Comparison of bone thickness in infrazygomatic crest area at various miniscrew insertion angles in Dravidian population - A cone beam computed tomography study

Introduction > Infrazygomatic crest miniscrews are an important advancement in the field of orthodontics for anchorage reinforcement. The size of the miniscrews and the site of placement depend on the bone thickness in the infazygomatic crest area. The bone morphology and the thickness vary among different ethnicities of population. Objectives > To assess the bone thickness in the infrazygomatic crest area around the distobuccal root of the maxillary first molar using cone beam computed tomography and determine the best possible site and angulation for the placement of the miniscrew. Therefore, to determine the size of the implant that will suit the Dravidian population. Methods > The infrazygomatic crest bone thickness was evaluated on 10 patients using cone beam computed tomography. The measurements were made along the distobuccal root of maxillary first molar at different angulations ranging from 75 degrees to 40 degrees to the occlusal surface of the molar. Results > The infrazygomatic crest bone thickness was of 4.5 mm to 9 mm for the Dravidian population, when measured at an angle of 40 degrees to 75 degrees to the maxillary first molar occlusal plane and of 11 to 17 mm above the occlusal plane. Student t-test (confidence interval 95%) was done to determine gender variation and compare the bone thickness of right and left side. ANOVA and post-hoc test were done to find the statistical difference between the bone thickness measured at different insertion angles. Conclusions > The best possible site for miniscrew insertion is 12 to 17 mm above the occlusal plane at an angle of 65 degrees to 70 degrees, with no injury to the adjacent anatomical structures, no mucosal irritation and adequate stability for the miniscrew. The ideal infrazygomatic crest screw length for Dravidian population is 9 to 11 mm.