ANCHORAGE IN

ORTHODONTICS
CONTENT:

1. Definition
2. Classifications
3. Sources of anchorage
4. Dental Implants
5. Anchorage Planning
6. Selection of Anchorage
7. Anchorage loss
 DEFINITION
According to T.M. Graber
“ The nature & degree of resistance to displacement offered by an
anatomic unit when used for the purpose of effecting tooth
movement ”
According to White and Gardiner
“ Anchorage is the site of delivery from which a force is
exerted.”
CLASSIFICATIONS
According to According to According According to
the manner jaw movement to the site the number of
of force of anchorage unit
application anchorage

• Simple • Intra-maxillary • Intra oral • Single or

anchorage anchorage anchorage primary
• • Inter- • Extra oral anchorage
Stationary maxillary anchorage • Compound
anchorage anchorage • Muscular
• Reciprocal anchorage anchorage
• Multiple or
anchorage reinforce
anchorage
SIMPLE
ANCHORAGE
Dental Anchorage in which the manner & application of force is such
that it tends to change axial inclination of tooth or teeth that form
the anchorage unit in the plane of space in which the force is being
applied .

Fig: Simple anchorage

(Upper removable
applience with reverse loop
canine retractor for
retraction of upper canine)
RECIPROCAL ANCHORAGE
When the two anchorage units with an equal root area or two similar groups of teeth
are used to move each other reciprocally to an equal extent ( towards each other or in
opposite directions)
)

Fig:Arch expansion using midline screw Fig: Cross elastic to correct molar cross bite
(Cross bite elastic are used to push the maxillary molars
labially and the mandibular molars lingually )
INTRA-MAXILLARYANCHORAGE
Anchorage obtained from a tooth or teeth in one jaw to move the tooth or teeth in
the
same jaw .

Fig: Intra-maxillary anchorage , the anchor units (maxillary posterior teeth and the the teeth to
be moved maxillary canine are present in the same arch ).
INTER-MAXILLARYANCHORAGE
When the teeth in one arch are used for anchorage to move the teeth in other
arch.

Fig: Class II inter-maxillary traction Fig: Class III inter-maxillary traction

EXTRA ORAL ANCHORAGE
Anchorage in which the resistance units are situated outside the oral cavity is
termed
extra oral anchorage .

Fig:Cervical headgear Fig: Facemask

(it derive anchorage form cervical or cranial region) (it derive anchorage from facial
bone )
MUSCULAR ANCHORAGE
It makes the use of forces generate by muscles to aid in the movement of
teeth.

Fig: lip bumper makes of the tonicity of the lip musculature and enhance potential of the
mandibular molars preventing their mesial movement ,
REINFORCED ANCHORAGE
The anchorage units are reinforced by the use of more than one
type of resistance units

fig: Anterior inclined exerts a

fig: Use of traspalatal arch in fixed mechanotherapy. plane: backward
pull on the
maxillary appliance through
the
mandible
STATIONARY ANCHORAGE
Dental anchorage in which the manner &application of force tends to displace
the
anchorage unit bodily in the plane of space in which the force is being applied .

Fig: pitting bodily movement of one group of teeth against tipping of

another .
SINGLE OR PRIMARY ANCHORAGE
The resistance provided by single tooth with greater alveolar support is used
to move another tooth with lesser alveolar support.

Fig: Molar being used to retract a pre

molar
COMPOUND
ANCHORAGE
The resistance is provided by more than one tooth with greater support is used to move
teeth with less support

Fig: Retracting incisors using loop mechanics

SOURCES OF ANCHORAGE

Sources

Intra oral: Extra oral :

1.The teeth. 1.Cranium (occipital or parietal
anchorage)
2.The alveolar bone
2. Back of the neck ( cervical)
3.The basal bone
3. Facial bone .
4.The musculature.
THE TEETH
When one teeth moves the others can
Act as anchorage units,it depends on

-Root form
-Root size
-No of roots
-Root length
-Root inclination
THE TEETH
Root form: On cross section of roots can be of three types, round, flat
and triangular.
•Round roots as seen in bi cuspids and palatal root of maxillary molars,
they can resist horizontally directed forces in any direction.
•Flat roots for example those of mandibular incisors and molars and
buccal roots of maxillary molar, can resist movements in mesio-distal
direction.
•Triangular roots of canine and maxillary central and lateral incisor
offer
maximum resistance to displacement compared to round or flat root
form.
THE TEETH
Size and no. of root: Multi rooted with large root
have a greater ability to withstand stress than single
rooted teeth.
Root length: The longer the root the deeper it is
embedded in bone and the greater is its
resistance to displacement.
Inclination of tooth: The greater resistance to
displacement is offered when the course exerted
to move teeth is opposite to that of their axial
inclination.
Ankylosed teeth: Orthodontic movement of such
teeth is not possible and they can therefore serve
as excellent anchors whenever possible.
ALVEOLAR BONE
•Alveolar bone resist tooth movement up to its limit, beyond that it
allow tooth movement by remodeling.
• Healthy alveolar bone-more anchorage.
BASAL BONE
Certain areas act as resistance areas-provide
good Anchorage-hard palate,lingual surface of
mandible
MUSCULATURE
 Hypertonic labial musculature used for anchorage in lip
bumper
 EXTRA ORAL ANCHORAGE
 Cranium (occipital or parietal anchorage:-
anchorage obtained from occipital or parietal
bone)
 Eg. Head Gear to restrict maxillary growth
 Cervical:- Anchorage from cervical or neck region
 Eg. Cervical Head Gear
 Facial Bones:- Face mask used to protract maxilla
take anchorage from mandibular symphysis
 Eg. Reverse Head gear
Mini dental implants:
 Used in patients having multiple lost teeth or hypodontia or to augment
teeth with periodontal diseases.
 Classification:
 According to exposure of head-
 1. Open –head is exposed to oral cavity –used when the implants is
placed in an area where the soft tissues are not movable.
 2. Closed-embedded under soft tissue –used when the implants is
placed in an area where the soft tissue is movable.
 According to implant placement:
 1. Self tapping method: Implant tapped into a previously drilled hole –
smaller diameter implants
 2. Self drilling method: Implants itself drilled into the bone-larger
diameter implants.
 According to path of insertion:
 1. Oblique :30 to 60 degrees to long axis of teeth
 2. Perpendicular: Inserted perpendicular to the bone surface
Mini dental implants
 ANCHORAGE PLANNING

 factors affecting are:-

 1)number of teeth being moved:-to move greater number of teeth, anchorage
should be more
 2)type of teeth:-teeth having more surface area require more anchorage
 3)type of movement:-bodily movement require more anchorage
 4)duration:-prolonged treatments require good anchorage
 5)skeletal growth pattern:-
a) vertical- require more anchorage due to poor tonicity of facial muscles
b) horizontal-require less anchorage due to strong tonicity of facial muscles
 6)occlusal interlock:- good occlusion=good anchorage
SELECTION OF ANCHORAGE:

 Since anchorage must be selected to make proper use of the

space created by extraction, a more rational approach of
classifying anchorage would be the one which guides the operator
to make use of the available space.
 Accordingly, anchorage in mandibular arch can be put into
three classes:
 DEPENDING ON ANCHOR LOSS EXPECTED:
• Minimum anchorage
• Moderate anchorage
• Maximum anchorage
Minimum Anchorage
 Minimum anchorage mechanics are selected when the mandibular posterior
teeth may be permitted to migrate mesially into half or more of the extraction
site.
Moderate Anchorage
Moderate anchorage mechanics are selected when the mandibular posterior
teeth may be permitted to move forward into one fourth to one half of the
extraction site.
Maximum Anchorage
 Maxillary anchorage mechanics are selected when the mandibular posterior
teeth may be permitted to move forward into no more than one fourth of the
extraction site.
ANCHORAGE LOSS
Anchorage loss in all 3 planes of sapce

a) Sagittal plane: 1. Mesial movement of molars

2. Proclination of anteriors

b) Vertical plane: 1.Extrusion of molars

2. Bite deepening due to
anterior
extrusion.
c) Transverse plane:1.Buccal flaring due
to over extended
arch form, unintentional
lingual root torque .
2. lingual dumping of molars.
Conclusion
As orthodontic treatment continues to change and
improve, innovative techniques may find acceptance in
certain types of cases. The list of adjuncts available may
increase. The objective in selection of treatment
mechanics is to have a bag of tricks that is large enough
to treat most of the conditions, but not so large as to be
unmanageable to incorporate into ones practice routine.
THANK YOU