Palatal implants are a good alternative to headgear: A randomized trial

Introduction: The objective of this study was to compare the effectiveness of midpalatal implants with that of headgear as methods of supplementing anchorage during orthodontic treatment. This was a randomized, clinical trial at the Chesterfield and North Derbyshire Royal Hospital NHS Trust and the Charles Clifford Dental Hospital, Sheffield, United Kingdom. Methods: Fifty-one orthodontic patients between the ages of 12 and 39 with absolute anchorage requirements were randomly allocated to receive either a midpalatal implant or headgear to reinforce orthodontic anchorage. The outcome measures of the trial were the surgical and orthodontic success rates of the implants, the number of visits, and the length of treatment time, and the success of treatment as judged by the peer assessment rating (PAR) score reductions and the patients' attitudes to implant placement. Results: The surgical success rate of the implants was 75%, and the orthodontic success rate was more than 90%. Both implants and headgear proved to be effective methods of reinforcing anchorage. The total number of visits was greater in the implant group, but the overall treatment times were almost identical. There were no statistically significant differences between the 2 groups in PAR scores either at the start or the end of treatment, and the percentages of PAR score reductions were almost identical. The patients had no problems accepting midpalatal implants as a method of reinforcing anchorage. Conclusions: Midpalatal implants are an acceptable technique for reinforcing anchorage in orthodontic patients and a good alternative for patients who do not wish to wear headgear. © 2008 American Association of Orthodontists.