Tomographic assessment of infrazygomatic crest bone depth for extra-alveolar miniscrew insertion in subjects with different vertical and sagittal skeletal patterns

Objective To evaluate bone availability at the infrazygomatic crest for extra-alveolar bone miniscrew insertion in subjects with different vertical and sagittal skeletal patterns. Setting and sample population Measurements of the infrazygomatic crest were performed on multislice computed tomography scans from 58 adults with different skeletal patterns. Materials and methods Infrazygomatic crest bone depth was measured at 4, 5 and 6 mm from the cementoenamel junction (CEJ) of the maxillary first molar at three different angles (60 degrees, 70 degrees and 80 degrees) in the first molar occlusal plane. The sagittal and vertical skeletal patterns were determined. Analysis of variance followed by Tukey's post hoc test was used (P <= .05). Results Bone depth was greater near the CEJ (8.7 +/- 3.1 mm) and lower in the apical area (5.8 +/- 2.7 mm). In Class II subjects, considering 6 mm from the CEJ, there was a significantly lower depth at the 80 degrees angle (5.4 +/- 2.5 mm) than at 60 degrees (8.6 +/- 3.5 mm; P = .007). In mesofacial subjects, considering 5 and 6 mm from the CEJ, bone depth was lower at 80 degrees (5.7 +/- 3.2 mm and 5.3 +/- 2.5 mm) than at 60 degrees considering 4 mm from the CEJ (P <= .019). Conclusion Bone availability was lower at the apical level, especially in Class II and mesofacial subjects. Therefore, when the planned insertion site is located in the apical direction, it is recommended to choose shorter miniscrews (2.0 x 12mm) and a smaller insertion angle (60 degrees) and/or to plan a miniscrew bone insertion deep enough to allow bicortical fixation.