Investigating the Effects of Diabetes on the Success of Mini Implant Anchorage Device Treatment

Jamie Silverberg

Silverberg, Jamie
Faculty / Advisor: Teixeira, Hellen
University of Pennsylvania School of Dental Medicine, Department of Orthodontics


The purpose of the study is to investigate if diabetes affects the success of using temporary anchorage devices (“TADs”) in orthodontic treatment. Previous studies pertaining to TADs consist of investigating the associated classification system, indications, anatomical issues, and risks/problems. Many other studies have been published since 1994 about osteointegration and the prognosis of dental implants in diabetic patients. Theoretical literature and studies in diabetic animals substantiate higher failure rates of implants in diabetics, but most clinical studies indicate statistically insignificant failure of dental implants even in moderately uncontrolled diabetic patients. Many studies conclude that the success of dental implants in well controlled diabetic patients can be just as successful as in non-diabetic patients with proper treatment planning, prophylactic remedies and adequate postsurgical maintenance. This study aims to investigate whether diabetes affects the success of orthodontic treatment using TADs by performing a retrospective study/chart review. The targeted population is diabetic patients treated using TADs in Penn’s Orthodontics clinic in the last 15 years. The primary objective of this study is to determine whether diabetes is correlated to a higher mini-implant failure rate. The secondary objective of this study is to determine whether diabetes affects the ulceration rate associated with MARPE (miniscrew-assisted rapid expander).


A systematic, retrospective chart review is being performed using the electronic records from UPenn’s Orthodontia Clinic from the past 15 years. We expect to evaluate the medical records of 400 subjects in order to identify 100 subjects who are eligible for inclusion. Inclusion criteria consists of: Males and Females ages 12-95, completed orthodontic treatment with a TAD within the time frame 1/1/2005 to 1/1/2020, diagnosed with diabetes (Type I or Type II), taking or not taking medication to manage diabetes. Exclusion criteria consist of age limitations as well as other bone morphological diseases. Dependent variables include: the rate of TAD failure and the rate of oral ulcerations in MARPE patient. Initial data evaluation will comprise of a normality verification (SPSS software, USA), and the appropriate parametric or non-parametric statistical methods and post-hoc tests will be selected. Statistical significance will be set at 0.05 for all parameters analyzed. Statistical significance between all dependent variables will be calculated using a t-test between diabetic patients receiving TAD treatment vs non-diabetic patients receiving TAD treatment.


We are in the process of performing a thorough retrospective chart review. We predict that in well-controlled diabetic patients, there is no difference in the success of using TAD treatment in diabetic vs non-diabetic patients. However, in the uncontrolled diabetic patient, there is less success with using TADs in orthodontic treatment. We are still in the process of collecting data in order to prove our null hypothesis.


We are in the process of performing a thorough retrospective chart review. We hope that by performing this retrospective study, orthodontists will better understand the benefits and risks of treating diabetic patients using TADs.