Angle Orthodontist, Vol 74, No 5, 2004
Sliding Mechanics with Microscrew Implant Anchorage
Hyo-Sang Park, DDS, MSD, PhD
; Tae-Geon Kwon, DDS, MSD, PhD
Three cases are illustrated. One was treated with maxillary microscrew implants, another withmandibular microscrew implants, and the third with both maxillary and mandibular microscrew implants.With the maxillary microscrew implants, the maxillary anterior teeth were retracted bodily with a slightintrusion and all the premolar extraction space was closed without loss of anchorage. Furthermore, themaxillary posterior teeth showed distal movement. The mandibular microscrew implants controlled thevertical position of the mandibular posterior teeth and played an important role in improving the facialproﬁle. The efﬁcacy of sliding mechanics with microscrew implant anchorage on the treatment of skeletalClass II malocclusion is also discussed. (
Microscrew implants; Absolute anchorage; Sliding mechanics with MIA; Skeletal Class IImalocclusion
With increased use of preadjusted appliances, variousforms of sliding mechanics have replaced closing loop arch-es. Sliding mechanics might have great beneﬁts, such asminimal wire-bending time and adequate space for activa-tions.
The retraction of four incisors after canine retraction isaccepted as a method to minimize the mesial movement of the posterior teeth segment, whereas en masse retraction of six anterior teeth may create anchorage problems. In addi-tion, the tipping action built into anterior brackets in pread- justed appliances may produce problems of anchorage.These problems may be aided by the use of a transpalatalbar and extraoral appliances.
However, intraoral anchor-age devices may provide unacceptable anchorage, whereasextraoral appliances provide a suitable anchorage but aredependent on patient compliance.Skeletal anchorage using dental implants,
provides an absolute an-chorage for tooth movement. Miniscrew or microscrew im-plants have many beneﬁts such as ease of placement andremoval and inexpensiveness. Most importantly, because of their small size, they can be placed in the intra-arch alveolar
Associate Professor, Department of Orthodontics, College of Den-tistry, Kyungpook National University, Taegu, South Korea.
Assistant Professor, Department of Oral and Maxillofacial Sur-gery, College of Dentistry, Kyungpook National University, Taegu,South Korea.Corresponding author: Hyo-Sang Park, DDS, MSD, PhD, Depart-ment of Orthodontics, College of Dentistry, Kyungpook National Uni-versity, 101, Dongin-2-Ga, Jung-Gu, Taegu 700-422, South Korea(e-mail: firstname.lastname@example.org).Accepted: October 2003. Submitted: July 2003.
2004 by The EH Angle Education and Research Foundation, Inc.
bone without discernable damage to tooth roots. In addi-tion, orthodontic force applications can begin almost im-mediately after placement,
in contrast to dental implants.Therefore, these advantages have expanded the use of mini-or microscrew implants for various orthodontic problems.
By using microscrew implants in the mechanics of enmasse retraction of six anterior teeth, treatment time can bereduced effectively and clinicians can move teeth to satisfythe treatment goal without patient compliance for anchoragedevices. To show the efﬁcacy of the microscrew implants inanchorage control during the retraction of the maxillary an-terior teeth, in vertical control of the mandibular posteriorteeth and on the facial proﬁle, three cases are presented.
CASE 1. EFFECT OF THE MAXILLARYMICROSCREW IMPLANTS IN CONTROLLINGANCHORAGE FOR RETRACTION OFANTERIOR TEETH
A 13-year-old female patient presented with lip protru-sion and proclined maxillary and mandibular incisors. Be-cause of the protruded incisors, her lips were hardly ableto close. The patient had a 5
ANB angle and a high man-dibular plane angle (39
) (Table 1). Intraorally, Class II ca-nine and Class I molar relationships were evident, and theoverjet and the overbite were six and two mm, respectively.There were no arch length discrepancies in either the max-illary or mandibular arches (Figure 1). The treatment plancalled for extraction of the maxillary ﬁrst and mandibularsecond premolars and the installation of maxillary micros-crew implants for anchorage control.
During the extraction appointment, a maxillary micro-screw implant (1.2 mm in diameter, six mm long, Stryker