Importance of CBCT Analysis in the Preoperative Planning of TAD Placement in the Anterior Maximally Region  
[PERSON]  
1 Department of Chemistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; 1 [EMAIL_ADDRESS] (I.J. ); [EMAIL_ADDRESS] (M.V. ); [EMAIL_ADDRESS] (M.J.); [EMAIL_ADDRESS] (M.Z.S. ); [EMAIL_ADDRESS] (V.R. ); [EMAIL_ADDRESS] (A.A.)  
[PERSON]  
3 Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; 34000 Krag  
space closure, and the management of anterior open bite cases [4; 5; 6]. Additionally, they offer dependable anchorage for managing dental asymmetries and are frequently used to optimize space distribution in preparation for prosthetic restorations [7]. The current literature indicates that orthodontic mini-implants are typically inserted into the buccal interdental bone of the maxillary arch [8]. In certain clinical scenarios, the anterior maxilla represents a necessary site for mini-implant placement. Fortunately, this region often exhibits favorable anatomical features, such as adequate cortical bone thickness and easy surgical access, which make it suitable for such procedures. Nevertheless, it also presents anatomical limitations, most notably the presence of the nasopalatine canal (NPC) in the midline, which contains the nasopalatine nerve and accompanying blood vessels [9]. Accidental damage to the nasopalatine canal during mini-implant insertion may lead to adverse outcomes such as bleeding, altered sensation (paresthesia), or compromised implant stability [10]. In addition to these risks, temporary anchorage devices may also cause soft tissue irritation, injury to nearby anatomical structures, discomfort, bone resorption, and other related complications [11; 12]. The risk of complications significantly increases when parameters such as mini-implant diameter, interdental bone width, buccal4 depth, and tooth angulation are not thoroughly evaluated prior to placement [13; 14; 15]. Various guidelines have been established to aid in the selection of optimal insertion sites for mini-implants within the buccal interdental region [16; 17]. According to these recommendations, a minimum clearance of 1 mm should be maintained from surrounding anatomical structures, including tooth roots and the mucogingival junction. Furthermore, mini-implants should be positioned at least 1 mm apical to the alveolar crest to reduce the risk of root proximity and enhance stability [11]. Placement within the mobile mucosa is associated with a higher failure rate, primarily due to the increased risk of soft tissue irritation and inflammation [18]. The region located 5 mm above the alveolar crest, corresponding to the area of the attached gingiva, is generally considered a safe soft tissue zone for mini-implant insertion [19]. Due to possible anatomical variability among individuals and the existence of mini-implant designs specifically adapted for use in mobile mucosa, bone dimensions were also assessed at greater vertical distances--namely at 6 mm and 8 mm from the alveolar crest [19]. Although current evidence suggests that anatomical landmarks are typically used to guide mini-implant site selection, there is still a lack of sufficient data regarding the relationship between radiographically defined insertion points and clinically visible dental reference structures [16; 17]. Due to the restricted and anatomically sensitive nature of the insertion site, orthodontic mini-implants are designed with specific macrostructural features that facilitate mechanical stability and simplify insertion into the bone. These devices commonly exhibit a screw-like configuration and are manufactured in diameters ranging from 1 to 2 mm [11; 20]. Unlike conventional dental implants, they are typically shorter--between 6 and 12 mm in length--to accommodate the available bone volume while minimizing the risk of contact with deeper anatomical structures [11].