anchorage in orthodontics

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anchorage in orthodontics

  1. 1. FATHIMA SISINI FINAL YEAR PART ONE ANCHORAGE
  2. 2. DEFINITION <ul><li>Anchorage in orthodontics as the nature and degree of resistance to displacement offered by an anatomic unit for the purpose of tooth movement. (GRABER) </li></ul><ul><li>Anchorage is the site of delivary from which force is exerted(White and Gardnier) </li></ul>
  3. 3. CLASSIFICATION(MOYERS) <ul><li>ACCORDING TO MANNER OF FORCE APPLICATION </li></ul><ul><li>SIMPLE STATIONARY RECIPROCAL </li></ul><ul><li>ACCORDING TO JAWS INVOLVED </li></ul><ul><li>INTER MAXILLARY INTRA MAXILLARY </li></ul><ul><li>ACCORDING TO SITE </li></ul><ul><li>INTRA 0RAL EXRAORAL MUSCULAR </li></ul>
  4. 4. <ul><li>INTRA ORAL;-TEETH,ALVEOLAR BONE,BASAL BONE </li></ul><ul><li>EXTRA ORAL;-CERVICAL,OCCIPITAL,CRANIAL,FACIAL </li></ul><ul><li>MUSCULAR </li></ul><ul><li>According to number of anchorage units;-single or primary,compound,multiple or reinforced </li></ul>CLASSIFICATION cntd….
  5. 5. INTRA ORAL ANCHORAGES <ul><li>1) teeth </li></ul><ul><li>2)alveolar bone </li></ul><ul><li>3)basal bone </li></ul><ul><li>4)musculature </li></ul>
  6. 6. TEETH <ul><li>WHEN ONE TEETH MOVES THE OTHERS CAN ACT AS ANCHORAGE UNITS,IT DEPENDS ON </li></ul><ul><li>-ROOT FORM </li></ul><ul><li>-ROOT SIZE </li></ul><ul><li>-NO OF ROOTS </li></ul><ul><li>-ROOT LENGTH </li></ul><ul><li>-ROOT INCLINATION </li></ul>
  7. 7. ROOT FORM <ul><li>FLAT-RESIST MOVEMENTS IN MESIO-DISTAL DIRECTION,BUT LITTLE RESISTANCE BUCCOLINGUALLY </li></ul><ul><li>EG;-MANDIBULAR INCISORS AND MOLARS,BUCCAL ROOT OF MAXILLARY MOLARS </li></ul><ul><li>ROUND:-RESIST HORIZONTALLY DIRECTED FORCE IN ANY DIRECTION </li></ul><ul><li>EG;-BICUSPID,PALATAL ROOT OF UPPER MOLARS </li></ul><ul><li>TRIANGULAR;-MAXIMUM ANCHORAGE </li></ul><ul><li>EG;-CUSPIDS,MAXILLARY CENTRALS AND LATERALS </li></ul>
  8. 8. SIZE AND NUMBER OF ROOTS <ul><li>MULTIROOTED TEETH HAVING THE MAXIMUM SIZE HAVE MAX. ANCHORAGE </li></ul><ul><li>ROOT LENGTH ;- DIRECTLY PROPOTIONAL TO ANCHORAGE </li></ul><ul><li>AXIAL INCLINATION ;-ANCHORAGE IS MORE WHEN FORCE EXERTED IS OPPOSITE TO THAT OF AXIS OF INCLINATION OF TEETH </li></ul><ul><li>ANKYLOSED TEETH ;-NO PDL, SO NO MOVEMENT-EXCELLENT ANCHORAGE </li></ul>
  9. 9. ALVEOLAR BONE <ul><li>ALVEOLAR BONE RESIST TOOTH MOVEMENT UP TO ITS LIMIT,BEYOND THAT IT ALLOW TOOTH MOVEMENT BY REMODELLING </li></ul><ul><li>HEALTHY ALVEOLAR BONE-MORE ANCHORAGE </li></ul>
  10. 10. BASAL BONE <ul><li>CERTAIN AREAS ACT AS RESISTANCE AREAS-PROVIDE GOOD ANCHORAGE-HARD PALATE,LINGUAL SURFACE OF MANDIBLE </li></ul>
  11. 11. MUSCULATURE <ul><li>HYPERTONIC LABIAL MUSCULATURE USED FOR ANCHORAGE IN LIP BUMPER </li></ul>
  12. 12. EXTRA ORAL <ul><li>1)CRANIUM(OCCIPITAL OR PARIETAL ANCHORAGE:-ANCHORAGE OBTAINED FROM OCCPITAL OR PARIETAL BONE </li></ul><ul><li>EG:-HEAD GEAR TO RESTRICT MAXILLARY GROWTH </li></ul><ul><li>2)CERVICAL:-ANCHORAGE FROM CERVICAL OR NECK REGION </li></ul><ul><li>EG:-CERVICAL HEAD GEAR </li></ul><ul><li>3)FACIAL BONES:- FACE MASK USED TO PROTRACT MAXILLA TAKE ANCHORAGE FROM MANDIBULAR SYMPHYSIS </li></ul><ul><li>REVERSE HEAD GEARS TAKE ANCHORAGE FROM FOR HEAD AND CHIN </li></ul>
  13. 13. head gear cervical head gear face mask
  14. 14. SIMPLE ANCHORAGE <ul><li>IS THE DENTAL ANCHORAGE SUCH THAT MANNER AND APPLICATION OF FORCE IS SUCH THAT IT TENDS TO CHANGE THE AXIAL INCLINATION OF THE TEETH </li></ul><ul><li>THE RESISTANCE OF ANCHORAGE UNITS TO TIPPING IS USED TO MOVE OTHER TEETH </li></ul><ul><li>THE COMBINED ROOT SURFACE AREA OF THE ANCHORAGE UNIT MUST BE DOUBLE TO THAT OF TEETH TO BE MOVED </li></ul><ul><li>EG:-PALATALY PLACED PREMOLAR IS PUSHED IN TO THE ARCH BY REST OF THE TEETH AS ANCHOR UNITS </li></ul>
  15. 15. simple anchorage
  16. 16. STATIONARY ANCHORAGE <ul><li>MANNER AND APPLICATION OF FORCE TEND TO DISPLACE THE ANCHORAGE UNIT </li></ul><ul><li>RESISTANCE PROVIDED BY THE ANCHORAGE UNITS IS AGAINST BODILY MOVEMENTS(DISPLACEMENT) </li></ul>
  17. 17. RECIPROCAL ANCHORAGE <ul><li>RESISTANCE OFFERED BY TWO MALPOSED UNITS WHEN THE APPLICATION OF TWO EQUAL AND OPPOSITE FORCES TEND TO MOVE EACH UNIT TO A MORE NORMAL POSITION </li></ul><ul><li>EG:-CLOSURE OF MIDLINE DIASTEMA </li></ul><ul><li>CROSS BITE ELASTICS,EXPANSION APPLIANCES </li></ul>
  18. 18. expansion appliances cross bite elastics diastema closure
  19. 19. INTRA MAXILLARY ANCHORAGE <ul><li>TEETH ARE TO BE MOVED AND THE ANCHORAGE UNITS ARE IN THE SAME ARCH </li></ul>
  20. 20. INTER MAXILLARY ANCHORAGE <ul><li>TEETH ARE TO BE MOVED IN ONE ARCH AND RESISTRANCE UNITS ARE IN OPPOSITE ARCH </li></ul><ul><li>EG:-CLASS II ,CLASS III ELASTICS </li></ul>
  21. 21. SINGLE OR PRIMARY ANCHORAGE <ul><li>SINGLE TEETH WITH MORE ALVEOLAR SUPPORT USED TO MOVE ONE WITH LESSER SUPPORT </li></ul>
  22. 22. COMPOUND ANCHORAGE <ul><li>ANCHORAGE PROVIDED BY MORE THAN ONE TEETH WITH GREAT SUPPORT TO MOVE TOOTH WITH LESS SUPPORT </li></ul>
  23. 23. REINFORCED ANCHORAGE <ul><li>MORE THAN ONE TYPE OF RESISTANCE UNIT IS UTILIZED </li></ul><ul><li>EG:-A)TO AUGMENT THE INTRA ORAL ANCHORAGE, EXTRA ORAL ANCHORAGES TRANS PALATAL ARCH,AND LINGUAL ARCHES IS USED </li></ul><ul><li>B)UPPER ANTERIOR INCLINED PLANE USED FOR FORWARD MOVEMENT OF MANDIBLE USES MUSCULAR ANCHORAGES </li></ul>
  24. 24. upper inclined plane
  25. 25. trans palatal arch lingual arch etraoral anchorages
  26. 26. MINI DENTAL IMPLANTS <ul><li>USED IN PATIENTS HAVING MULTIPLE LOST TEETH OR HYPODONTIA OR TO AUGMENT TEETH WITH PERIODONTAL DISEASES </li></ul><ul><li>CLASSIFICATION </li></ul><ul><li>-ACCORDING TO EXPOSURE OF HEAD:- </li></ul><ul><li>OPEN-HEAD IS EXPOSED TO ORAL CAVITY-USED WHEN SOFT TISSUES ARE NOT MOVABLE </li></ul><ul><li>CLOSED-EMBEDED UNDER SOFT TISSUES-MOVABLE TISSUES </li></ul>
  27. 27. <ul><li>ACCORDING TO IMPLANT PLACEMENT </li></ul><ul><li>1)SELF TAPPING METHOD:-IMPLANT TAPPED IN TO A PREVIOUSLY DRILLED HOLE-SMALLER DIAMETER IMPLANTS </li></ul><ul><li>2)SELF DRILLING METHOD:-IMPLANT IS ITSELF DRILLED IN TO THE BONE-LARGER DIAMETER IMPLANT </li></ul><ul><li>ACCORDING TO THE PATH OF INSERTION:- </li></ul><ul><li>1)OBLIQUE;-30=60DEGREES TO LONG AXIS OF TEETH-WHERE INTER RADICULAR BONE IS NARROW </li></ul><ul><li>2)PERPENDICULAR;-INSERTED PERPENDICULAR TO THE BONE SURFACE-WHEN SUFFICIENT INTER RADICULAR BONE PRESENT </li></ul>
  28. 28. self drilled self tapped
  29. 29. SITE OF PLACEMENT OF MICRO IMPLANTS <ul><li>1)MAXILLARY TUBEROCITY </li></ul><ul><li>2)INFRA ZYGOMATIC CREST </li></ul><ul><li>3)BUCALLY B/W MAX 6 & 7 </li></ul><ul><li>4)BUCALLY B/W MAX 5&6 </li></ul><ul><li>1)MAXILLRY POSTERIORS </li></ul><ul><li>2)RETRACTION OF MAX.ANTERIORS &INTRUSION OF MAX.POSTERIORS </li></ul><ul><li>3)SAME AS ABOVE </li></ul><ul><li>4)SAME AS ABOVE &TO TIP BUCALLY </li></ul>
  30. 30. <ul><li>5)BUCALLY B/W MAX 3&4 </li></ul><ul><li>6)LABIALLY B/W MAX. CENTRALS </li></ul><ul><li>7)PALATALLY B/W MAX 5&6 </li></ul><ul><li>5)DISTAL &MESIAL MVMT OF MAX.MOLARS AND INTRUSION OF MAX BUCCAL TEETH </li></ul><ul><li>6)INTRUSION AND TORQUE CONTROL OF INCISORS </li></ul><ul><li>7)RETRACTION OF MAX ANTERIORS AND INTRUSION OF MAX MOLARS </li></ul>
  31. 31. <ul><li>1)RETROMOLAR PADS </li></ul><ul><li>2)BUCALLY B/W MAND. 6&7 </li></ul><ul><li>3)BUCALLY B/W 4&5 </li></ul><ul><li>4)BUCALLY B/W 3&4 </li></ul><ul><li>5)MADIBULAR SYMPHYSIS </li></ul><ul><li>1)UPRIGHTING&RETRACTION OF MAND.TEETH </li></ul><ul><li>2)INTRUSION &DISTAL MVMT OF MAND MOLARS,RETRACTION OF MAND.ANTERIORS </li></ul><ul><li>3)SAME AS ABOVE </li></ul><ul><li>4)PROTRACTION OF MOLARS </li></ul><ul><li>5)INTRUSION OF MANDIBULAR ANTERIORS </li></ul>SITES IN MANDIBLE
  32. 32. distalising molars buccal tipping
  33. 33. ANCHORAGE PLANNING <ul><li>FACTORS AFFECTING ARE:- </li></ul><ul><li>1)NO; OF TEETH BEING MOVED:-TO MOVE GREATER NO;OF TEETH, ANCHORAGE SHOULD BE MORE </li></ul><ul><li>2)TYPE OF TEETH:-TEETH HAVING MORE SURFACE AREA REQUIRE MORE ANCHORAGE </li></ul><ul><li>3)TYPE OF MOVEMENT:-BODILY MOVEMENT REQUIRE MORE ANCHORAGE </li></ul><ul><li>4)DURATION:-PROLONGED TREATMENTS REQUIRE GOOD ANCHORAGE </li></ul><ul><li>5)SKELETAL GROWTH PATTERN:- </li></ul><ul><li>A)VERTICAL-REQUIRE MORE ANCHORAGE DUE TO POOR TONICITY OF FACIAL MUSCLES </li></ul><ul><li>B)HORIZONTAL-VICE VERSA </li></ul>
  34. 34. <ul><li>6)OCCLUSAL INTERLOCK:-GOOD OCCLUSION=GOOD ANCHORAGE </li></ul><ul><li>ANCHORAGE LOSS :-UNWANTED TOOTH MOVEMENTS DURING ORTHODONTIC THERAPY </li></ul><ul><li>BASED ON THE ANCHORAGE LOSS THE ANCHORAGE DEMAND OF THE EXTRACTION CASES ARE OF THREE TYPES </li></ul><ul><li>MAXIMUM,MODERATE,MINIMUM </li></ul>anchorage loss
  35. 35. MAXIMUM ANCHORAGE CASES <ul><li>ANCHORAGE DEMAND IS VERY HIGH </li></ul><ul><li>NOT MORE THAN 1/4 TH OF THE EXTRACTION PLACE SHOULD BE LOST BY ANCHORAGE LOSS </li></ul><ul><li>SO AUGMENTATION OF ANCHOR TEETH REQUIRED </li></ul>
  36. 36. MODERATE ANCHORAGE CASES <ul><li>ANCHORAGE LOSS 1/2TH TO 1/4 TH OF EXTRACTION SPACE </li></ul>
  37. 37. MINIMUM ANCHORAGE CASES <ul><li>ANCHORAGE LOSS CAN BE MORE THAN 1/2TH OF EXTRACTION SPACE </li></ul>
  38. 38. BIBLIOGRAPHY <ul><li>TEXT BOOK OF ORTHODONTICS-S I BHALAJI,PROFET </li></ul><ul><li>WWW.FUNNYTOOTH.COM </li></ul><ul><li>WWW.WIKIPEDIA.COM </li></ul>
  39. 39. THANK YOU...

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