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1. The efficacy of
different
anchorage
systems in
Orthodontics

2. INTRODUCTION
An important aspect of treatment is
maximizing the tooth movement that is desired,
while minimizing undesirable side effects
In planning orthodontic therapy, it is
simply not possible to consider only the teeth
whose movement is desired, reciprocal effects
throughout the dental arches must be carefully
analyzed, evaluated & controlled.

3. ANCHORAGE
Nature & degree of resistance to displacement
offered by an anatomic unit when used for the
purpose of effecting tooth movement. [Graber]
Resistance to unwanted tooth movement.
[Profitt]

4. ANATOMIC UNITS USED FOR
ANCHORAGE
 Teeth – most commonly used
 Palate
 Lingual alveolar supporting bone in
mandible
 Cortical bone
 Muscular anchorage
 Occiput
 Back of the neck

5. TYPES OF ANCHORAGE
 Simple anchorage
 Stationary anchorage
 Reciprocal anchorage
 Intra-oral anchorage
 Extra-oral anchorage
 Intramaxillary anchorage
 Intermaxillary anchorage
 Multiple anchorage
 Cortical anchorage

6. MAXIMUN, MODERATE, MINIMUM
ANCHORAGE
GROUP A or MAXIMUM ANCHORAGE
Posterior teeth contribute less than ¼ to space closure
GROUP B or MODERATE ANCHORAGE
Post. teeth contribute from ¼ to ½ to space closure
GROUP C or MINIMUM ANCHORAGE
Post. teeth contribute more than ½ to total space closure

7. ANCHORAGE
1) Tooth anchorage
2) Anchorage savers
reduce the amount of tooth anchorage
necessary to correct the malocclusion
Head gear
Palatal bar
Lip bumper

8. STRATEGY FOR ANCHORAGE
CONTROL
To concentrate the force needed to produce
tooth movement where it is desired
To dissipate the reaction force over as many
other teeth as possible, keeping the pressure in
the PDL of anchor teeth as low as possible.

9. SIMPLE ANCHORAGE
Dental anchorage in which the manner &
application of force tends to displace or change
the axial inclination of the tooth or
teeth that forms the anchorage unit in the plane
of space in which the force is being applied.

10. STATIONARY ANCHORAGE
Dental anchorage in which the manner &
application of force tend to displace
the anchorage unit bodily in
the plane of space in which the force is
being applied.

11. RECIPROCAL ANCHORAGE
 Anchorage in which the resistance of one
or more dental units is utilized to move one or
more opposing dental units

12. REINFORCED ANCHORAGE
[MULTIPLE
ANCHORAGE]
Adding additional teeth
Anchorage from extraoral sources
Use of palate through bite plane/guide plane

13. EXTRAORAL ANCHORAGE
One of the anchorage unit is situated outside
the oral cavity
Cervical
Occipital
Cranial

14. INTRAMAXILLARY ANCHORAGE
•Resistance units are all situated within the
same jaw
INTERMAXILLARY ANCHORAGE
[BAKERS ANCHORAGE]
•Anchorage units situated in one jaw are used to
effect tooth movement in other jaw

15. CORTICAL ANCHORAGE
 The different response of cortical compared to
medullary bone can be utilized for anchorage
 Cortical bone is more resistant to resorption &
tooth movement is slowed when a root contacts
the cortical bone

16. FACTIORS AFFECTING
ANCHORAGE
 Root area of anchor teeth
 Force used
 Mesial drift

17. ROOT AREA OF ANCHOR
TEETH
Large surface area Vs small surface area
Multirooted tooth Vs single rooted tooth
Longer rooted tooth Vs shorter rooted tooth
Triangular rooted tooth Vs conical root

18. FORCES USED
Concentrate the force needed to produce tooth
movement where desired & to dissipate the
reaction force over as many other teeth as possible
Light force - below the threshold value
Heavy force – exceed the threshold value for
anchor teeth.

19. MESIAL DRIFT
Resistance value is least in
downward & forward direction

20. HEAD GEAR
CLASSIFICATION
Cervical
Occipital
Combination

21. COMPONENTS
Head straps - named according to where they
are used
Face bow
Inner – Outer bow type
J – Hook type

22. FORCE SYSTEM
Orientation of the outer bow
Length of the outer bow
Point of attachment of head strap

23. DIRECTION OF FORCE & MOMENTS

25. OCCIPITAL
PULL

26. CERVICAL PULL

27. TRANS PALATAL ARCH
Extends from one maxillary first molar along
the contour of the palate to the molar on the
opposite side
Removable
Fixed

28. FUNCTIONS OF TPA
To prevent the mesial migration of the upper I
molar during the transition from II deciduous
molars to the second premolars
Can produce molar rotations & change in root
torque
Molar stabilization & Anchorage
Intrusion of molars

29. LOWER LINGUAL ARCH
Similar functions like TPA
Indications
Class I crowding
Class III patients

30. NANCE PALATAL BUTTON
INDICATIONS
Class I, crowding cases
To hold the maxillary expansion achieved by
expansion appliances
CONTRAINDICATION
Class II maxillary protrusion cases

31. DIFFERENT
ANCHORAGE
SYSTEMS

32. REMOVABLE APPLIANCES
Mostly intra oral anchorage is used
Clasps
Base plates
Intramaxillary / Intermaxillary
Extra oral anchorage

33. CLINICAL CONTROL
ANCHORAGE
Few teeth are moved at a time
As many teeth as possible are included in
anchorage unit
Appliance produce light forces

34. SVED BITE PLATE
ANTERIOR INCLINED BITE
PLANE

35. LIGHT ARCH WIRE
TECHNIQUE
[BEGG
MECHANOTHERAPY]

36. No extra oral anchorage
 Initial stages
Bodily control given to the anchor units
The units that are to be moved are free
to tilt
Light forces
 Final stages
Reciprocal forces from the root torquing
auxiliaries are born by the dental arch as
a unit, not by a section of the dental arch

37. THEORY OF DIFFERENTIAL
PRESSURES
Dr.Begg- AJO-1956
There was a range of light pressures which would
cause teeth to move at an optimal rate & with minimal
disturbance of the supportive tissues.
Force below this range – Slow rate of response
Force above this range – undermining resorption

38. BEGG TECHNIQUE
STAGE I
Light class II elastics
Retraction of upper anteriors
Minimal mesial movement of anchor molar
STAGE II
Heavy force
Excess pressure in the anteriors
Mesial movement of molars

39. ANCHORAGE BEND – Horizontal &
vertical movement of teeth
Anchorage for vertical movement:

40. ORTHODONTIC JUDO
 Using the opponent’s strength & weight
to his disadvantage
 Attainment of beneficial crown tipping
movements from root tipping forces or the
prevention of detrimental crown movements
by using these forces is called orthodontic
Judo.

41. ELEMENTS
1) Lever arm - archwire
2) Area of high resistance- supporting bone
around the roots

42. Net Distal movement of mesially
inclined lower II molar

43. REFINED BEGG

44. Anchor curve instead of anchor bend
Suggested by Mollenhauer
Causes extrusion of premolars – indicated in
low angle growing patients
Anchorage reinforcement mechanisms
TPA
Head gear
Lip Bumpers

45. MODERN BEGG

46. COMBINED ANCHORAGE TECHNIQUE
[FOUR STAGE LIGHT WIRE APPLIANCE
Developed by J.Thompson in 1981, AJO
Combination of light & straight wire appliance
Brackets have both Ribbon arch & Edgewise
slots
Buccal tubes have both round & rectangular tubes

48. ANCHORAGE CONTROL
DYNAMIC ANCHORAGE
Physical forces + Biologic forces
STATIC ANCHORAGE
Pure stationary anchorage
Stage I - Dynamic anchorage
Stage II - Dynamic anchorage
Stage III – Dynamic / Static
Stage IV – Static anchorage

49. VERTICAL CONTROL
OVERBITE CORRECTION
Incisor intrusion
Prevention of incisor eruption
Molar elevation

50. HIGH ANGLE CASES
Molar extrusion is not desirable
Controlled by
Decreasing the anchor bend
Modifying class II elastics
Decreasing the - force level
- time of wear

51. OVERBITE CORRECTION IN ADULTS
Primarily by incisor intrusion, secondarily by
molar extrusion
45°anchorage bend & mild reverse curve in the
anterior segment to get maximum incisor intrusion
Class II elastics & check elastics to extrude the
molars

52. SAGITTAL CONTROL
AP correction is achieved through
anchor bend & intermaxillary elastics
Autonomous retraction of canines
Lingual tipping movement of lower incisors &
canines without retractive force

53. REDUCTION IN ANB ANGLE
Lingual movement of A point occurring as
maxillary incisors are torqued lingually
Inhibition of maxillary anterior growth
&enhancing forward growth of mandible by class
II elastic traction

54. BRAKING MECHANICS
Braking springs on the canines & lateral
incisors or torquing auxiliary on incisors
Rectangular archwire in the edgewise
slot & it is inserted into the Begg tube

55. DIFFERENTIA
L STRAIGHT
ARCH
TECHNIQUE
[TIP EDGE BRACKETS]

56. Developed by Kesling
Tip Edge brackets are modifications of Edgewise
brackets
DSAT & TIP-EDGE BRACKETS

57. ANCHORAGE CONSIDERATIONS
Differential force technique
Extra oral anchorage is absolutely not needed in
this technique
Reduced friction - Very light forces can be used -
Less strain on the anchor teeth
Anteroposterior & vertical control – Anchor bend

58. VERTICAL CONTROL
OVERBITE CORRECTION
Intrusion with lighter forces - 5gm/ tooth
Conventional Edgewise slots - Prevent free root
movement & cause lateral movement
Tip edge slots - uni- point contact – no lateral
pressure

60. VERTICAL CONTROL DURING
SPACE CLOSURE
CONVENTIONAL SLOT
TIP – EDGE SLOT

61. SAGITTAL CONTROL
STAGE I
Intrusion & retraction of u/ant
Bend back – To prevent labial flaring

62. STAGE II
0.022’’ ss archwire with appropriate bite
opening bends
Maximum anchorage situations
Archwire is inserted into the large diameter
gingival round tubes
Mild to moderate anchorage situations
Archwire is engaged through the occlusal
rectangular molar tubes

63. BRAKING MECHANICS
Side winder springs on PM, canines &
incisors
0.022’’ss or 0.0215x0.028’’ archwire
Heavy forces [6-8 oz] are used for molar
protraction

64. STAGE III
Anchorage strain during uprighting & torquing
Can be prevented by
Keeping the occlusion in class I,
No spacing,
Ideal overbite & overjet
0.022 ss / .0215x.028 ss can be used
Ends of the archwire are bent
Intermaxillary elastics to maintain incisor relation

65. MOLAR CONTROL
[MULLIGAN]

66. FORCE SYSTEMS TO CONTROL
MOLAR POSITION
Center bends / Gable bends
Off center bends
Step / parallel bends

67. OFF-CENTRE BENDS
CENTRE BEND

68. STEP BEND
Combination of two off-center bends with short
sections bent in opposite direction parallel to
each other

69. CENTER BEND
Equivalent to two off-center bends with short
sections bent in the same direction

70. CAUSES OF MOLAR DISPLACEMENT
Vertical forces through molar tubes
Prevented by Horizontal bends

71. SEQUENCE OF MOLAR CONTROL
BENDS
Rotations first & displacements
second
Rotation correction - Toe-in / out
Displacement correction- in/out bends

72. IN / OUT BENDS
Placed in the embrasures b/w cuspids & bicuspids

73. TOE IN / OUT BENDS
Off centered bends
- located just mesial to molar tubes
Toe in bend produce horizontal force in
a buccal direction & distal in moment

74. STEP BENDS
Whenever 2 bends are involved & each bend
produces forces in the same direction we are
dealing with a step bend

75. CENTER BEND
Whenever 2 bends are involved &produce
forces in the opposite direction we are
dealing with a center bend

76. EDGEWISE
APPLIANCES

77. ANCHORAGE PREPARATION
Classification
Charles H. Tweed
First degree
Second degree
Third degree

78. FIRST DEGREE ANCHORAGE
PREPARATION
ANB – 0° - 4°, Good facial esthetics, Total
discrepancy within 10mm
Mandibular terminal molar – upright
Direction of pull of intermaxillary elastics will
not exceed 90° when related to the long axis of
these teeth

79. SECOND DEGREE PREPARATION
ANB - > 4.5°
Facial esthetics make it desirable to move
point B anteriorly & point A posteriorly
Prolonged cl II elastics
Mandibular terminal molars must be tipped
distally so that their distal marginal ridges are
at gum level.

80. THIRD DEGREE [TOTAL] ANCHORGE
PREPARATION
Total discrepancy 14 to 20 mm, ANB
doesn’t exceed 5°
All the posterior teeth from II Pm to the
terminal molar be tipped distally to anchorage
preparation positions
Distal marginal ridges of the terminal molars
are below gum level

81. SEQUENTIAL MANDIBULAR
ANCHORAGE PEREPARATION
First described by Tweed
Cl III elastics & compensation bends
All the bends at the same time
Modified by Merrifield
Tipping only 2 teeth at a time
High pull head gear [ not cl III elastics]
Merrifield ‘10 – 2’ system

82. II MOLAR PREPARATION
Maxillary archwire – 17x 22
Mandibular archwire – 18x 25
Stop loops – Flush with II molar tube
Maxillary II molar - 5°distal tip
Mandibular II molar - 15°distal tip

83. I MOLAR PREPARATION
Mandibular archwire – 19x25
Stop loops – flush with II molar tube
10° distal tip
Compensating bend to maintain II
molar

84. II PREMOLAR PREPARATION
5°distal tip mesial to II pm
Compensating bend for I molar
High pull headgear

85. The efficacy of
different
anchorage
systems in
Orthodontics
PART II

86. ROTH
SYSTEM

87. ANCHOR LOSS
Attempting to upright extremely distally tipped
canines
Retraction of extremely procumbent anterior
teeth
Leveling the curve of spee with a continuous
archwire
Lingual root torquing of maxillary anteriors
Expanding the mandibular arch with a labial
arch wire

88. SAGITTAL CONTROL
II molar banding
Upright anteriors - little resistance to lingual
tipping
Anterior facebow is used to retract the proclined
incisors
Maximum anchorage – Asher facebow
Moderate anchorage - Double key- hole loops

89. LEVELLING & ALIGNING
Begin leveling with very small flexible
wires - .015’’ Wildcat / Respond
These wires can not overcome the
occlusal & other forces & can only bring
about bracket alignment

90. VERTICAL CONTROL
CURVE OF SPEE CORRECTION
 Utility arches to intrude incisors
SHORT INTERMAXILLARY ELASTICS
1/8’’, 4-8 oz pull – no extrusion of molars
TRANSPALATAL ARCH
6-8mm away from the palate – intrusion of
molars

91. VARI – SIMPLEX
DISCIPLINE

92. VARI- SIMPLEX DISCIPLINE
Developed by Wick Alexander
Single width brackets except u/incisors
Increased interbracket distance - Lighter force
Driftodontics in lower arch
Lewis Lang

93. DRIFTODONTICS
The mandibular anterior teeth have a tendency to drift
distally & the mandibular posterior teeth to drift
mesially.
Appliances are placed only on the maxillary arch until
a class I cuspid relation is achieved. The late placement
of mandibular appliance is referred to as driftodontics.

94. INDIVIDUAL CANINE RETRACTION
More control over molar anchorage
Cuspid is the longest rooted tooth in the mouth, it is
important to put it into position as quickly as possible.
By retracting cuspids first, incisor retraction can be
achieved with out significant loss of torque.

95. ANCHORAGE CONSERVATION
IN MANDIBLE
Mandibular molar has – 6 ° distal tip
incorporated in it which promotes leveling &
helps in gaining arch length (Tweed’s
philosophy)

96. ANCHORAGE CONSERVATION IN
MAXILLA
Tying back of orthodontic wires
Omega loops - Preferred method
Archwire bend backs

97. RETRACTOR / HEADGEAR
The most important element of varisimplex
discipline
It is the only appliance with which the
orthodontist can control all 3 dimensions –
vertical , sagittal & transverse both skeletally
& dentally

98. DIRECTION OF PULL & INDICATION
Low angle/normally growing patients – Cervical
[SN –MP < 37°] pull
SN – MP - 37 to 41° - Combination pull
SN – MP > 42° - High pull

99. FORCE & TIME OF WEAR
Initially - 8 oz , from next appointment – 16oz
If ANB is 3° or less – Only during sleeping
 ANB 3 to 5° - 10 hrs / day
ANB > 5° - 14 hrs / day or more

100. ELASTICS
To align maxillary dentition with mandibular
dentition
Cross bite or midline discrepancy correction
To finalize the occlusion at the end of Rx

101. ANCHORAGE CONSIDERATIONS
DURING ELASTIC WEAR
Elastics are not used until the pt is in finishing
archwires - 17x25 ss in both arches
Attached from the mandibular II molar to the
hook on maxillary lateral incisor
Elastics are used only for a few months near
the end of treatment

102. OTHER INTRA ORAL APPLIANCES
Trans palatal arch
Lower lingual arch
Nance holding arch
Contraindication – Class II maxillary protrusion

103. MBT VERSATILE†
SYSTEM

104. MBT VERSATILE †
SYSTEM
ANCHORAGE CONTROL IN 3 PLANES
Horizontal
Vertical
Lateral

105. HORIZONRTAL ANCHORAGE CONTROL
To achieve a correct antero-posterior position of
teeth in the profile
CONTROL OF ANTERIOR
SEGMENTS
ROLLER COASTER EFFECT
Tipping & rotation of teeth into extraction site
Deepening of the bite
Bite opening in the PM region

106. To minimize Roller coaster effect
No elastic force
Lacebacks
Bendbacks

107. CONTROL OF POSTERIOR SEGMENTS
UPPER ARCH
Anchorage control requirements are greater in
u/ arch
Upper ant segment has larger teeth
Greater amount of tip in upper brackets
Upper incisors require more torque control
U/molars move mesially more readily
Typical caseload has more cl II malocclusion

108. POSTERIOR ANCHORAGE
CONTROL FOR UPPER ARCH
Head gears
Occipital
Cervical
Combination
Palatal bars

109. CONTROL OF POSTERIOR
SEGMENTS IN LOWER ARCH
Lingual arch
Lacebacks
Push coil springs – in crowded blocked out
incisors
Class III elastics to the lower cuspids

110. ANCHORAGE ASSESMENT IN
VERTICL PLANE
INCISOR VERTICAL CONTROL
To restrict temporary increase in the overbite
in deep bite cases
MOLAR VERTICAL CONTROL
In high angle cases to prevent extrusion of
posterior teeth & further opening of mandibular
plane angle

111. INCISOR VERTICAL CONTROL
DISTALLY TIPPED CANINES

112. HIGH LABIAL CANINES

113. MOLAR VERTICAL CONTROL
HIGH ANGLE CASES
Upper II molars are not included
Bodily expansion of I molars – Fixed expander
+ High pull HG
TPA - 2mm away from the palate
High / combi pull HG
Posterior bite plates to minimize molar extrusion

114. TRANSEVERSE CONTROL
INTER CANINE WIDTH
kept as close as possible to starting dimension
MOLAR CROSSBITES
tipping of molars should be avoided

115. SPACE CLOSURE
MAXIMUM ANCHORAGE
II molars are included
Palatal bars, lingual arches to restrict mesial
movement of molars
Headgears + class III elastics

116. MINIMUM ANCHORAGE
II molars are not included
Mesial movement of molars should be started
as soon after extraction of II pm, to avoid the
possibility of alveolar bone becoming narrow.
Light class II along with sliding mechanics

117. SEGMENTED ARCH
TECHNIQUE
Charles. J. Burstone

118. SEGMENTED ARCH TECHNIQUE
Segmentation allows the Rx to proceed by
consolidation of teeth into segments
Right & left buccal segments are consolidated
by TPA & lingual arches
Once teeth within each segments are aligned,
each is treated as one large multi-rooted teeth.

119. ANCHORAGE CONTROL
Stress levels on the anchor unit should be kept
low
Heavy rigid archwire segments in anchor unit
Applying a moment for bodily control of anchor
unit
Differential force system to control the moment
to force system

120. ANCHORAGE UNITS
Posterior units consists of buccal segments –
Pm,I molar, II molar
Connected by TPA in the maxilla & Lingual
arch in the mandible
Buccal stabilizing segments – 19x25
- 21x25 ss / TMA

121. VERTICAL CONTROL
DEEP OVERBITE CORRECTION
Intrusion of anterior teeth
Extrusion of posterior teeth
Combination

122. PRINCIPLES OF ANTERIOR INTRUSION
Use of optimal magnitudes of force & constant
force delivery
Use of point contacts in the anterior region
Careful selection of point of force application
Selective intrusion based on anterior tooth
geometry
Control over the reactive units
Inhibition of eruption of posterior teeth

123. POINT OF FORCE APPLICATION
Intrusive force should pass through the CRes
for true intrusion
Proclined Incisors
Should be upright
Apply vertical force lingual to the Cres
[continuous intrusion arch / 3 piece int. arch,
17x25

124. CONTROL OF REACTIVE UNITS
Minimize the forces used for intrusion
Incorporate as many teeth as possible in the
anchor unit
Do as much retraction as possible to decrease
the length of moment arm
Lingual displacement due to extrusive force can
be prevented by lingual arch

125. POSTERIOR EXTRUSION
Extrusion arches with higher forces promote
posterior eruption
Extrusion arch is similar to intrusion arch
except larger forces are produced & hence ss is
used instead of TMA

126. SAGITTAL CONTROL
TIE BACK
Buccal segment wire is bent gingivally in
to a small hook
0.018’’TMA can be welded mesial to the
molar
Omega loop – mesial to the I molar
Washer can be crimped on the wire

127. SPACE CLOSURE
Alpha or anterior moment
Beta or posterior moment
Horizontal force

128. GROUP A ANCHORAGE
Requires a relative increase in the posterior
M/F ratio & decrease in the anterior M/F ratio
Spring is positioned closer to the posterior
segment
Extra oral appliances
Inter maxillary elastics
Applying differential M/F ratio

129. GROUP B ANCHORAGE
Requires equal translation of the anterior &
posterior segments into the extraction space
Equal & opposite forces & moments are
indicated
T- loop is placed in the center b/w anterior &
posterior attachments

130. GROUP C ANCHORAGE
Alpha moment is increased relative to the
Beta moment
Spring is positioned closure to the
anterior segment
Anchorage reinforcement
Intermaxillary elastics
Protraction headgear

131. LEVEL ANCHORAGE
SYSTEM
Terrell L. Root

132. LEVEL ANCHORAGE SYSTEM
Integrated approach to orthodontic treatment.
Pre adjusted edgewise appliance
Preformed arch wires
Detailed & carefully validated approach to Rx
planning
Step by step Rx procedure for 7 ext. & non ext
cases
Timing chart, Self check chart

133. DISTAL CROWN TIP
2 choices of distal crown tip for the mandibular
buccal teeth
Regular
Major

134. REGULAR MAJOR

135. ANALYSIS & TREATMENT PLAN CHART
Treatment time for each step
Length of time class II & class III elastics were
worn
Type of head gear & length of time worn
Length of time palatal bars were worn
High / Low mandibular plane angle.

139. PURPOSE OF FILLING ANALYSIS
CHART
To visualize how to treat the
malocclusion
Establishes a definite goal & reveals
which teeth to extract.

140. INVERSE ANCHORAGE
TECHNIQUE
Jose Carriere

141. Anchorage preparation in maxilla
Rx begins in the maxilla,
Starts from distal segment & moves sectionally
towards mesial --- Distomesial sequence

142. EQUATION FOR INVERSE ANCHORAGE
C = Dc / 2 + R1
Dc – Lower arch length discrepancy
R1 - Cephalometric anterior limit of mand. Incisors
C - Distance from the cusp tip of u/canine to the
distal surface of L/canine

143. STAGES OF TREATMENT
Maxillary stage – Sequence of movement in U/ jaw
Mandibular stage - Sequence of movement in l/ jaw
Steps
Posterior leveling
Posterior retraction
Anterior leveling
Anterior retraction

144. PLAN OF CL II, DIV 1 EXTRCTION Rx
C = Dc / 2 + R
8/2 +2

151. SKELETAL
ANCHORAGE

152. SKELETAL ANCHORAGE
The conventional methods of reinforcing
anchorage are less than ideal, because they
either rely on structures that are themselves
potentially mobile [teeth] or they rely too
heavily on patient compliance [ HG & Elastics].
Skeletal anchorage overcomes many of these
shortcomings.

153. REQUIREMENTS OF AN ORTHODONTIC
ANCHOR IMPLANT
Small
Affordable
Easy to place
Resistant to orthodontic forces
Able to be immediately loaded
Usable with familiar orthodontic mechanics
Easy to remove

154. CONVENTIONAL DENTAL IMPLANTS
Can only be placed in retromolar or edentulous
areas
Too large for horizontal orthodontic traction
Troublesome for patients because of
Severity of the surgery
Discomfort of initial healing
Difficulty of oral hygiene maintenance
Time required for osseous integration

155. TYPES OF SKELETAL ANCHORAGE
Direct anchorage
Utilizes force from the actual implant that takes the
place of a missing tooth & eventually supports a dental
restoration
Indirect anchorage
Placed solely for orthodontic purposes & is
generally removed once its anchorage duties have been
fulfilled

156. CLASSIFICATION
Based on implant morphology
1) Implant disks
Onplant
2) Screw designs
Mini-implant
Orthosystem implant system
Aarhus implant
Micro implant
Newer systems – Spider screw,OMAS system,

157. 3) Plate designs
Skeletal anchorage system [SAS]
Graz implant supported system
Zygoma anchorage system
BASED ON AREA OF PLACEMENT
Subperiosteal implants
Osseous implants
Inter dental implants

158. SUBPERIOSTEAL IMPLANTS
ONPLANT
- Block & Hoffman, AJO-1995
Circular disc – 8-10 mm

159. OSSEOUS IMPLANTS
Placed in Zygoma, body & ramus area,
midpalatal areas.
Skeletal anchorage systems
Graz implant supported system
Zygoma anchorage system

160. SKELETAL ANCHORAGE SYSTEM
Umemori,Sugawara, AJO-1999
Titanium miniplates, stabilized with screws
Different designs - L, Y, T

161. ORTHOSYSTEM IMPLANT
Developed by Wehrbein, 1996
Titanium screw implant – 3.3mm
Mid palate/ Retromolar area
Available in two sizes- 4/6mm

162. GRAZ IMPLANT SUPPORTED SYSTEM
Karcher & Byloff,2000
Modified titanium miniplate
4 miniscrews, 2 oval shaped cylinders
Support for Pendulum appliance

163. ZYGOMA ANCHORAGE SYSTEM
Hugo De Clerck & Geerinckx, JCO-2002
Curved Ti miniplate
3 screws of 2.3 mm
Lower end – projects outward
vertical slot
Zygomaticomaxillary buttress

164. INTER DENTAL IMPLANTS
Endosseous implants
Smaller diameter
Mechanical retention
Advantages
Placement is easy, can be done under LA
Brings about all types of tooth movement
Removal is easy.

165. MINI IMPLANT
Ryuzo Kanomi, JCO-1997
Modified surgical miniscrew
1.2mm diameter, 6mm length

166. MICRO-IMPLANTS
Park et al, JCO-2001
Placed in the buccal sulcus/ palatal inter dental
areas

167. OTHER INTERDENTAL SYSTEMS
Spider screw, Maino-JCO, 2003
OMAS [ orthodontic mini anchor
system]
JCO,2003

168. SPIDER SCREWS
JCO 2003, Giuliano Maino
Self tapping mini screws available in 3 lengths– 7,9,11 mm
3 Types
Regular
Low profile
Low profile flat

169. ANATOMOCAL SITES
Alveolar bone in an extraction site
Palate in the median / paramedian area
Retroincisive
Retromolar site
Anterior nasal spine
Chin symphysis

170. CONCLUSION
Conservation of anchorage in the
correct areas and at the proper time is one
of the most important & difficult tasks in
orthodontics.
The biomechanical setup that delivers
the correct type & magnitude of force
must be established to achieve the goals of
the treatment.