anchorage in orthodontics
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anchorage in orthodontics anchorage in orthodontics Presentation Transcript

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