A miniplate system for improved stability of skeletal anchorage.

miniscrews reportedly have failure rates as high as 10-30%.1-4 Miniscrew loosening or tipping can result from any of the following factors: • Insufficient bone quantity or quality at the insertion site.5-7 • Use of a screw of inadequate diameter or length.3,8-10 • Inappropriate intraosseous design.10-12 • Root contact during insertion.13 • Manipulation by the patient’s fingers or tongue.8 • Poor oral hygiene. • Application of excessive forces or moments.9,14 • Too long a lever arm, if the miniscrew is inserted in a region where the gingiva or mucosa is too thick.9,14,15 • Peri-implantitis from insertion in the mucosal region.2,8 • Insufficient primary stability.15-17 • Bone damage on insertion from stress or overheating.2,18,19 In an attempt to improve stability and prevent tipping, we tried coupling two miniscrews in the line of force. Initially, we tied the miniscrews together with an .017" × .025" stainless steel sectional wire or a premolar band surrounding the screw heads, covering the assembly with Transbond LR* resin. Application and removal of these components were time-consuming, however, and in some cases the attachments failed because of resin fracture. As an alternative, we developed the Benefit** miniscrew system,20 with four different types of stainless steel abutments that can be attached to the top of the implant with integrated miniature fixing screws (Fig. 1). The Benefit system can provide stable skeletal anchorage, especially when two coupled miniscrews are used (Fig. 2). The two abutments have to be connected by welding or soldering, however, which requires an impression