Titanium alloy vs. stainless steel miniscrews: An in vivo split-mouth study

OBJECTIVE: To compare in vivo Titanium Alloy (TiA) with Stainless Steel (SS) miniscrews Temporary Anchorage Devices (TADs) using removal torque and Scanning Electron Microscopic (SEM) analysis. PATIENTS AND METHODS: 15 subjects (6 males and 9 females) who required maximum anchorage were recruited. For each patient, a TiA TAD and a SS TAD with same length and width were implanted following a randomized splitmouth study design. Retraction was carried out with nickel-titanium spring ligated directly from the anterior hooks of the archwire to the TADs to produce 90 to 100 g of force. When no further anchorage supplementation was needed, the TADs were removed. The removal torque values were registered with a digital screwdriver. After removal, the TADs were collected in a fixed solution and examined using SEM and X-ray microanalysis. RESULTS: All TADs remained intact, with a 100% success rate. There was no difference in removal torque between TiA and SS miniscrews (4.4 ± 1.3 N-cm and 5.1 ± 0.7 N-cm, respectively). All specimens' loss of gloss with signs of biological contaminations resulted in a dull implant surface. SEM photomicrographs of TiA miniscrews showed predominantly blood cells while SS miniscrews showed the precipitation of an amorphous layer with low cellular component. There was no difference in spectroscopic analysis between TiA and SS miniscrews. CONCLUSIONS: TiA and SS miniscrews had comparable removal torque values. SEM photomicrographs showed no evidence of osteointegration with both TADs having similar biological responses.