 Angle & Case defined anchorage as resistance

offered by units to unwanted tooth movement. These

units may be a single tooth, a group of teeth or any
other anatomical area of the head which, by use of
an appliance, can be made to offer resistance to
movement.

 Graber:Anchorage in orthodontics refers to the

nature and degree of resistance to displacement
offered by anatomic units when used for the
purpose of effective tooth movement.
 Proffit stated that anchorage is defined as the resistance
to unwanted tooth movement. It is resistance to reaction
forces created whenever any type of movement is
carried out.

 NANDA: Anchorage may be defined as the amount of

movement of the anterior and posterior teeth to close the
extraction space in order to achieve selected treatment
goals.
CLASSIFICATION OF ANCHORAGE

Ottofy’s classification:

 Simple anchorage
 Stationary anchorage
 Reciprocal anchorage
 Moyer’s Classification

 According to manner of force According to the

application:
site of anchorage:
1) Simple anchorage
2) Stationary anchorage
3) Reciprocal anchorage 1)Intraoral
 According to jaw involved: 2) Extraoral
1) Intramaxillary
a. Cervical
2) Intermaxillary
b. Occipital
 According to number of c. Cranial
anchorage unit: d. Facial
1) Single or primary anchorage
2) Compound anchorage
3) Multiple or reinforced anchorage 3) Muscular
 Nanda’s classification
Depending on the
extent to which teeth
1) “A” anchorage
of active and reactive
2) “B” anchorage units should move
3) “C” anchorage (Gianelly and Goldman)

-maximum anchorage
-moderate anchorage
-minimum anchorage
 Simple anchorage is that form of anchorage in which the
the anchor teeth are permitted to tip or change its axial
inclination in plane of space of force application. Thus
resistance of anchorage unit to tipping is needed to
move another teeth.

 It is obtained by engaging with the appliance a greater

number of teeth than those are to be moved in the same
dental arch. It is the weakest form of anchorage.

 Ex- expansion screw to move incisors

labially against anchor teeth.
 Anchor teeth are not permitted to tip. The
displacement of anchor unit caused by the
force if at all has to occur results in bodily
movement.

 Thus the anchorage provided by a tooth

resisting bodily movement is considerably
greater than one resisting tipping force.

 It is the most advantageous and desirable

form of anchorage.
 Ex in stage II of Begg Technique, a
combination of anchor bends and Class II
elastics pits the Mn molars against the
maxillary ant segment. The resistance to
bodily movement of Mn molars helps in
retracting the Mx anteriors by tipping them.
 Simple anchorage

Stationary anchorage
 Refers to mutual resistance offered by two anatomical units against
each other.

 This is equalized,controlled and balanced tooth movement, and is

obtained by a reciprocal action between various teeth or groups of
teeth in which the movements desired are more or less in opposite
directions.
 Ex closure of midline diastema.
 -arch expansion appliance
 Use of cross elatics
 Use of box elastics to close open bite
 Use of Class II/ III elastics
 Reciprocal Anchorage
Closure of Midline Correction of crossbite
diastema using cross elastics
 Intramaxillary anchorage:
When all the units offering resistance are
situated within same jaw either in maxillary or
mandibular arch.

 Intermaxillary anchorage:
Anchorage in which the resistance units in one
jaw are used to effect tooth movement in the
opposing jaw. Also termed as Bakers
anchorage. Class II and Class III elastics.
Class II elastics Class III elastics
 Type “A” Anchorage:
75% or more of the extraction space is needed for
retraction. Hence posterior teeth should be
maintained in their position

 Type “B” Anchorage:

Relatively symmetrical space closure with equal
movement of posterior and anterior teeth to close
space.

 Type “C” Anchorage:

Noncritical post anchorage. 75% or more of the
space closure is achieved through mesial
movement of the posterior teeth.
 Maximum anchorage

Moderate anchorage

Minimum anchorage
Single or primary anchorage
Anchorage is provided by single tooth as a
resistance unit. Teeth with increased surface
area and multirooted teeth are selected.

 Compound anchorage-anchor unit is formed

by more than one tooth. Componded unit has
greater anchorage value. Inclusion of second
molar with first molar as anchorage unit.
Loop mechanics to retract incisors.
 SIMPLE ANCHORAGE

COMPOUND
ANCHORAGE
 Reinforced anchorage

 Anchorage in which more than one type of

resistance unit is utilized is called as
reinforced anchorage.

 Ex use of headgears

 Use of transpalatal arch

 Normal tonus of perioral musculature can be
utilized to provide anchorage

 Ex lip bumper does not allow Mn M to move

forward and if activated can move the molar
distally. The same appliance if used in upper
arch is called Denholtz appliance.
LIP BUMPER
 1.Alveolar bone

2.The teeth
•Root form (cross sectional)
•Size and number of roots
•Root length
•Position of tooth in dental arch
•Inclination of tooth
•Mutual support

3. Basal bone:

 4. The musculature
 Teeth
Whenever anterior teeth are retracted,
posterior teeth act as anchorage unit.
Anchorage potential of teeth depends on:-
1.Root surface value
Root form/shape

1.Round roots of bicuspids and palatal root of Mx 1

M can resist hor directed forces but offer least
anchorage.

2.Flat roots of Mn incisors and molars can resist

forces better.

3.Triangular roots of incisors and canine do offer

resistance to displacement.

4. Tripod arrangement of Mx 1 molar helps in

increasing anchorage value.
Size and no of roots

 Root length-greater the length of root, greater is its depth

of insertion-hence greater resistance to displacement.
 More is the no of roots-increased anchorage value
 Flared roots> fused roots

Position of roots-

 Mn molar offers more resistance than Mx M b’coz its

placed between two dense cortical plates.
 Mn 2nd PM also offfers resistance as placed between
mylohyoid and external oblique ridge.
 Inclination of tooth
Greater resistance to tooth displacement is offered when
the tooth is attempted to be moved in a direction
opposite to its axial inclination.

 Ankylosed teeth- union of cemntum and bone increases

its resistance to tooth displacement.

 Better anchorage value in teeth with good

intercuspation, broad contact points and teeth moved
mesially.
 Alveolar bone- resists tooth movement upto
a limit. Dense alveolar bone seen in adults
increases the resistance to tooth movement.

 Basal Bone –areas of basal bone like palate

reinforces anchorage.

 Cortical anchorage-Cortical bone in Mn is

thicker, with less blood supply and bone
turnover hence if molars are torqued to touch
cortical bone-it offers resitance to its
movement. (Ricketts)
The devices which make use of basal bone are
known as:

1-Holding arches
 Maxillary holding arch or Nance

holding arch
 Mn holding arch

2-Removable Anchorage appliances

 Maxillary removable anchorage
 Mn removable anchorage
Nance holding arch
Lingual arch

Mx & Mn removable anchorage appliance

 Anchorage from resistance units situated outside the oral cavity like
cranium, occiput, back of neck and face.

 Used to reinforce anchorage

 Disadvantage-lack of pt compliance, poor esthetics

 Derieved by use of headgears. Can move molars distally or

provides anchorage

 Facial bones provides anchorage when using reverse pull

headgear.
T
Y
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 USE OF EXTRAORAL ANCHORAGE

 To provide additional support for intraoral

anchorage.
 To prevent increased procumbency of Mn
incisor teeth.
 To prevent posterior teeth from shifting
forward.
 To move the teeth or the entire dental arch
distally.
 Reinforcing anchorage in posterior teeth by
facebows.
 Retraction of anterior teeth.
 Headgear can be named according to the
point of attachment of the straps:

a) In accordance with anatomical locations:

1) Cervical headgear
2) Occipital headgear
3) Combination type (both cervical
and occipital)
4) Reverse pull headgear
Mode of attachment of headgear

 Elastic straps or J hook to outer bow.

 Inner bow is inserted into molar tube by the

patient for desired function.
 Rigid osseous fixation in form of miniscrews
or mini plates redefines anchorage in new
perspective.

Why implants?????
 Conventional methods are less than ideal as

they take anchorage from structures like

teeth which are itself mobile or they rely too
heavily on patients compliance(headgear or
elastics)
 Implants used as source of anchorage are
termed as TEMPORARY ANCHORAGE DEVICES
(TAD’s)

 Requirements
-Small and affordable
-easy to place and resist orthodontic forces
-able to be immediately loaded
-easy to remove
-usable with common orthodontic mechanics
 Premature loss of permanent molars
 For retraction in Max anchorage situations
 In severe vertical problems( open bite)
 For intrusion of molars or incisors

Types
 Onplant
 Implant –mini screw, mini plate
 Direct bone apposition at the endosseous interface
results in rigid fixation (osseointegration).

 From an anchorage perspective, a rigid endosseous

implant is the functional equivalent of an ankylosed
tooth.

 Complete bony encapsulation is not necessary for an

implant to serve as a rigid anchorage unit.

 Miniscrews are loaded soon so as not to cause

osseointegeration
Inserted in Alveolar bone to close extraction
space or to intrude molars

 Available in different diameters like

1.2,1.4mm and different length like
6,8,9mm.
 Has a head that can be used to tie ligature.
 Placed at an angulation in attached gingiva

between the roots.

 Can be self threading or

self tapping
For retraction For molar intrusion

HOW TO INSERT

Using a jig or guide mark

the position of insertion

Drill pilot hole

Insert miniscrew.

Can be loaded
immediately
ANTERIOR NASAL
SPINE
For intrusion of incisors
 Onplant is placed at the center of palate for reinforcing
anchorage

 Superior surface of onplant with internal thread for

placement of transgingival abutment.

 Textured, HA coated surface of onplant is placed

against bone for biointegration
 When determing space requirement to treat
malocclusion always consider the space lost
by the movement of anchor teeth

 Anchorage requirement depends on:-

No of teeth to be moved

Retracting canine seperately and then incisors
decreases anchorage loss in comparison to
enmasse retraction of incisors and canines.
 Type of tooth to be moved

Teeth with flat and long roots like canines

cause more load on anchor teeth

 Type of tooth movement

Bodily movement is more taxing than tipping
movement
 Periodontal condition

Teeth with compromised bone support are

less taxing.

 Duration of treatment
Prolonged treatment time places more stress
on anchor teeth