An article published in 1997 by Kanomi ignited the intense wave of clinical interest in Orthodontic Mini-Implants (OMIs). Throughout the late 1990’s, multiple case reports were published, but the devices that were available were not very user friendly. Starting in 2000, more OMIs were developed specifically for orthodontic use. Today, there are at least a dozen brands that have been proved to be highly clinically effective.
One of the most confusing aspects regarding OMIs is the fact that there are so many names used to describe them. Various examples are: Temporary Anchorage Device (TAD), mini-screw, micro-screw, mini-implant, and micro-implant. This is only pointed out so that in case you hear various terms from different sources, you will know everyone is likely speaking about the same thing.
One of the strengths of OMIs is that they can be used in a wide array of clinical situations  where anchorage is required. For example, OMIs can be used to close the space left over from the extraction of teeth, intrude or extrude teeth, pull in teeth that are impacted, or upright teeth that are severely tipped. This is only a partial list as new strategies are always being discovered.
There are a couple risks associated with the use of OMIs. The most frequent problem is that the OMIs fall out. This is usually painless, but may require that the OMI is replaced. The success rate of OMIs reported in the literature is 70-100%. The other significant risk would be damage to the root of any tooth in the area of OMI insertion. Fortunately, studies have shown that minor root contact by an OMI is tolerated quite well by the teeth and that they are rarely permanently damaged if care is taken during the insertion procedure.
Either topical or local anesthesia can be used prior to placement to nearly eliminate any discomfort during OMI insertion and removal is even easier, not even requiring anesthesia in most cases. The majority of OMIs are placed directly through the gingiva and into the bone. The procedure often takes less than 5 minutes and rarely requires post-operative pain medication.
This discussion should have allowed you to understand the issue of orthodontic anchorage and the strategies that your orthodontist has at his or her discretion to achieve the optimal result in your case. OMIs applied to the correct situation can be an invaluable tool for the both the patient and the orthodontist.
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Dr. Garfinkle is a Board Certified Orthodontist practicing in Portland, Oregon. Read more about Dr. Garfinkle or visit his practice online at www.garfinkleortho.com.
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