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This study sought to assess the effect of miniscrew insertion angle (vertical and oblique) on its clinical survival under shearing forces in orthodontic patients undergoing canine retraction.    Materials and methods  In this split-mouth randomized controlled clinical trial, 50 miniscrews were placed bilaterally in 25 patients with 45° and 90° insertion angles relative to a line perpendicular to the occlusal plane distal to the maxillary first premolar extraction site. Allocation of insertion angles to the right/left side was random using the Random Allocation Software. The patients, clinician, and statistician were blinded to the allocation of miniscrews to the side of jaw. The patients were followed-up monthly for 6 months. The primary outcome was the clinical survival of miniscrews, which was evaluated at each follow-up session. The secondary outcomes were the miniscrew stability based on the Periotest value (PTV) and the level of pain experienced by patients at 1, 12, and 24 h, and 7 days after miniscrew placement using a visual analog scale (VAS). Data were analyzed using paired t-test, repeated measures ANOVA, and McNemar’s test.    Results  The clinical survival rate of miniscrews placed at 90° and 45° angles was 76% and 88%, respectively. This difference was not statistically significant ( P  = 0.375). No significant difference was noted between the two groups regarding the PTV or the pain score either ( P  > 0.05).    Conclusion  Clinically, the insertion angle of miniscrews (90° versus 45° relative to a line perpendicular to the occlusal plane) has no significant effect on the miniscrew survival rate or stability during orthodontic treatment.    Trial registration  This trial was registered at  www.irct.ir  ( IRCT20190901044659N1 ).    Protocol  The protocol was published after trial commencement.

Effect of miniscrew insertion angle in the maxillary buccal plate on its clinical survival: a randomized clinical trial