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Orthodontic implants


temporary acnchorage devices

temporary acnchorage devices

Published in Education
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  • 1. Member A.O.I.AFellow I.C.O.IScientific consultant of sybron implant solutionsManager of implant direct company Dr. Amr Saad 2012
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  • 15. Direct versus Indirect Anchorage :In general, two different types of anchoragemust be distinguished: direct and indirect.Determiningthe type of anchorage that is morefavorable depends on the following clinical orradiological factors: local bone quality, availablespace (in particular for interradicular insertion)and mucosal thickness. Furthermore, theexpectedload on the mini-implant should betaken into consideration. Dr. Amr Saad 2012
  • 16. Direct anchorage :In a direct anchorage situation, the implant isdirectly connected to the dental unit(s) to bemoved. In this manner, a purely mini-implantsupported anchorage is the result. Dependingon the treatment objective, forces can betransferred from the implant to the dentalunit(s) using the following modules. Dr. Amr Saad 2012
  • 17. Compression Spring :The use of a compression spring always requiresan additional arch wire or wire segment tostabilizethe compression spring (open coil spring).The insertion can sometimes be difficult, andregular reactivation or a change to a new, longerspring is often required. This can often be donewithout removing the entire set-up by crimpinga stop or using an arch lock on the arch wireor segment. It is for these reasons that tensionmechanics are often preferred. Dr. Amr Saad 2012
  • 18. Tension Spring :Super-elastic nickel titanium (NiTi) springs (closedcoil springs) are biomechanically more favorablethan elastic chains due to their consistent andconstant force delivery. Depending on the makeof the tension spring and head design of the miniimplant, it may be necessary to attach the springusing a stainless steel ligature or Monkey Hook(American Orthodontics, Sheboygan, WI). Dr. Amr Saad 2012
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  • 24. Dental Arch Coordination:Palatal Expansion and Rapid Palatal Expansion (RPE):Mini-implant anchorage can also be helpful inthe coordination of the maxillary and mandibulardental arches. Rapid palatal expansion (RPE)is often indicated with a maxillary transverseconstriction of skeletal origin. Sometimes, however,sufficient dental anchorage cannot be establishedand more tipping than sutural expansionresults. Dr. Amr Saad 2012
  • 25. A frequent reason for this can be the dental age. If therequired deciduous teeth are mobile, during the latephase of the mixeddentition, adequate anchorage for continuous suturalmaxillary expansion is not available.This is especially true when concurrent protraction of themaxilla is planned using a facemask, aswaiting forcomplete eruption and root formation of the premolars isnot desirable.An alternative mechanism would be to use the firstmolars in the posterior and two mini-implants for theanterior area as an anchorage for the Hyrax expander(Dusseldorf Hybrid-Hyrax) Dr. Amr Saad 2012
  • 26. In the mutilated dentition (e.g. loss of firstmolars), mini-implants can be used to replaceteeth as anchorage units. Since there is limitedbony support in the posterior maxilla in theseinstances, two mini-implants should be insertedin the loading direction, next to each other,and then connected Dr. Amr Saad 2012
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