2. NEWTON’S third law of motion :
“ Every action has an equal and opposite
reaction.”
3. DEFINITIONS :
Moyers :
• “ Resistance to displacement.”
• Active elements and reactive elements.
T.M. Graber :
• “The nature and degree of resistance to
displacement offered by an anatomic unit when
used for the purpose of effecting tooth
movement.”
4. DEFINITIONS :
Proffit :
• “Resistance to unwanted tooth movement.”
• “Resistance to reaction forces that is provided (usually)
by other teeth, or (sometimes) by the palate, head or
neck (via extraoral force), or implants in bone.”
Nanda :
• “The amount of movement of posterior teeth (molars,
premolars) to close the extraction space in order to
achieve selected treatment goals.”
5.
6.
7. CLASSIFICATIONS:
Moyers :
• According to the site of anchorage:
1. Intra oral :
Anchorage established within the mouth.
2. Extraoral
3. Muscular
8. CLASSIFICATIONS:
2. Extra oral :
Anchorage obtained outside the oral cavity.
a.) Cervical : eg. neck straps
b.) Occipital : eg. Head gears
c.) Cranial : eg. High pull headgears
d.) Facial : eg. Face masks
11. CLASSIFICATIONS:
Moyers :
• According to the number of anchorage units :
simple/primary compound reinforced
one tooth two/more teeth non-dental sites
Mucosa,head, muscles
16. BIOLOGICAL ASPECTS OF
ANCHORAGE :
Factors affecting anchorage:
• Number of roots
• Shape, size and length of each root
• multirooted > single rooted
longer rooted > shorter rooted
triangular shaped root > conical or ovoid root
larger surface area > smaller surface area
17. BIOLOGICAL ASPECTS OF
ANCHORAGE :
• Cortical anchorage: Cortical bone vs. medullary bone
• Muscular forces: Horizontal growers vs. vertical
growers
• Relation of contiguous teeth
• Forces of occlusion
• Age of the patient
• Individual tissue response
18. BIOLOGICAL ASPECTS OF
ANCHORAGE :
• Pressure in the PDL= Force applied to a tooth
Area of distribution in PDL
• Tooth movement increases as pressure increases upto a
point, remains at same level over a broad range and then
may gradually decline with extremely heavy pressure.
• Anchorage control : Concentration of desired force and
dissipation of reactionary force
20. BIOLOGICAL ASPECTS OF
ANCHORAGE :
Anchorage situations :
• Reciprocal tooth movement :
Equal force distribution over the PDL
eg. Midline diastema,
First premolar extraction site
Anchorage value depends on the root surface
area
21. BIOLOGICAL ASPECTS OF
ANCHORAGE :
• Reinforced anchorage:
Distribution of force over a larger surface area
Light forces vs. heavy forces
eg. Addition of extra teeth,
Extra oral anchorage
• Stationary anchorage:
Bodily movement of anchor teeth vs. tipping of
teeth to be moved
22. BIOLOGICAL ASPECTS OF
ANCHORAGE :
Anchorage situations :
• Differential effect of very large forces:
More movement of arch segment with the
larger PDL area.
Questionable response.
23. MECHANICAL ASPECTS OF
ANCHORAGE :
• Tooth movement is brought about after
overcoming the frictional resistance during
sliding of wire in the bracket.
• Frictional force is proportional to the force
with which the contacting surfaces are pressed
together
• Affected by the nature of the surface
• Independent of the area of contact
24. MECHANICAL ASPECTS OF
ANCHORAGE :
• Asperities :
Peaks of surface irregularities.
• Local pressure at asperities
causes plastic deformation
• At low sliding speeds, ‘stick
slip’ phenomenon occurs
• Anchor teeth feel reaction to
both friction and tooth moving
forces
25. ANCHORAGE LOSS:
Anchor loss in all 3 planes of space :
• Sagittal plane:
- Mesial movement of molars,
- Proclination of anteriors
26. ANCHORAGE LOSS:
• Vertical plane:
- Extrusion of molars,
- Bite deepening due to anterior extrusion
27. ANCHORAGE LOSS:
• Transverse plane:
- Buccal flaring due to over expanded arch form and
unintentional lingual root torque,
- Lingual dumping of molars,
29. ANCHORAGE IN REMOVABLE
APPLIANCES:
Early removable appliances:
• Crozat appliance
- Lingual extensions
- Heavy palatal bar
- High labial base wire
- Rest on molar clasp
30. ANCHORAGE IN REMOVABLE
APPLIANCES:
CLASPED REMOVABLE APPLIANCES:
- Active part,
- Clasps,
- Baseplate.
• Baseplate :
- Point of attachment for the active
components,
- Distribution of the reactionary forces to the
teeth and tissues.
31. ANCHORAGE IN REMOVABLE
APPLIANCES:
• To ensure adequate anchorage from
baseplates:
- Extension as far as possible, also for stability,
- Close fit to the tissues,
- Contouring along the lingual gum margins,
- Adequate bulk of acrylic.
- Eg. Schwartz expansion plate
36. ANCHORAGE IN REMOVABLE
APPLIANCES:
REMOVABLE FUNCTIONAL APPLIANCES:
• Anchorage obtained by:
- capping of incisal margins of lower incisors
- proper fit of cusps
of teeth into the acrylic
- deciduous molars
used as anchor teeth
37. ANCHORAGE IN REMOVABLE
APPLIANCES:
REMOVABLE FUNCTIONAL APPLIANCES:
- edentulous areas after loss of deciduous molars
- noses in upper
and lower interdental spaces
- labial bow prevents
anterior flaring and posterior
displacement of appliance
38. ANCHORAGE IN REMOVABLE
APPLIANCES:
REMOVABLE FUNCTIONAL APPLIANCES:
• Tissue borne appliances:
- Vestibular screen, Frankel’s function regulator
• Anchorage by acrylic extending into vestibule
• Headgears
39. ANCHORAGE IN FIXED
APPIANCES:
• Historical perspective
• Edgewise: Angle, Tweed, Andrews, Ricketts,
Alexander, Roth, Burstone, Bennett and Mclaughlin
• Methods to reinforce anchorage
• Begg: conventional and refined
• Tipedge
• Studies in anchorage
• Newer methods in anchorage conservation
41. • Long clamp band: crown tipping resistance of
posterior teeth pitted against crown tipping
resistance of cuspid.
- simple anchorage vs. simple anchorage
42. • Pin and tube appliance: root control by pins soldered
to labial archwire
• Ribbon arch appliance: size of archwire itself did not
provide anchorage of posterior teeth
44. TWEED TECHNIQUE:
“ When teeth are tipped distally as they are in
anchorage preparation, osteoid tissue appears to be
laid down adjacent to the mesial surface of the tooth
being moved distally.”
- Kaare Reitan
45. Anchorage preparation:
• First degree: ANB = 0 – 4
- mandibular molars must be uprighted and maintained
- direction of pull of intermaxillary elastics should be
perpendicular to long axis of the tooth
• Second degree: ANB > 4.5
- mandibular molars must be distally tipped till distal
marginal ridges are at gum level
- direction of pull of Cl II elastics should be greater
than 90 to the long axis of the tooth
46. • Third degree: ANB =5,
- total discrepancy = 14- 20 mm.
- mandibular molars must be distally tipped till
distal marginal ridges
are below gum level
- jigs are required
for anchorage
47. • Mandibular anchorage prepared first by distal
tipping of the canines, premolars and first and
second molars.
• Resist displacement
by Cl II elastic force
• Stabilizing arch
wire: .0215 by .0275
48. • Hooks soldered for intermaxillary elastics and/ or
headgear on the wires
• High pull headgear: b/w centrals and laterals
• Intermediate pull headgear and elastics: b/w
laterals and canines
49. TWEED MERRIFIELD TECHNIQUE:
• Sequential directional force edgewise technique –
1965
• .022 slot
• 20 degree tip back achieved
• J hook headgear used to upright cuspids and apply
distal force to terminal molars
50. Denture preparation:
Mandible:
• 20 degree tip back achieved
• Straight pull J hook headgear used to upright
cuspids and apply distal force to terminal molars
52. • Class III elastics not used
• Tip backs used instead of second order bends:
better incisor control
• Maxillary third order bends applied sequentially (
anterior lingual root torque, posterior buccal root
torque)
53. • Sequential anchorage: the 10-2 system
MANDIBLE:
• .0215 by .028 continuous archwire used
• Ten teeth anterior to the second molars are
stabilised while the two terminal molars receive
the active force
• High pull headgear used
• Second molars: +10 to +15
• First molars: 0 to –3 tip
• Second premolars: 0 to –5
54. • Distal tip of 10 degree in first molars with
compensation bends in 2nd molars
• High pull headgear
• End of 1 month: second molars: +10 to +15
first molars: +5 to +8
second premolars: 0 to -3
55. • 10 degree tip in second premolar region with
compensating bend just mesial to first molar
bracket
• High pull headgear only at night
• Second premolars: 0 to 5 degree tip
57. • High pull headgear used for enhancing molar
effect and incisor intrusion
• Next appointment: additional 5 degree tip
placed on 1st molar
• Second molar : 20
first molar : 15
second premolar: 10
59. ANCHORAGE IN FIXED
APPIANCES:
RICKETTS’ BIOPROGRESSIVE TECHNIQUE:
• Adverse effects of light continuous round wires
with reverse curve of Spee and tieback: lower
incisors thrown against the lingual cortical plate
causing forward movement of lower molars
• Class III elastics with high pull headgear:
extrusive effect on lower incisors and upper
molars
60. • Lower utility arch: late 1950s
• Position of lower molar to allow for cortical
anchorage:
- tooth movement through dense cortical bone is
retarded because of reduced blood supply, which
diminishes resorption
- buccal root torque of lower molars
• Tip back: gain in arch length – 4mm
• Headgears: cervical, combination and high pull
61.
62. THE STRAIGHT WIRE APPLIANCE:
• Dr. Lawrence Andrews , mid 70s
• Preadjusted bracket system
• Extra torque added to incisor brackets to
prevent bite deepening
• Anti-tip and anti-rotation features in canine,
premolar and molar brackets: extraction and
non- extraction series
• Same force levels and treatment mechanics as
previous systems
63. LEVEL ANCHORAGE SYSTEM:
• Terrell Root
• Preadjusted appliance used with .018 slot
• Anchorage:
- inherent resistance of teeth to move
- distance they can be allowed to move
Orderly manipulation of need and
availability of anchorage
• High pull headgear to maxillary 1st molars or
J hook headgear to anteriors: reduction in
ANB by 1 degree (1mm) every 6 months
64. Anchorage savers:
• Palatal bar: decreases vertical descent due to
tongue pressure; reduction in space by 1mm
• Delaying upper first molar extraction by one year:
reduces mandibular anchorage space by 1mm
• Class III elastics worn 24 hrs: flatten the curve of
Spee and upright buccal segments at the rate of
1mm / month
66. ANCHORAGE IN FIXED
APPIANCES:
Anchorage conservation during treatment in level
anchorage system:
• Stabilization of upper arch: .018* .025 s.s.
• Anchorage preparation in lower arch:
Class III elastics: level curve of Spee
• High pull headgear
• Vertical loops in mandibular archwire to
prevent space loss with class II elastics
67. ANCHORAGE IN FIXED
APPIANCES:
ALEXANDER DISCIPLINE:
• Vari-Simplex discipline
• -6 degrees angulation of lower first molar
tubes for gain in arch length
• ‘Retractors’ ( Dr. Fred Schudy)
• Cervical, combination or high pull depending
on growth pattern and control needed
68. ANCHORAGE IN FIXED
APPIANCES:
• Other intra oral appliances to control
anchorage:
1. Transpalatal arch in
high angle cases with
high pull headgear.
2. Nance holding arch
in class I cases with crowding;
preserves sagittal anchorage
and retards vertical eruption
69. • Other intra oral appliances to control
anchorage:
4. Mandibular lingual arch: sagittal and transverse
control
5. Lip bumper:
- uprighting of mandibular first molars
- distal force on lower molars
- muscular anchorage
70. BURSTONE’S SEGMENTAL ARCH TECHNIQUE:
• Arch divided into 1 anterior and 2 posterior
segments, treated as separate units
• Frictionless mechanics using TMA springs; low
load deflection rate
• Differential space closure: anterior retraction or
posterior protraction or both should be possible
• Proper moment to force ratios
71. Anterior retraction: group A arches: (AJO
1982)
• Buccal stabilizing segment with a transpalatal
arch in maxilla and lingual arch in mandible:
posterior anchorage unit
• Anterior segment
• Two tooth concept:
large distance b/w canine
and molar;
low load- deflection rates
72. • En masse controlled tipping followed by en
masse root movement
• TMA 0.018 loop welded to 00.017 by 0.025 base
arch
• - magnitude of moment
on molar increases due
to additional wire
in the loop
- low load deflection rate
73. ANCHORAGE IN FIXED
APPLIANCES:
• Heavy base arch withstands the higher moments
without permanent deformation
• Spring is positioned mesially
• Posterior tipping of buccal segments along with
TPA and consolidation of posterior teeth :
anchorage reinforcement
74. ANCHORAGE IN FIXED
APPLIANCES:
Group B arches:
• M/F ratio needed = 10:1 for translation
• Spring placed centrally b/w the two tubes
for same rate of change in M/F in both
alpha and beta moments
75. ANCHORAGE IN FIXED
APPLIANCES:
Group C arches:
• Loop is positioned at 1/3 rd interbracket
distance from the molar tube
or
• Symmetrically placed spring with Cl II or Cl
III elastics
• Side effects: flaring of anteriors, vertical
extrusion of anteriors
• Can be eliminated by using headgear to upper
arch
76. ANCHORAGE IN FIXED
APPLIANCES:
• Staggers and Germane (1991)
Placement of gable bend near the beta moment to
increase the M/F ratio
• Kuhlberg and Burstone (1997)
Use of a loop with symmetric angulation but
asymmetric placement
77. ROTH’S TECHNIQUE:
• .022 slot
• Double key hole loops used b/w lateral and
canine, and canine and premolar
- control canine rotation during extraction
space closure
78. Things that tend to slip posterior anchorage forward:
• Use of resilient wires and continuous wires to
level a deep curve of Spee
• Rapid bracket alignment with very resilient
wires
• Attempts to upright distally inclined canines
• Attempts at moving maxillary incisor roots
lingually
• Attempts at expansion with a labial arch wire
• Using a reciprocal force system to retract
extremely proclined anteriors
79. Ways to avoid anchor loss:
• Leveling with small flexible wire
• Retraction of lower anteriors using a facebow
• Band second molars in the beginning of
treatment
• Use of utility arch to level curve of Spee
• Use of multiple short Cl II or Cl III elastics for
intra-arch adjustment: do not extrude molars
and do not change cant of occlusal plane
80. • Use of mandibular
lingual arch with finger
springs to widen premolar areas
• Transpalatal bar:
intrusion of molars and
rotational control
81. • Critical anchorage cases: Asher facebow
used to retract anteriors
82. BENNETT AND MCLAUGHLIN:
Anchorage control:
‘The manoeuvres used to restrict undesirable
changes during the opening phase of
treatment, so that leveling and aligning is
achieved without key features of the
malocclusion becoming worse.’
83. Anchorage control in the horizontal plane:
• Inbuilt tip: proclination of anteriors (especially
uppers)
• Elastic forces : anchorage loss,
distal rotation of anteriors,
bite deepening and increase
in curve of Spee
84. Control of anterior segment:
• Lacebacks from most
distally banded molars
to canines
• Bending the archwire back immediately distal
to the molar tube
85. • Robinson in 1989:
- lower molars moved
forward 1.76 mm on an average
with lacebacks and 1.53mm
without lacebacks
- lower incisors moved distally
1.0 mm with lacebacks and 1.47 mm
without lacebacks
86. Control of the posterior segments:
• Greater need in upper arch:
- larger teeth
- greater tip
- more torque control and bodily movement
- upper molars move mesially more readily
- greater number of class II cases
• Headgears : cervical, combination and high pull
with long outer bow
• Palatal bar
87. Control of posterior segments: lower arch
Soldered lingual arch
Severe anterior crowding cases: push coil
springs with class III elastics; reinforced with
upper palatal bar and high pull headgear
89. Anchorage assessment in the vertical plane:
• Incisor vertical control: temporary increases
in overbite
90. • Avoid bracketing incisors or avoid tying the
wire in the incisor brackets
• Avoid early engagement of highly placed
canines
91. • Molar vertical control: prevent extrusion of
posterior teeth and opening up of mandibular
plane angle ( high angle cases)
• Upper second molars not banded or archwire step
placed distal to first molars
• Avoid extrusion of palatal cusps during
expansion : fixed expander with headgear
92. • Palatal bars lie away from palate by 2mm:
vertical intrusive effect of the tongue
• Avoid cervical pull headgear (combination
pull or high pull)
• Upper or lower posterior biteplates
Anchorage assessment in the lateral plane:
• Intercanine width maintained: avoid
uncontrolled expansion
• Molar crossbites: bodily correction to avoid
overhanging palatal cusps
93. INVERSE ANCHORAGE TECHNIQUE:
Jose Carriere- 1991
• Mandible is a preferred point of reference for diagnosis
and treatment planning, while maxilla is better suited to
adapting orthodontic correction
• - maxilla is anatomically a more stable reference than
mandible
- functionally mandible is the center of convergence of
force vectors, while maxilla is less influenced by forces
94. ANCHORAGE IN FIXED
APPLIANCES:
- histological difference between maxilla and
mandible ; maxilla has more plasticity of
response
• Treatment starts from the distal segments and
moves towards the mesial part sectionally
( distomesial sequence)
95. • Inverse anchorage equation:
C - Dc/2 – R1 = 0 where,
• C= horizontal distance b/w the vertical line
passing through the cusp tip of the upper
canine and the vertical line passing through
the posterior end of the distal ridge of the
lower canine
• Dc= arch length discrepancy of the
mandibular arch, measured from distal of
both lower canines
• R1= amount in mm which the anterior limit
of the lower incisors should be moved in the
ceph for the correction of a case
96. Stages:
• Maxillary stage:
treatment started in the maxilla with posterior
leveling, canine retraction, anterior leveling
and anterior retraction
• Mandibular stage:
same sequence
105. • Other anchorage reinforcements used:
- lingual arch, labial arch and transpalatal arch
- extraoral anchorage with Cl III elastics
106.
107. BEGG TECHNIQUE:
• 1950s by Dr. Begg in Australia
• Use of vertical slot
• Use of light forces for tipping teeth
• Use of optimal forces, so that extra oral
forces are not required
• No anchorage preparation necessary
108. Storey and Smith’s experiment on differential forces:
1954
• Series of animal experiments
• Bodily applied force will slow the rate of tooth
movement through a bone compared with a tipping
force
• Optimal force concept by Storey:
“ There is an optimum range of force which produces
maximum amount of tooth movement through
bone, and with forces above or below this range
there is reduced tooth movement.”
109. • Experiment using cuspid retraction spring:
• Free crown tipping retraction of cuspid and
bodily movement anchorage resistance by molar
and bicuspid
110. • Optimal force range for moving canines
distally: 150-200 gm.
• Further increase of force reduced the canine
movement till it approached zero
• Movement of molar unit occurred with force
values of 300-500 gm.
• Therefore, use of light differential forces in
Begg technique
111. • Anchorage considerations in stage I:
1. Sagittal: Upper molar anchorage:
- upper Cl I elastics not used
- TPA , when using power arms and palatal
elastics ( also consolidating the first and second
molars)
112. ANCHORAGE IN FIXED
APPLIANCES:
• Anchorage considerations in stage I:
1. Sagittal: lower molar anchorage:
- stiff lower wire ( 0.018” P or P+)
- light (yellow or road runner) elastics
- molar stop in case of Cl II and lower Cl I
elastics
- lip bumper in critical anchorage cases
113. Causes of anchorage loss in sagittal direction in
stage I:
• Insufficient resistance from anchor bends
due to inadequate anchor bends or use of
flexible wires like NiTi and undersize or
multilooped SS wire
• Excessively heavy
elastic pull
114. Causes of anchorage loss in sagittal direction in stage
I:
• Increased resistance from anterior teeth:
- incisor and/ or canine roots touching labial
cortical plate
- abnormal tongue or lip function
- overjet reduction before overbite reduction
• High mandibular plane angle with reduced
masticatory forces
115. Causes of anchorage loss in vertical
direction in stage I:
• Extrusion of molars due
to the anchor bends
• Vertical component of Cl II elastics
in lower arch
116. • Resistance to extrusion of upper molars
by masticatory forces in normal or low
angle cases
• In high angle cases, reinforcement with
TPA kept slightly away from palate
• High pull headgear
• Lower molars: light elastics with mild
anchor bends; posterior acrylic bite
blocks or EVAA appliance
• Engagement of wire in first and second
molars
117. Causes of anchorage loss in the transverse direction:
• Anchor bends and Cl II elastics cause lingual rolling
of lower molars
Control of anchor loss:
• Sufficiently stiff wires kept expanded
• TPA or expanded headgear facebow or lip bumper
118. Anchorage control in stage II:
• Use of heavy arch wires ( 0.018 or 0.020) to
maintain rotational correction, deep bite correction
and arch form
• Also resist distobuccal rotational tendency of molars
due to Cl I elastics
• Mild anchor bends to maintain over bite correction
119. Anchorage control in stage II:
• Anterior anchorage for posterior protraction:
- braking springs,
- angulated T pins
- combination wires with
anterior rectangular ribbon
mode and posterior round wire
- torquing auxiliaries like
two spur and four spur or MAA
120. Anchorage control in pre stage III:
• Upper wire: Gable bend for holding the deep bite
correction and uprighting distally tipped molars
• Lower wire: gable and anchor bends
• Inversion of segments to avoid canine extrusion due
to gable bends
• End of arch wires are bent back to prevent opening
of extraction spaces
121. Causes of anchorage loss in stage III:
• Torquing auxiliaries and uprighting springs
cause reciprocal reactions in all three planes of
space:
- lingual root torquing and distal root uprighting:
labial crown movements, extrusion of anteriors and
intrusion of posteriors, buccal crown movement
of posteriors
- reverse effects for labial root torquing and
mesial root movements
122. Control of anchorage in stage III:
• Minimise need for root movements by:
- careful diagnosis and planning of extractions
- controlled tipping of incisors
- use of brakes
• Use of heavy base wires ( 0.020 P)
• Lighter auxiliaries and uprighting springs
• Light Cl II elastics
123. Control of anchorage in stage III:
• Reinforcement of anchorage:
1. Sagittal:
- reverse torquing auxiliary on lower incisors
- headgear or TPA on upper molars and lip bumper
on lower molars
2. Vertical:
- high pull headgear, TPA or posterior bite blocks
- molar uprighting springs in case of second
premolar and first molar extraction cases
124. Control of anchorage in stage III:
• Reinforcement of anchorage:
3. Transverse:
- contraction and toe-in in heavy base wires
- TPA or overlay wires
- molar torquing auxiliary for buccal root
torque
125. Differences between conventional Begg and refined
Begg:
• Use of Special grade wire in conventional Begg
as opposed to P and P+ and Supreme
• Use of lighter elastic forces in refined Begg
• Use of extraoral anchorage and other
reinforcements
• Use of lighter auxiliaries and springs ( 0.009,
0.010, 0.012 as opposed to 0.014 and 0.016)
126. DIFFERENTIAL STRAIGHT ARCH TECHNIQUE: TIP-
EDGE
• Peter Kesling
• 0.022 by 0.028 slot size with increase to 0.028
• Vertical slot for placement of auxiliaries
• Finishing possible with rectangular wires
127. ANCHORAGE IN FIXED FUNCTIONAL
APPLIANCES:
• Herbst appliance:
partial anchorage: maxilla:
first permanent molars and first premolars
are banded and connected with a lingual or
buccal sectional wire
mandible: first premolars are banded and
connected with a lingual sectional wire
touching anterior teeth
129. - total anchorage: maxilla:
labial arch wire attached to brackets on
premolars, canines and incisors
Mandible: lingual sectional arch wire
extended to permanent first molars
• Bands are replaced by cast splints
132. Jasper jumper:
• Preparation of anchorage:
- full size arch wires cinched back at the ends;
inclusion of second molars
- anterior lingual crown torque in lower wire
- TPA and lingual arch
134. IMPLANTS :
• Boucher: Implants are alloplastic devices which are
surgically inserted into or onto jaw bone.
• Anchorage source:
Orthopedic anchorage:
- maxillary expansion
- headgear like effects
Dental anchorage:
- space closure
- intrusion ( anterior and posterior)
- distalization
135. • Implant designs for orthodontic usage:
- onplant
- mini-implant
- impacted titanium post
- skeletal anchorage system
Why implants?
Limitations of fixed orthodontic therapy:
• Headgear compliance and safety
• Reactive forces from dental anchors
136. Implants for orthopedic anchorage:
• Maxillary protraction:
- Smalley (1988)
- insertion of titanium
implants into maxilla,
zygoma, orbital and occipital
bones of monkeys
-12-16mm widening of sutures
with 5-7mm increase in overjet
137. • Implants for skeletal expansion:
-Guyman (1980) intentionally ankylosed maxillary
permanent lateral incisors of monkeys
No movement of
laterals during expansion
138. • Parr, Roberts, et al (1997):
Midnasal expansion using endosseous titanium
screws; Rabbit study
Stability of implants seen for 1N and 3N loading
139. Implants for intrusion of teeth:
• Creekmore ( 1983)
Vitallium implant for
anchorage while intruding
upper anterior teeth
6mm intrusion with
25degrees torque
140. • Southard (1995)
Comparison of intrusion
potential of titanium
implants and that of teeth
Titanium implants placed
in extracted 4th premolar
area of dogs
Intrusive force = 60gms
143. Implants for space closure:
• Eugene Roberts: use of retromolar implants for
anchorage
Size of implant: 3.8mm width and 6.9mm length
0.019 x 0.025 TMA wire from premolar to
retromolar implant to prevent distal movement
of premolar
145. Other implant designs:
• Onplant: Block and Hoffman (1995)
“an absolute anchorage device”
Titanium disc- coated with hydroxyapatite on one
side and threaded hole on the other
Inserted subperiosteally
146.
147.
148. • Impacted titanium posts:
Bousquet and Mauran (1996)
Post impacted between upper
right first molar and second
premolar extraction space on
labial surface of alveolar process
Perpendicular to bone surface
150. • Mini-implant:
Ryuzo Kanomi ( 1997)
Small titanium screws 1.2mm diameter and
6mm length
Initially used for incisor intrusion
6mm intrusion of mandibular incisors
153. • Skeletal anchorage system (SAS):
Sugawara and Umemori (1999)
Titanium miniplates
Placement in key ridge for upper molar and
ramus for lower molar intrusion
Uses:
- molar intrusion
- Molar intrusion and distalisation
- Incisor intrusion
- Molar protraction
154. ANCHORAGE IN FIXED
APPLIANCES:
Zygoma ligatures: Melsen et al JCO ’98
• Anchorage for intrusion and retraction of
maxillary incisors in partially edentulous
patients
• Horizontal bony canal drilled 1cm lateral to
alveolar process with entrance and exit holes in
superior portion of infrazygomatic crest
• Double twisted 0.012 ligature wire inserted
through the canal
159. ANCHORAGE IN FIXED
APPLIANCES:
Methods of anchorage conservation:
Transpalatal arch:
• Introduced by Goshgarian
• 0.036 SS wire
• Anchorage reinforcement
• Other uses: distalization,
rotation, torque, expansion
or contraction, vertical control
160. ANCHORAGE IN FIXED
APPLIANCES:
• Burstone : ( JCO ’88-’89)
use of 0.032 by 0.032 SS or TMA in transpalatal
arches depending on the passive or active
161. ANCHORAGE IN FIXED
APPLIANCES:
Lip bumper:
• Alters equilibrium b/w cheeks, lips and tongue
• Transmits forces from perioral muscles to the
lower molars
• Can be used for distalization of molars
• Attachment of Cl III elastics
162. ANCHORAGE IN FIXED
APPLIANCES:
Lingual arch:
Introduced by Hotz
0.036 SS wire
Loops mesial to the lower molars
Prevents mesial migration of molars
Can be used for gaining arch length
Springs soldered to lingual arches
for premolar movements
