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PubMed2004

A case for absolute anchorage.

It would be an understatement to say that implant technology has changed the face of dentistry in the past 10 years or so. Both the surgical and restorative specialties have undergone dramatic transformation from treatment planning through all phases of rehabilitation. However, the same cannot necessarily be said for the specialty of orthodontics. Although it could be argued that implants have had an impact on the planning and setup of orthodontic cases (such as in congenitally missing teeth situations), the actual utilization of implants as an integral part of mechanotherapy has only begun to be realized. The ultimate extension of this application of using implants to enhance tooth movement would be to employ implants that are designed solely for the purpose of facilitating orthodontic therapy, with no intention to restore, but rather to explant such implants, after their purpose is fulfilled.

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PubMed2003

Implant-enhanced tooth movement: indirect absolute anchorage.

Four case reports demonstrate the effectiveness of indirect anchorage in orthodontics. These cases demonstrate the variety of situations in which absolute anchorage can be applied. A maxillary premolar extraction case illustrates the effectiveness of anterior retraction with this technique. A maxillary posterior protraction case shows the ease with which space closure can be achieved. Dual-arch capability is demonstrated through a four-premolar extraction case. Lastly, a case of severe dental mutilation devoid of any anchor units under conventional methods depicts how effectively distal driving can be accomplished. The technique involves the simple placement of a midpalatal endosseous implant that provides anchorage by indirect means to various teeth by virtue of a transpalatal arch soldered to its abutment. Once stabilized by such means, dramatic movements can be achieved in situations that would otherwise overtax anchor units and result in loss of anchorage. Teeth that would otherwise require stepwise and sequential movements can be mobilized en masse, greatly simplifying mechanotherapy and dramatically shortening treatment time. When no longer needed, the palatal implant is explanted and leaves no permanent deformation or defect after 2 or 3 weeks of healing.

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