{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:29:01Z","timestamp":1791203341908,"version":"4.2.0"},"reference-count":49,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea, Oradea, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background\/Objectives: Orthodontic mini-implants have become indispensable in modern orthodontics due to their ability to provide absolute anchorage, independent of patient compliance. Our research aims to illustrate the versatility of mini-implants in addressing diverse biomechanical challenges across different planes of tooth movement (sagittal, transverse, and vertical) based on a retrospective clinical analysis. Methods: A retrospective analysis of orthodontic treatments performed with mini-implants (Dual Top and JS systems) was conducted, focusing on predefined biomechanical objectives and outcomes. The analysis encompassed distinct biomechanical applications, including incisor retraction and space closure using sequential direct and indirect anchorage; transverse and vertical correction of adult open bite through mini-implant\u2013assisted rapid palatal expansion (MARPE) and molar intrusion; deep bite correction via simultaneous upper and lower incisor intrusion; and unilateral molar distalization using palatal skeletal anchorage. Results: Mini-implants provided stable, reproducible anchorage in all cases, enabling complex three-dimensional tooth movements with minimal side effects. Sequential reuse of the same mini-implants for both indirect and direct anchorage reduced treatment invasiveness and enhanced anchorage efficiency. Combined skeletal expansion and posterior intrusion allowed improved transverse and vertical control in adult open-bite presentations. Pure incisor intrusion was achieved without molar extrusion or incisor proclination, while unilateral molar distalization was effectively managed using palatal skeletal anchorage. Across all cases, mini-implants enhanced treatment efficiency, reduced the need for auxiliary appliances, and ensured predictable outcomes. Conclusions: Orthodontic mini-implants represent a highly versatile and minimally invasive anchorage system adaptable to a broad range of biomechanical situations. Their ability to provide stable, reusable, and site-specific anchorage supports efficient correction of complex malocclusions and reinforces their pivotal role in contemporary orthodontic practice.<\/jats:p>","DOI":"10.3390\/dj14030132","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T09:31:32Z","timestamp":1772098292000},"page":"132","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Applications of Orthodontic Mini-Implants in Orthodontic and Esthetic Practice: A Case Series Exploring Biomechanical Versatility"],"prefix":"10.3390","volume":"14","author":[{"given":"Teodora Consuela","family":"Bung\u0103u","sequence":"first","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ada","family":"Radu","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1417-5963","authenticated-orcid":false,"given":"Gabriela","family":"Ciavoi","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref_1","unstructured":"Jong, S.L., Kook, K.J., Park, Y.-C., and Vanarsdall, R.L. (2008). Applications of Orthodontic Mini-Implants, Quintessence Publishing Company Limited."},{"key":"ref_2","first-page":"77","article-title":"Mini Implants in Orthodontics\u2014A Review","volume":"11","author":"Dhayal","year":"2023","journal-title":"J. Adv. Med. Dent. Sci. Res."},{"key":"ref_3","unstructured":"Proffit, W.R., Fields, H., Larson, B., and Sarver, D.M. (2018). Contemporary Orthodontics, Elsevier Health Sciences. [6th ed.]."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Bucur, S.-M., Vaida, L.L., Olteanu, C.D., and Checchi, V. (2021). A Brief Review on Micro-Implants and Their Use in Orthodontics and Dentofacial Orthopaedics. Appl. Sci., 11.","DOI":"10.3390\/app112210719"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Currier, F., and Kadioglu, O. (2013). The Orthodontist\u2019s Role in MDI Therapeutics: ORTHO Transitional Anchorage Devices (TADs) and Related Applications. Mini Dental Implants: Principles and Practice, Mosby.","DOI":"10.1016\/B978-1-4557-4386-5.00009-9"},{"key":"ref_6","first-page":"e31476","article-title":"Modern Anchorage Systems in Orthodontics","volume":"14","author":"Umalkar","year":"2022","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Panaite, T., Balcos, C., Savin, C., Olteanu, N.D., Karvelas, N., Romanec, C., Vieriu, R.M., Chehab, A., and Zetu, I. (2024). Exploring the Use, Perceptions, and Challenges of Mini-Implants in Orthodontic Practice: A Survey Study. Front. Oral Health, 5.","DOI":"10.3389\/froh.2024.1483068"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"835","DOI":"10.11607\/jomi.4197","article-title":"Factors Affecting the Clinical Success Rate of Miniscrew Implants for Orthodontic Treatment","volume":"31","author":"Jing","year":"2016","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_9","first-page":"385","article-title":"Preferences in mini-implant dimensions among romanian orthodontists","volume":"17","author":"Bungau","year":"2025","journal-title":"Rom. J. Oral Rehabil."},{"key":"ref_10","unstructured":"(2023, March 27). WMA Declaration of Helsinki\u2014Ethical Principles for Medical Research Involving Human Subjects. Available online: https:\/\/www.wma.net\/policies-post\/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects\/."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"407","DOI":"10.2334\/josnusd.53.407","article-title":"Clinical Indices for Orthodontic Mini-Implants","volume":"53","author":"Motoyoshi","year":"2011","journal-title":"J. Oral Sci."},{"key":"ref_12","first-page":"39","article-title":"Guidelines for Success in Placement of Orthodontic Mini-Implants","volume":"43","author":"Luzi","year":"2009","journal-title":"J. Clin. Orthod."},{"key":"ref_13","first-page":"191","article-title":"\u201cSafe Zones\u201d: A Guide for Miniscrew Positioning in the Maxillary and Mandibular Arch","volume":"76","author":"Poggio","year":"2006","journal-title":"Angle Orthod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"397","DOI":"10.2319\/061710-111.1","article-title":"\u201cSafe Zones\u201d for Miniscrew Implant Placement in Different Dentoskeletal Patterns","volume":"81","author":"Chaimanee","year":"2011","journal-title":"Angle Orthod."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Liu, P.-H., Chen, Y.-F., Pan, C.-Y., Sheen, M.-H., Chen, B.-S., and Chang, H.-P. (2022). Maxillary Skeletal Expansion with Monocortical and Bicortical Miniscrew Anchorage: A 3D Finite Element Study. Appl. Sci., 12.","DOI":"10.3390\/app12094621"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.ajodo.2016.10.025","article-title":"Effects of Monocortical and Bicortical Mini-Implant Anchorage on Bone-Borne Palatal Expansion Using Finite Element Analysis","volume":"151","author":"Lee","year":"2017","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1590\/2177-6709.21.4.017-023.oin","article-title":"Miniscrew-Assisted Rapid Palatal Expander (MARPE): The Quest for Pure Orthopedic Movement","volume":"21","author":"Suzuki","year":"2016","journal-title":"Dent. Press J. Orthod."},{"key":"ref_18","first-page":"e72008","article-title":"Effect of Anchorage Modifications on the Efficacy of Miniscrew-Assisted Rapid Palatal Expansion: A Systematic Review and Meta-Analysis","volume":"16","author":"Ardila","year":"2024","journal-title":"Cureus"},{"key":"ref_19","first-page":"ZE11","article-title":"Microimplant Assisted Rapid Palatal Expansion: A Comprehensive Review","volume":"15","author":"Hoque","year":"2021","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.ajodo.2020.03.024","article-title":"Microimplant Assisted Rapid Palatal Expansion vs Surgically Assisted Rapid Palatal Expansion for Maxillary Transverse Discrepancy Treatment","volume":"159","author":"Ayub","year":"2021","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.ajodo.2017.11.033","article-title":"Midfacial Changes in the Coronal Plane Induced by Microimplant-Supported Skeletal Expander, Studied with Cone-Beam Computed Tomography Images","volume":"154","author":"Cantarella","year":"2018","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.ajodo.2013.12.026","article-title":"Stability of Surgically Assisted Rapid Palatal Expansion with and without Retention Analyzed by 3-Dimensional Imaging","volume":"145","author":"Prado","year":"2014","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ajodo.2004.12.024","article-title":"Soft-Tissue and Cortical-Bone Thickness at Orthodontic Implant Sites","volume":"130","author":"Kim","year":"2006","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_24","unstructured":"Paik, C.-H., Park, O.-K., Woo, Y., and Kim, T.-W. (2012). Miniscrew Implant Anchorage for Intrusion of Teeth. Orthodontic Miniscrew Implants: Clinical Applications, Mosby Ltd."},{"key":"ref_25","unstructured":"Paik, C.-H., Park, O.-K., Woo, Y., and Kim, T.-W. (2012). Anatomic Considerations and Placement\/Removal of Orthodontic Miniscrew Implants. Orthodontic Miniscrew Implants: Clinical Applications, Mosby Ltd."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S707","DOI":"10.4103\/jpbs.jpbs_957_23","article-title":"Effectiveness of Miniscrew-Supported Molar Intrusion: A Clinical Study","volume":"16","author":"Patel","year":"2024","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"56","DOI":"10.14219\/jada.archive.2007.0021","article-title":"The Use of Temporary Anchorage Devices for Molar Intrusion","volume":"138","author":"Kravitz","year":"2007","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_28","unstructured":"Papadopoulos, M.A., and Tarawneh, F. (2013). Miniscrew Implants for Temporary Skeletal Anchorage in Orthodontic Treatment. Skeletal Anchorage in Orthodontic Treatment of Class II Malocclusion. Contemporary Applications of Orthodontic Implants, Miniscrew Implants and Mini Plates, Mosby Ltd."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Becker, K., Pliska, A., Busch, C., Wilmes, B., Wolf, M., and Drescher, D. (2018). Efficacy of Orthodontic Mini Implants for En Masse Retraction in the Maxilla: A Systematic Review and Meta-Analysis. Int. J. Implant Dent., 4.","DOI":"10.1186\/s40729-018-0144-4"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kuc, A.E., Kotu\u0142a, J., Nahajowski, M., Warnecki, M., Lis, J., Amm, E., Kawala, B., and Sarul, M. (2022). Methods of Anterior Torque Control during Retraction: A Systematic Review. Diagnostics, 12.","DOI":"10.3390\/diagnostics12071611"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"197","DOI":"10.5152\/TurkJOrthod.2020.20064","article-title":"Efficient Distalization of Maxillary Molars with Temporary Anchorage Devices for the Treatment of Class II Malocclusion","volume":"33","author":"Papadopoulos","year":"2020","journal-title":"Turkish J. Orthod."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s13005-021-00273-3","article-title":"Class II Correction by Maxillary En Masse Distalization Using a Completely Customized Lingual Appliance and a Novel Mini-Screw Anchorage Concept\u2014Preliminary Results","volume":"17","author":"Beyling","year":"2021","journal-title":"Head Face Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ajodo.2016.06.053","article-title":"Miniscrew-Assisted Customized Lingual Appliances for Predictable Treatment of Skeletal Class II Malocclusion with Severe Deep Overbite and Overjet","volume":"152","author":"Wang","year":"2017","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.ajodo.2009.07.023","article-title":"Class III Malocclusion with Complex Problems of Lateral Open Bite and Severe Crowding Successfully Treated with Miniscrew Anchorage and Lingual Orthodontic Brackets","volume":"139","author":"Yanagita","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.3889\/oamjms.2019.332","article-title":"Intrusive Arch versus Miniscrew-Supported Intrusion for Deep Bite Correction","volume":"7","author":"Bushnak","year":"2019","journal-title":"Open Access Maced. J. Med. Sci."},{"key":"ref_36","first-page":"CD005972","article-title":"Orthodontic Treatment for Deep Bite and Retroclined Upper Front Teeth in Children","volume":"2","author":"Millett","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Romanec, C.L., Panaite, T., and Zetu, I.N. (2025). Dimensions Define Stability: Insertion Torque of Orthodontic Mini-Implants: A Comparative In Vitro Study. J. Clin. Med., 14.","DOI":"10.3390\/jcm14051752"},{"key":"ref_38","first-page":"10","article-title":"Comparison of Intrusive Effects of Miniscrews and Utility Arch and Their Effects on Root Resorption","volume":"17","author":"Phor","year":"2018","journal-title":"IOSR J. Dent. Med. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"767","DOI":"10.2319\/120610-703.1","article-title":"Effects of Mandibular Incisor Intrusion Obtained Using a Conventional Utility Arch vs Bone Anchorage","volume":"81","year":"2011","journal-title":"Angle Orthod."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1093\/ejo\/cjt046","article-title":"Assessment of Changes Following En-Masse Retraction with Mini-Implants Anchorage Compared to Two-Step Retraction with Conventional Anchorage in Patients with Class II Division 1 Malocclusion: A Randomized Controlled Trial","volume":"36","author":"Hajeer","year":"2014","journal-title":"Eur. J. Orthod."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.ajodo.2006.10.025","article-title":"Mini-Implant Anchorage for En-Masse Retraction of Maxillary Anterior Teeth: A Clinical Cephalometric Study","volume":"134","author":"Upadhyay","year":"2008","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jdsr.2014.05.001","article-title":"Risks and Complications of Miniscrew Anchorage in Clinical Orthodontics","volume":"50","author":"Kuroda","year":"2014","journal-title":"Jpn. Dent. Sci. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1016\/j.ajodo.2006.04.027","article-title":"Risks and Complications of Orthodontic Miniscrews","volume":"131","author":"Kravitz","year":"2007","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.ajodo.2012.05.016","article-title":"Failure Rates and Associated Risk Factors of Orthodontic Miniscrew Implants: A Meta-Analysis","volume":"142","author":"Papageorgiou","year":"2012","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2334\/josnusd.17-0377","article-title":"Risk Factors for Failure of Orthodontic Mini-Screws Placed in the Median Palate","volume":"61","author":"Ichinohe","year":"2019","journal-title":"J. Oral Sci."},{"key":"ref_46","first-page":"100","article-title":"A Prospective Study of the Risk Factors Associated with Failure of Mini-Implants Used for Orthodontic Anchorage","volume":"19","author":"Cheng","year":"2004","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"5848","DOI":"10.1038\/s41598-020-62838-7","article-title":"Risk Factors for Orthodontic Mini-Implants in Skeletal Anchorage Biological Stability: A Systematic Literature Review and Meta-Analysis","volume":"10","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1055\/s-0043-1772249","article-title":"The Orthodontic Mini-Implants Failures Based on Patient Outcomes: Systematic Review","volume":"18","author":"Tarigan","year":"2024","journal-title":"Eur. J. Dent."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Bung\u0103u, T.C., Moca, A.E., Ciavoi, G., Romanul, I.M., Vaida, L.L., and Buha\u0219, C.L. (2024). Usage and Preferences of Orthodontic Mini-Implants Among Romanian Practitioners: A Survey Study. Dent. J., 12.","DOI":"10.3390\/dj12120400"}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/3\/132\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T17:04:56Z","timestamp":1772125496000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/3\/132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":49,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["dj14030132"],"URL":"https:\/\/doi.org\/10.3390\/dj14030132","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]}}}