic appliances with skeletal anchorage.”

“These orthodontic appliances are anchored to mini-implants, which provide us with stable bony support. In this way, we minimise adverse effects on the teeth and promote new bone formation within the dental arch, even after bone growth has ceased.”

In this way, we are able to create additional bone and widen the maxillary arch by applying forces to the midline suture (located in the roof of the mouth). This allows us to avoid tooth extractions or correct the bite more effectively.

In certain cases, skeletal-anchored orthodontic appliances allow us to treat patients even after the growth period has ended, not just adolescents or children.

For the correction of complex bite problems

In certain bite problems, such as open bite, deep bite or other occlusal imbalances, the dentist may need to move the teeth vertically as well.

For example, in an open bite, some teeth do not touch when the mouth is closed. In a deep bite, the upper front teeth cover the lower ones too much.

“Sometimes, we need to move a tooth or a group of teeth in a controlled manner deeper into the bone that supports them. This movement is called dental intrusion.”

In certain cases of an open bite, we use mini-implants to achieve this movement in the teeth at the sides of the dental arches, so that the front teeth can make contact.

“In deep or collapsed bites, we need to open the bite, and the support provided by mini-implants is very useful, reducing the duration of treatment. Tooth movements are easier to control, thereby minimising side effects. The anchor teeth are subjected to fewer forces and are not under as much strain,” explains Dr Andruseac.

Mini-implants can provide the necessary anchorage to achieve these movements, depending on the specifics of the case and the orthodontic plan.

When existing teeth do not provide sufficient support for treatment

We usually use existing teeth as anchor points. However, this solution is not always sufficient.

For example, in patients who have lost one or more teeth, the options for anchorage may be limited. At other times, the treatment requires moving certain teeth in a specific direction without altering the position of the surrounding teeth.

In such situations, a mini-implant can provide an additional point of support, without relying solely on the existing teeth.

To prepare the space required for a dental restoration

Orthodontic treatment can form part of a wider dental rehabilitation plan, particularly when the patient is missing teeth and the existing gaps need to be corrected before a dental implant is inserted.

“We often use mini-implants to create the space required for the correct placement of the dental implant. The correct positioning of the teeth adjacent to the dental implant allows a crown of the correct shape and size to be fitted,” explains Dr Andruseac.

In these cases, orthodontics, implantology and dental prosthetics are planned together, so that each stage prepares the way for the next. 

The need for an orthodontic mini-implant is determined following a clinical assessment and treatment planning.

For example, computed tomography helps us to identify areas of higher bone density that are suitable for the insertion of mini-implants. These can be placed between or above the tooth roots, depending on the individual case.

“In adults, we most commonly use mini-implants to create space between teeth for prosthetic purposes, to allow for the insertion of dental implants. In adolescents, we often use mini-implants to expand the upper jaw or to move the teeth backwards – a movement known as distalisation.” 

The main advantage of orthodontic mini-implants is the ability to control certain tooth movements more precisely, without relying solely on existing teeth for anchorage.

More precise control of tooth movement

The mini-implant provides a stable anchor point for the application of orthodontic forces. This allows the dentist to limit unwanted movement of other teeth and to better control the direction of the required movements.

The ability to perform complex orthodontic movements

Certain movements, such as tooth intrusion or the controlled movement of molars, may require additional anchorage.

The use of mini-implants can expand treatment options in cases where conventional anchorage is insufficient.

Can mini-implants reduce the duration of orthodontic treatment?

In certain situations, mini-implants can streamline the stages of treatment by providing better control over tooth movement.

However, the use of a mini-implant does not guarantee a shorter duration of orthodontic treatment. The total duration depends on the complexity of the case, the biological response of the tissues and the objectives set by the dentist. 

In conventional orthodontic treatment, teeth are frequently used as anchor points to move other teeth. Depending on the case, auxiliary devices such as elastics or certain anchorage appliances may also be used.

Mini-implants offer an alternative form of temporary skeletal anchorage that does not rely solely on the support provided by the other teeth.

This difference is important in treatments that require additional control of forces or the prevention of unwanted tooth movement.

However, mini-implants involve a surgical procedure and require monitoring. They do not replace braces, but can be used in conjunction with them when the treatment plan so requires.

The insertion of an orthodontic mini-implant is a minor procedure, carried out following an assessment of the area where the device is to be placed.

Generally, the procedure involves the following steps:

1. Planning the position of the mini-implant. The dentist determines the insertion site based on the local anatomy and the required anchorage.
2. Administration of local anaesthesia. The area is numbed to prevent pain during the procedure.
3. Insertion of the mini-implant. The device is fixed into the bone using a technique tailored to the area and the type of mini-implant.
4. Connection to the orthodontic system. The mini-implant can be used to apply orthodontic forces immediately or at a later stage, depending on its stability and the treatment plan.

The procedure does not usually require extensive surgery, and the patient can resume their normal activities in accordance with the dentist’s recommendations. 

The insertion of the orthodontic mini-implant is carried out under local anaesthetic. During the procedure, the patient may feel a sensation of pressure, without any significant pain.

Once the anaesthetic has worn off, temporary local sensitivity or discomfort may occur. The intensity and duration of this vary from patient to patient.

The dentist will provide advice for the period immediately following the insertion. If the pain persists, worsens or is accompanied by significant inflammation, the area will need to be re-assessed. 

Orthodontic mini-implants are frequently used for temporary anchorage, but their insertion and use may be associated with certain risks.

These include:

• Inflammation or irritation of the tissues surrounding the mini-implant.
• Local sensitivity and discomfort following insertion.
• Loosening or loss of stability of the device.
• The possibility of damage to tooth roots or other neighbouring anatomical structures.

The risk of complications may be influenced by the positioning of the device, the quality and quantity of bone, oral hygiene and the patient’s medical history.

Active periodontal disease, certain systemic conditions or medication may require additional precautions and an individualised assessment.

The orthodontist determines whether a mini-implant is appropriate and whether any additional measures are required prior to insertion.

• Oral hygiene is essential in the area around the mini-implant to reduce the risk of inflammation.
• Dental hygiene is carried out as normal using a toothbrush, toothpaste and dental floss.
• Use additional hygiene aids, such as a mouthwash, around the mini-implant.
• You can use mouthwash twice a week.
• Do not apply pressure to the mini-implant with your fingers or tongue.
• Attend your regular orthodontic check-ups to check the stability of the device and adjust the forces applied
• If you notice that the mini-implant is moving or if you experience persistent pain and severe inflammation, contact your orthodontist.

For further advice, find out how to maintain good oral hygiene during orthodontic treatment. 

An orthodontic mini-implant may be recommended when treatment requires additional control over tooth movement, particularly in cases of insufficient anchorage or complex tooth movements.

It is not a mandatory step for all patients wearing braces. The need for it is determined on a case-by-case basis, following an orthodontic assessment and analysis of the treatment objectives.

Book an orthodontic consultation at DENT ESTET to find out which solutions are suitable for straightening your teeth and correcting your bite.