What is the Spider Screw made of?

In one case I tried immediate loading and in another I did not load right away, which procedure is correct?

If you are pre-drilling prior to spider screw placement, what RPM's should be used with the low speed handpiece?

What is the pitch of the Spider Screws?

How is the Spider Screw removed?

I use long neck Spider Screws (2mm) and have encountered several cases where the tissue was deep in the posterior area and it is growing over the screw head, have you thought of an even longer neck height Spider Screw, possibly 3mm?

If I have a patient with a bilateral cross bite in the posterior segments and an anterior open bite, do I use Spider Screws to intrude the posterior segments first then rapid palatal expander or vise versa?

Could you explain how the Spider Screw can be placed painlessly with only a topical anesthetic?

When distalizing the first and second lower right molars, what kind of Spider Screw should be used and where should it be inserted?

I am planning treatment for an adult patient who is missing the mandibular left second bicuspid. The first molar and the second molar along with the third molar have healthy bone support. I would like to use this third molar and possibly an anchor in the edentulous area for archwire support. Would this be an application for the Spider Screw and how would it be accomplished?

I have a patient with bilateral maxillary second molar reverse crossbite. I am inquiring relative to the ideal position of screw placement on the palate to facilitate intrusion and medial retraction of molars into proper occlusion. Are there any palatal locations where screw placement would be contraindicated? I would assume the nasal cavity and the maxillary sinus would need to be avoided.

Is the Spider Screw packaged sterile? How can the Spider Screw be sterilized if it becomes contaminated?
Yes. The Spider Screws have been cleaned, decontaminated, and sterilized via gamma radiation. Should the screw become contaminated prior to placement, simply clean and process the screw according to normal sterilization protocol.

When sterilizing the Spider Screw with steam or dry heat sterilization, exact compliance with the manufacturer's user instructions is required. Always make sure special cleaning and sterilization methods are used for deactivation of specific pathogens and to validate sterilization cycles to account for differences in sterilization procedures, wrapping methods, and load configurations.

Trained personnel should wrap the screw according to recognized standards such as AAMI/ANSI ST42:1998. The following sterilization schedule is recommended.

For both methods, Spider Screws must be removed from plastic capsule prior to the sterilization process. Sterilizing will not hurt the Spider Screw's integrity or strength.
Back To Top

I am reluctant to administer an injection of local anesthetic, is it necessary?
Placement of the Spider Screw in most cases does not require nerve block or local anesthesia. The use of a topical anesthetic applied directly to the screw placement site will suffice. Place the topical anesthetic onto dry mucosa for 2-3 minutes, peak anesthesia is usually achieved in 5-10 minutes and will last for approximately 20-30 minutes.
Back To Top

If you are pre-drilling prior to spider screw placement, what RPM's should be used with the low speed handpiece?
Maintain a speed of about 100 RPM's when using low speed handpiece to perforate the tissue and bone.
Back To Top

What is the pitch of the Spider Screws?
The pitch is exactly how far the screw will go in with each full rotation (every 360° degrees).

K1 pitch = 0.7mm
K2 pitch = 1.0mm

Back To Top

If I have a patient with a bilateral cross bite in the posterior segments and an anterior open bite, do I use Spider Screws to intrude the posterior segments first then rapid palatal expander or vise versa?
In my experience I have discovered that I achieve the best results when I first use the rapid palatal expander then intrude with Spider Screws in the posterior segments.
Back To Top

How precise is the placement of the Spider Screw when roots are in close proximity? Is it possible to infringe or damage the adjacent roots?
Sometimes the space between the roots of adjacent teeth is small and we need to find a larger space or to prepare the site moving the teeth apart before inserting a Spider Screw. Having at least 3 mm of space, we can insert a Spider Screw of 1.5mm of diameter without disrupting the roots of adjacent teeth. A precise x-ray (Periapical x-ray with parallel technique) is needed when a narrow space is available and sometimes a surgical guide is also useful; especially in difficult places to access.
Back To Top

Could you explain how the Spider Screw can be placed painlessly with only a topical anesthetic?
To make it completely painless for the patient, I use a few drops of local anesthesia (local Infiltration), because I have not found a topical anesthetic that is strong enough. I do use topical anesthetic before I do the local infiltration. The sole use of a topical anesthetic is not advised.
Back To Top

When distalizing the first and second lower right molars, what kind of Spider Screw should be used and where should it be inserted?
Two options that may be used

A) If the third molar has been extracted and there is a flat retromolar region, insert a Spider Screw K2, 10.0mm in length distally to the second molar. Avoid touching the alveolar nerve measuring the bone depth with an x-ray film. Usually the soft tissue is thick in this area and the amount of Spider Screw that will go into the bone is only 7.0mm. Use the Spider Screw to retract the first and second molars (direct anchorage). Start with the second one and then move to the first. Be sure that the head of the Spider Screw doesn't touch the teeth in the opposite arch.

B) If the above is not an option, find an interproximal space mesially to the first molar to insert a Spider Screw K1 8.0mm length. Place brackets AND an archwire (i.e. Stainless Steel .016" x .022") on the lower arch. Apply a titanium metal ligature from the head of the Spider Screw to the canine or the first bicuspid in order to block one of these teeth. Put an open coil spring from the first molar to the second one to push it back. Note: If you have any tooth missing, place a closed coil spring in the space of the missing tooth as a space maintainer. When you have successfully distalized the second molar, do the same with the first. The metal ligature will hold the teeth in place mesially to the molars and the Spider Screw will provide the anchorage that is required (indirect anchorage).
Back To Top

I am planning treatment for an adult patient who is missing the mandibular left second bicuspid. The first molar and the second molar along with the third molar have healthy bone support. I would like to use this third molar and possibly an anchor in the edentulous area for archwire support. Would this be an application for the Spider Screw and how would it be accomplished?
This is not a common situation, although it can be managed. When having a very large edentulous area, I would recommend using one or two Spider Screws vertically inserted (2mm of diameter) in the position of the second bicuspid and the first molar. On top of the two Spider Screws, you will need to place a resin core. Then attach the brackets on the resin core. If a resin core is not available, it can be fabricated in the lab by affixing two temporary crowns onto each head of the Spider Screws and connecting the two crowns with acrylic. When using two Spider Screws with vertical insertion, it's advisable to connect them with the temporary crowns or resin core in order to have a longer life. It is important to avoid any occlusal contact on the resin core and/or the temporary crowns on top of the Spider Screws. Advise the patient to use caution on lateral movements.
Back To Top

I have a patient with bilateral maxillary second molar reverse crossbite. I am inquiring relative to the ideal position of screw placement on the palate to facilitate intrusion and medial retraction of molars into proper occlusion. Are there any palatal locations where screw placement would be contraindicated? I would assume the nasal cavity and the maxillary sinus would need to be avoided.
In a case like this, a Spider Screw could be applied in the Palatal Vault. Although it is necessary to measure the thickness of the palatal bone in this area using CTCB image or Lateral Cephalometric Film. Normally in the Mid-Palatal Suture, the bone thickness is 2mm thicker than it appears on the Lateral Head Film. Considering that the bone quality is good in this area, select the appropriate Spider Screw length to ensure the proper anchorage will be provided for treatment. In case the bone thickness of the Palatal Vault is too thin (less than 5mm), then two Spider Screws should be applied in the interproximal space between the first and second molars on the palatal side at a level that can permit intrusion and constriction of the second molars.
Back To Top