Manuel Nienkemper

Publications of Manuel Nienkemper

• Early Class III treatment with a hybrid hyrax-mentoplate combination.

  Authors: Benedict Wilmes, Manuel Nienkemper, Björn Ludwig, Chung How Kau, Dieter Drescher

  Journal of clinical orthodontics : JCO. 01/2011; 45(1):15-21; quiz 39.

• Application and effectiveness of a mini-implant- and tooth-borne rapid palatal expansion device: the hybrid hyrax.

  Authors: Benedict Wilmes, Manuel Nienkemper, Dieter Drescher

  World journal of orthodontics. 01/2010; 11(4):323-30.

  Rapid palatal expansion (RPE) is used for treatment of skeletal crossbites. It may be combined with a face mask if the maxilla is to be protracted. Conventional tooth-borne appliances rely on anRapid palatal expansion (RPE) is used for treatment of skeletal crossbites. It may be combined with a face mask if the maxilla is to be protracted. Conventional tooth-borne appliances rely on an almost complete dentition to transmit the relatively high forces to the bony structures of the maxilla and midface. In most situations, tooth-borne appliances produce adverse effects such as buccal tipping of the lateral teeth, imposing the risk of recessions and vestibular bone fenestrations. To overcome these drawbacks, an RPE appliance was developed that utilizes mini-implants anteriorly in the palate for skeletal anchorage. Because this device is also attached to the first molars, it can be denominated as a bone- and tooth-borne appliance (hybrid hyrax). The objective of this clinical pilot study was to investigate its dental and skeletal effects. RPE was performed in 13 patients (seven females, six males; mean age 11.2 years). In 10 patients with a skeletal Class III occlusion, a face mask was used simultaneously for maxillary protraction. Three-dimensional scans of the individual study models were digitally superimposed for the assessment of the dental effects. Skeletal effects were evaluated by lateral cephalograms taken before and after RPE and protraction. The time needed to achieve the intended expansion ranged from 4 to 14 days (mean 8.7 ± 3.6 days). The mean expansion in the first premolar/first primary molar region was 6.3 ± 2.9 mm and 5.0 ± 1.5 mm in the first molar region. The Wits appraisal changed from -5.2 ± 1.3 mm to -2.5 ± 1.5 mm (mean improvement 2.7 ± 1.3 mm). The right first molar migrated 0.4 ± 0.6 mm mesially and the left one 0.3 ± 0.2 mm. The hybrid hyrax is effective for RPE and can be employed especially in patients with reduced anterior dental anchorage. Since most teeth are not in the appliance, regular orthodontic treatment can start early. The combination of the hybrid hyrax with a face mask for maxillary protraction appears to be effective in minimizing mesial migration of the dentition.

• A miniplate system for improved stability of skeletal anchorage.

  Authors: Benedict Wilmes, Dieter Drescher, Manuel Nienkemper

  Journal of clinical orthodontics : JCO. 08/2009; 43(8):494-501.

• Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique.

  Authors: André Büchter, Johannes Kleinheinz, Hans-Peter Wiesmann, Jan Kersken, Manuel Nienkemper, Hendrik von Weyhrother, Ulrich Joos, Ulrich Meyer

  Clinical oral implants research. 02/2005; 16(1):1-8.

  The influence of the osteotome technique on the osseointegration and biomechanical behaviour of cylinder implants (SLA, ITI was compared with conventional preparation of the implant site in an animalThe influence of the osteotome technique on the osseointegration and biomechanical behaviour of cylinder implants (SLA, ITI was compared with conventional preparation of the implant site in an animal model. A total of 56 implants were placed in the cranial and caudal tibia condyle of six Gottinger minipigs. The implant site was prepared either by the conventional technique with drills (control group A) or by the osteotome technique (experimental group B). Resonance frequency measurements (RFMs) were made on each implant at the time of fixture placement and at the time of scarification. Half of the minipigs were sacrificed 7 days and 28 days after implant placement and the implants were removed with the surrounding bone. Bone tissue responses were evaluated by histological analysis and removal torque testing. For histological evaluation 30-50 microm-thick ground sections were examined. Biomechanical testing revealed a significantly higher stability of implants in the control group (A) than in the experimental group (B) (P = 0.004) at day 7. After 28 days implant stability in the control group remained significant higher (47%) than those of group B (P > 0.001). RFM demonstrated no significant difference between both groups and during the experimental course. Histological analysis demonstrated fractured trabeculae in peri-implant bone in the experimental group at day 7, while they were not posed at day 28. We conclude that the decreased implant stability by using the osteotome technique is based on microfractures in peri-implant bone.