Evaluation of Maxillary Buccal Miniscrew Insertion Using Digital Guides

Orthodontic miniscrews have become an effective source of temporary skeletal anchoragebecause they provide absolute anchorage with minimal dependence on patient compliance.However, the success of orthodontic miniscrews largely depends on accurate insertionwhile avoiding adjacent anatomical structures, particularly dental roots and themaxillary sinus. Incorrect placement may lead to root damage, instability, or failure ofthe miniscrew Cone‐beam computed tomography (CBCT) allows three‐dimensional evaluation ofalveolar bone morphology and cortical bone thickness before miniscrew insertion. Digitaltechnologies combining CBCT, intraoral scanning, CAD/CAM planning, and three‐dimensionalprinting have enabled fabrication of customized surgical guides designed to improveinsertion accuracy This study is designed as a randomized split‐mouth controlled clinicaltrial. Patients requiring bilateral orthodontic miniscrews in the posterior maxilla willreceive one miniscrew inserted using a CAD/CAM 3D‐printed surgical guide and thecontralateral miniscrew inserted using the conventional free‐hand technique. The sideallocated to each intervention and the order of insertion will be randomized Placementaccuracy will be evaluated by superimposing preoperative planning data with postoperativedigital models using Geomagic Studio software. Three‐dimensional deviations, includingcoronal and apical positional deviations and angular deviations, will be calculated.Miniscrew stability, success rate after three months, postoperative pain measured by theVisual Analog Scale (VAS), patient satisfaction, operative time, and treatment‐relatedcomplications will also be evaluated. Additionally, CBCT will be used to measure corticalbone thickness at multiple posterior maxillary interradicular sites, and correlationsbetween cortical bone thickness and miniscrew accuracy and stability will be analyzed