Académique Documents
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as Orthodontic Anchorage
Sahar Shafi
02/13/06
Anchorage
Extraoral
non-compliance
Patient
discomfort
Limited
range of movement
Intraoral Anchorage
Intraarch
-assumes more teeth offer greater anchorage than fewer
teeth and that tipping is easier than translation
Interarch
-move teeth in one direction in ie. the upper jaw and in the
opposite direction in the lower jaw
Extradental
-transfer of reactive forces to the interface between metallic
anchorages and bone
Onplants
-Same as above but considerably easier to remove
Zygomatic Wires
-Limited available sites but immediate load possible for the
first time, leading to the discovery of miniscrews using the
same principles.
Miniscrews
Direct anchorage
Can be attached with elastics
or NiTi superelastic coils to
fixed appliances
Reduced cost compared to
implants
Titanium or Stainless steel
miniscrews 6-12mm in length
and 1.5-2mm in diameter
penetrating bone 5-8mm
depending on location
Cap placed over top of
miniscrew and secured with
light cured composite to avoid
contamination
Introductory Kit
A screw driver
Burs for drilling bony hole
Miniscrews 6,8,10, & 12mm in length
and 1.5-2mm in diameter
2 different screw head designs
Maxillary Locations
Midpalatal suture
-Dense crista nasalis bone for intrusion and retraction of
flared and over-erupted incisors
Infrazygomatic crest
-Retraction and intrusion of anterior teeth or intrusion of
molars
Mandibular Locations
Retromolar position
-Mesal movement of molars w/o retraction of anterior teeth
Edentulous areas of alveolar process
-Move single tooth w/o interfering with remaining dentition
Laterally in molar/premolar region
-Vertical and/or transverse movement of molars and premolars
Anterior Mandible
-Intrusion and proclination of incisors
Advantages
Disadvantages
Local
irritation
Risk of infection specific in relation to
different locations (associated with
all transmucosal anchorages)
Perforation of maxillary sinus when
screw placed in infrazygomatic crest
(no associated problems)
Potential risk of contacting roots or
nerves (leading to complicatons
depending on location)
Mucosal Incision
Mucosa Punch
Side Notes
Clinical Examples
Premolar Distalization
Discussion
References
Costa
et al. Miniscrews as
orthodontic anchorage: A preliminary
report. Int. J. Adult Orthodontics and
Orthognathic Sx. 1998;13(2):201-9
Fortini
Questions?