Orthodontic Microimplants in Astana: What They Are, Why They Are Needed, and How Placement Is Done

Design and material of the temporary screw

A microimplant resembles a small self-tapping screw with a smooth neck and a head to which a spring or elastic is attached. It is made of titanium alloy—the same class as regular implants. Length and diameter vary: shorter ones are used for the upper jaw, longer ones for the lower jaw, because bone density differs. The thread can be conical or cylindrical, which affects primary stability. The head extension may have a hook, a hole, or a flat platform for a bracket. It is placed through the mucosa without flap elevation. Unlike a classic implant, a microimplant does not have an intraosseous portion that fuses with the bone to support a crown—it is held by mechanical wedging in the cortical layer. Therefore, it can be loaded immediately and just as easily unscrewed when it is no longer needed. Patients often search for “orthodontic implants” and see different names—it is the same product. The material is not magnetic, does not oxidize in the mouth, and does not interfere with MRI scans.

Key differences from a classic implant

Why additional anchorage is needed at all

Sometimes teeth that should stay in place begin to move along with those that need to be moved. This happens because the anchorage is weak. A microimplant provides a rigid point from which traction can be applied without loss. Then the orthodontist does not waste time compensating for unwanted shifts. For example, when pulling a canine into the space of a missing tooth, adjacent incisors may tilt toward the defect. The screw holds the traction and prevents them from shifting. The second scenario is distalization: when the entire dental arch needs to be moved backward. Without anchorage on a screw, part of the force goes to the front teeth, and they protrude forward. With a microimplant, the traction vector is set more precisely. The third case is teeth that are tilted or rotated around their axis. They are difficult to rotate with conventional archwires, but a screw allows force to be applied in the desired plane. The decision on whether such anchorage is needed is made by the doctor based on X-rays and a model. If anchorage is insufficient, treatment is prolonged or the result is incomplete.

Situations where anchorage is essential

How a TAD works with braces

The TAD is screwed into the bone between the roots, most often in the area between the second premolar and the first molar. The head remains above the gum. A spring, elastic, or traction is attached to it. The archwire continues to work according to its own plan. The force from the anchorage is applied separately from the archwire, and this is the main difference. The orthodontist calculates the direction and amount of force rather than simply screwing in the TAD. Too much force overloads the root; too little produces no movement. The doctor checks the anchorage position at follow-up visits. If the TAD has loosened, it can be reinserted at an adjacent site. Sometimes anchorage is needed for a few weeks, sometimes for the entire duration of braces treatment. It depends on the clinical situation. When anchorage is no longer needed, the TAD is removed under local anesthesia. The site heals on its own and requires no separate treatment.

Use with clear aligners: is there a difference?

Removable aligners move teeth more gently than an archwire. But they just as often require an anchorage point. The TAD is placed in the same areas as with braces. The difference is in the attachment. An elastic or button is fixed to the anchorage, and the aligner has a cutout for it. The patient changes the elastic themselves according to the schedule given by the doctor. The aligner must fit snugly, otherwise the force goes in the wrong direction. Therefore, when wearing anchorage, it is especially important not to skip aligner changes. The TAD does not replace aligners but complements them. It takes on the movements that the aligner cannot perform: for example, extruding a canine from the bone or rotating a molar. The duration of anchorage wear depends on the task. The doctor decides based on follow-up imaging. If the patient removes the aligner more often than needed, movement slows down, but this is a matter of compliance, not of the appliance design.

Daily hygiene around the TAD

Which products help and which harm

Toothpaste should be mild, without abrasives or whitening granules. Large particles scratch the TAD surface and the polished enamel nearby. Whitening products should be postponed during treatment: peroxide irritates the gum around the neck of the TAD. Dental floss is useful for adjacent teeth, but there is no need to wrap it around the anchorage itself — an interdental brush is used there. Hard toothbrushes, tooth powders, and homemade rinses with baking soda are harmful: they injure the mucosa and prevent it from holding the anchorage. Antiseptics are used in a course, not continuously. Prolonged use of chlorhexidine stains enamel and disrupts the microflora. If the doctor has prescribed a chlorhexidine gel, it is applied precisely to the gingival margin around the TAD. Therapeutic toothpastes for sensitive teeth are suitable if they do not contain aggressive ingredients. Anything that causes burning or bleeding should be discontinued and discussed with the orthodontist. Special implant-care toothpastes are not required — a regular hygiene formula will do. If bleeding occurs, do not stop brushing; instead, change your technique: gentler movements, less pressure, more frequent toothbrush replacement.

Diet and habits to keep in mind

Hard food puts stress on the anchorage. Nuts, croutons, pits, and hard candies are best avoided or crushed. Apples and carrots should be cut into slices rather than bitten whole. Sticky foods — toffee, nougat, caramel — stick to the TAD head and pull on it during chewing. After eating, rinse your mouth with water if you cannot brush your teeth. Coffee, tea, and red wine leave stains on the enamel around braces but do not stain the TAD itself. Smoking slows gum healing and worsens hygiene: tar deposits on brackets and the TAD neck. Habits such as biting nails, pens, or opening packages with your teeth create lateral force. Your tongue should also be trained: do not press on or play with the anchorage. Sports involving a ball or martial arts require a mouthguard — the doctor will select one. If you have bruxism, a night guard is mandatory, otherwise the load on the TAD increases. If pain or mobility of the head appears after eating, do not try to adjust it yourself. An orthodontic examination will show whether correction is needed.

What the wearing period depends on

A mini-implant is a temporary anchorage device, not a permanent implant. It is placed in an area where a point of force application is needed and is kept for exactly as long as the corresponding stage lasts. On average, this means several months, but the exact time is determined by the clinical picture: tooth movement, space closure, correction of inclination. If movement over a long distance is planned, the anchorage stays longer. When the task is resolved within a couple of months, it is removed earlier. There is also a second group of reasons — the condition of the screw itself. Stability in the bone, tissue density around it, hygiene, and loading affect how long the device remains functional. Placement of the anchorage is a reversible procedure: the screw is unscrewed, and the site heals on its own. Therefore, the wearing period is a manageable value, not something fixed once and for all. Sometimes patients ask about mini-implant cost, but it does not determine how long the anchorage will last: the duration is dictated by the orthodontic task, not the budget. The doctor decides based on follow-up images and on how the movement is progressing.

Signs that the anchorage has served its purpose

Planned and early removal

Planned removal is the usual ending. The doctor confirms that the stage is complete and unscrews the screw under local anesthesia. The procedure is short, the site closes without intervention, and orthodontic treatment continues according to the planned schedule. Early removal happens when the anchorage stops coping. The screw has become loose, the tissues around it have become inflamed, or the task itself has changed. Then it is removed ahead of schedule and, if necessary, a new one is placed — sometimes in the same area, sometimes in a neighboring one. The decision is made by the doctor: they assess stability, gum condition, and the progress of movement. If the anchorage is needed for another task, it may be left for the next stage. Separately, it is worth mentioning situations when a patient asks about re-placement of the anchorage: this is possible, but it is assessed individually. In any case, removal does not cancel treatment — only the point of force application changes. The site heals at its own pace, and the next step is planned with this in mind.

Removal procedure: step by step

Sensations and healing of the site

The unscrewing itself takes less than a minute. Many describe it as pressure rather than pain: the gum around the microscrew has already adapted, and the bone is not traumatized as it is during tooth extraction. If anesthesia was used, sensitivity returns within a couple of hours. Afterward, a small opening remains at the site. It heals over with mucosa rather than bone because the diameter of the microscrew is small. The timing depends on the clinical picture: in one patient the gum closes within a few days, in another it takes longer — this is influenced by mucosal thickness, hygiene, and whether there was inflammation around the mini-implant. Sometimes the opening does not close completely, and then a small depression remains in the gum. This does not interfere with chewing or hygiene. Swelling and redness in the first days are normal, especially if the microscrew was placed in a mobile area. How smoothly healing proceeds is determined by the doctor at the follow-up visit.

Is special care needed after removal?

No special care is required. Ordinary hygiene is enough: a soft brush, toothpaste without harsh abrasives, and gentle movements around the former microimplant site. In the first few days, it is better not to press the bristles there or floss right up against the gum. Antiseptic rinses are not prescribed for everyone — only if the doctor sees signs of inflammation or the socket is healing sluggishly. Hot, spicy, and coarse foods should be avoided for the first 24 hours: this is not a lifelong restriction, but a sensible pause while the gum settles. If an orthodontic appliance component was attached at the removal site, the doctor decides how to redistribute the load going forward — sometimes right away, sometimes at the next visit. Smoking slows mucosal healing, and this is worth keeping in mind. Once the socket has closed, there are no restrictions left: the removal site is no different from the neighboring areas of gum. If pain appears after a few days, swelling increases, or there is discharge from the socket, you need to see the doctor — this is a reason for an examination, not for self-treatment.

Diameter and length: what the choice affects

Different systems and brands: what is important to know

System names are often confused. “Diamond,” “diamond,” and “Damon system” are one system, Damon, not three different manufacturers. This refers to brackets, not microimplants, but confusion in terminology also occurs with screws. Orthodontic microimplants come in several common systems: Korean, Swiss, and American. They differ in head shape, thread type, and fixation method. Some screws are self-tapping, while others require pre-drilling. The material is usually titanium or its alloys. Compatibility with instruments is a separate issue: a screwdriver from one system may not fit a screw from another. The doctor focuses on which system is well established in their practice and available at the clinic. For the patient, what matters more is not the brand, but how well the screw fits the anatomy. Placement of an orthodontic screw is performed after diagnostics, and the choice of system is part of planning.

How the doctor selects the right screw

Selection begins with a CT scan or panoramic X-ray. The doctor assesses bone thickness, root position, and the intended placement area. Based on these data, the diameter and length are chosen. If the cortical plate is thin, a smaller-diameter screw is used. If the bone is soft, a longer screw with a larger thread is needed. The placement site also dictates the size: the space between roots is limited. The angle of inclination affects how the load is distributed. The manufacturer is chosen from those available and familiar to the doctor: instrument compatibility and the availability of spare screws in case of replacement are important. Sometimes the required size is not in stock, and then the decision is made as the procedure goes along. This is not a universal procedure, but an individual calculation. The doctor decides based on the images and the clinical picture.

Key facts about orthodontic screws

A microimplant is a temporary anchor. It does not replace a tooth and does not remain in the mouth after treatment. Its job is to give the orthodontist a point from which to pull a tooth or group of teeth in the desired direction without loading the neighboring teeth. The screw is held in the bone mechanically, without osseointegration, so removing it is easier than removing a conventional implant. The size is selected according to the placement area and mucosal thickness: the shorter and thinner the pin, the less trauma, but also the lower the permissible load. The manufacturer affects the thread geometry and the instrument set. The name of the system alone does not guarantee the outcome: anatomy and the treatment plan are what matter. The stability of the anchor depends on hygiene and control of traction force. If plaque accumulates around the neck, the gum becomes inflamed, and the screw has to be replaced or removed ahead of schedule. The wearing time is individual: for one patient it is weeks, for another it is months, while the movement stage continues. The exact timeframe is given by the doctor based on the clinical picture.

When to see a doctor

Reason for the visit — a loose screw. If it starts to wobble, the traction loses its purpose, and the pin itself can injure the gum. The second signal is pain, swelling, or redness around the neck of the screw that does not go away within a couple of days. The third is a bad odor or purulent discharge: these are signs of inflammation, and it is not worth delaying an examination. You should also seek care when it rubs against the cheek or tongue, and wax and silicone no longer help. If the cap or elastic band comes off, do not try to put it back on yourself: incorrect traction shifts the tooth in the wrong direction. The bite changes according to plan, but sudden shifts, clicking in the joint, or discomfort when chewing are also reasons for a check-up. The orthodontist schedules routine check-ups themselves, and it is undesirable to miss them. Anything that seems unusual is better shown to the doctor: early correction is easier than redoing a stage.