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ANCHORAGE
CONSIDERATIONS IN
LINGUAL ORTHODONTICS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

www.indiandentalacademy.com
Specific anchorage problems in lingual
orthodontics
Majority of patients are non growing adults
Mutilated malocclusion with one or more missing
teeth
Compromised periodontal condition
High esthetic demands precluding use of many
conventional orthodontic anchorage device
www.indiandentalacademy.com
Reduced anchorage due to loss of
intercuspation.
It has been suggested that the lingual technique
provides superior anchorage control because of
the smaller arch perimeter, which in turn
increases the rigidity of lingual archwires during
retraction.

www.indiandentalacademy.com
Takemoto compared anchorage loss in labial
versus lingual extraction cases treated with
loop mechanics and found higher anchorage
value of the posterior dentition in lingual cases.
He suggested 2 reasons for this:1. Proximity of lingual brackets to the center of
resistance of the tooth.
2. The direction of forces during space closure creates
a degree of buccal root torque and distopalatal
rotation of the molar crown, which in turn produces
cortical bone anchorage.

www.indiandentalacademy.com
In certain cases where anchorage needs to be
reinforced, a modified pendulum appliance can
be placed to reduce anchorage loss.

www.indiandentalacademy.com
When using lingual orthodontic mechanics,
retraction of the six anterior teeth is generally
performed en masse.
In view of the anchorage requirements for this
procedure, the “six keys for anchorage control in
lingual sliding mechanics” have been suggested
as a means of providing maximum anchorage
control.

www.indiandentalacademy.com
Six Anchorage Keys
1.

Standard lingual bracket jig prescription for the
anterior teeth, incorporating slight extrapalatal
root torque and no extra tip for extraction
cases; molar tubes placed off-center in a more
mesial position and incorporating a mesial tip
to encourage molar tip back (uprighting)

www.indiandentalacademy.com
2.

Reduced friction, using sliding mechanics
together with bidimensional archwires
incorporating a rectangular anterior section
and round posterior sections or using a
standard archwire and placing brackets on the
posterior teeth with larger slot sizes

www.indiandentalacademy.com
3.

Posterior bite stops placed on the molar teeth
to open the bite

4.

Light Class I, II, or III forces for retraction or
space closure

5.

Incorporation of the second molars in the
anchorage unit

6.

Incorporation of an exaggerated curve of Spee
in the maxillary space-closing archwire

www.indiandentalacademy.com
Thank you
www.indiandentalacademy.com
Leader in continuing dental education

www.indiandentalacademy.com

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Anchorage considerations in lingual orthodontics courses training

  • 1. ANCHORAGE CONSIDERATIONS IN LINGUAL ORTHODONTICS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. Specific anchorage problems in lingual orthodontics Majority of patients are non growing adults Mutilated malocclusion with one or more missing teeth Compromised periodontal condition High esthetic demands precluding use of many conventional orthodontic anchorage device www.indiandentalacademy.com
  • 3. Reduced anchorage due to loss of intercuspation. It has been suggested that the lingual technique provides superior anchorage control because of the smaller arch perimeter, which in turn increases the rigidity of lingual archwires during retraction. www.indiandentalacademy.com
  • 4. Takemoto compared anchorage loss in labial versus lingual extraction cases treated with loop mechanics and found higher anchorage value of the posterior dentition in lingual cases. He suggested 2 reasons for this:1. Proximity of lingual brackets to the center of resistance of the tooth. 2. The direction of forces during space closure creates a degree of buccal root torque and distopalatal rotation of the molar crown, which in turn produces cortical bone anchorage. www.indiandentalacademy.com
  • 5. In certain cases where anchorage needs to be reinforced, a modified pendulum appliance can be placed to reduce anchorage loss. www.indiandentalacademy.com
  • 6. When using lingual orthodontic mechanics, retraction of the six anterior teeth is generally performed en masse. In view of the anchorage requirements for this procedure, the “six keys for anchorage control in lingual sliding mechanics” have been suggested as a means of providing maximum anchorage control. www.indiandentalacademy.com
  • 7. Six Anchorage Keys 1. Standard lingual bracket jig prescription for the anterior teeth, incorporating slight extrapalatal root torque and no extra tip for extraction cases; molar tubes placed off-center in a more mesial position and incorporating a mesial tip to encourage molar tip back (uprighting) www.indiandentalacademy.com
  • 8. 2. Reduced friction, using sliding mechanics together with bidimensional archwires incorporating a rectangular anterior section and round posterior sections or using a standard archwire and placing brackets on the posterior teeth with larger slot sizes www.indiandentalacademy.com
  • 9. 3. Posterior bite stops placed on the molar teeth to open the bite 4. Light Class I, II, or III forces for retraction or space closure 5. Incorporation of the second molars in the anchorage unit 6. Incorporation of an exaggerated curve of Spee in the maxillary space-closing archwire www.indiandentalacademy.com
  • 10. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com