What is the impact of patient attributes, implant characteristics, surgical techniques, and placement location on the success of orthodontic mini-implants in young adults? A Systematic Review and Meta-Analysis

Background: Temporary anchorage devices (TADs) address challenges in traditional orthodontic anchorage like patient compliance and precision, showing significantly improved clinical outcomes, particularly for cases requiring maximum anchorage. Materials and Methods: A systematic electronic search was performed in five research databases, focusing on studies published between 2015 and 2023. The ROBINS-I tool from the Cochrane Bias Methods Group assessed the risk of bias. Data analysis included categorical and numerical variables, with categorical variables analyzed using Cohen's method in a random effects model to account for variability. Sensitivity and heterogeneity were evaluated using a 'leave-one-out' approach and the I-2 statistic, respectively. At the same time, publication bias was checked using Egger's test, with findings presented through Forest and Funnel plots. Numerical variables were subjected to weighted regression analysis. Results: Examination of 15 studies involving 1981 patients and 3272 orthodontic mini-implants identified key factors affecting implant stability. Failure rates varied significantly, influenced by factors such as the characteristics and insertion site of the orthodontic mini-implants (OMIs), patient-specific variables, and operator experience. Notably, the insertion site and implant characteristics like size did not significantly affect failure rates, but there was a negative correlation between the magnitude of force applied and failure rates. Conclusion: The success of orthodontic mini-implants is broadly consistent across patient demographics and is not significantly impacted by gender or age, though failure rates were higher in males and when implants were placed in the maxilla. These findings suggest that higher applied forces might reduce failure rates. Clinical Significance: This review underlines mini-implant efficacy across varied patient demographics, emphasizing the importance of site selection, jaw location, and force application in enhancing success rates and guiding tailored treatment strategies.