Effect of Miniscrew Implant Anchorage in Orthodontic Orthognathic Treatment of Patients With Skeletal Class II Malocclusion

Abstract

Objective: To compare the therapeutic efficacy of miniscrew implant anchorage with that of conventional extraoral arch anchorage, both of which are combined with orthodontic–orthognathic treatment, in patients with skeletal Class II malocclusion. Methods: This prospective nonrandomised controlled study included 130 patients. In terms of treatment method and patient preference, 58 patients received conventional orthodontic-orthognathic treatment with extraoral arch anchorage (conventional group), whereas 72 patients received treatment augmented with miniscrew implant anchorage (study group). The treatment protocol for all patients followed the conventional three-stage orthodontic–orthognathic approach. The outcomes assessed included treatment effectiveness, adverse events, root resorption (volume via CT), skeletal and dental changes (via comprehensive cephalometric analysis), soft tissue profile changes, facial aesthetics, and alveolar bone morphology (via CBCT). Results: The total effective rate was significantly greater in the study group (95.83%) than in the conventional group (74.14%) (p < 0.05). While both groups presented significant root resorption posttreatment (p < 0.05), the degree of resorption did not differ significantly between the groups (p > 0.05). Crucially, CBCT analysis revealed significantly better preservation of the palatal bone plate and alveolar bone height in the study group (p < 0.05). The study group also demonstrated significantly greater improvements in skeletal parameters (SNA, SNB, FMA, and PP-FH), dental decompensation (U1-SN, U1-NA, L1-MP, and L1-NB), soft tissue indices, and facial aesthetics (p < 0.05). The incidence of adverse events was significantly lower in the study group (34.72% vs. 75.86%, p < 0.05). Logistic analysis revealed that oral hygiene, vertical facial pattern, peri-implant swelling, and force application time were independent risk factors for miniscrew success. Conclusion: The integration of miniscrew implant anchorage in orthodontic-orthognathic treatment for skeletal Class II malocclusion provides superior clinical efficacy. Its primary advantage lies in enabling enhanced control over dental decompensation and skeletal correction, leading to significantly improved facial aesthetics, a more favorable mandibular position, and better alveolar bone preservation, with a lower complication profile. This represents an effective and reliable treatment option for these patients.