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DEFINITIONS :
 Louis Ottofy :
“The base against which orthodontic force or
reaction of orthodontic force is applied.“

 White and Gardiner :

“The site of delivery from which a force is
exerted".

 Moyers :
“ Resistance to displacement.”
Active elements and reactive elements.

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DEFINITIONS :
 T.M. Graber :
“The nature and degree of resistance to
displacement offered by an anatomic unit when used for
the purpose of effecting tooth movement.”

 Proffit :
“Resistance to unwanted tooth movement.”

“Resistance to reaction forces that is provided

(usually) by other teeth, or (sometimes) by the palate,
head or neck (via extraoral force), or implants in bone.”

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Classification of anchorage ( MOYER’S)
According to manner of force application-
a) Simple anchorage
b) Stationary anchorage
c) Reciprocal anchorage

According to the jaws involved-

a) Intramaxillary
b) Intermaxillary

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 According to the site of anchorage-
a) Intraoral
b) Extraoral
 Cervical
 Occipital
 Facial
c) Muscular

According to the number of anchorage units-

a) Single or primary anchorage
b) Compound anchorage
c) Reinforced anchorage
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 Simple anchorage – is said to exist when the manner
and application of force is such that it tends to change
the axial inclination of the tooth or teeth that form the
anchorage unit in the plane of space in which the force
is being applied.

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 Stationary anchorage - is said to exist
when the application of force tends to
displace the anchorage units bodily in the
plane of space in which the force is being
applied.
 Reciprocal anchorage - is not a distinct form of
anchorage, but a reciprocal force working equally
at both ends.

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 Intramaxillary anchorage

 Intermaxillary anchorage

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 Single / primary anchorage
Anchorage involving only one tooth
 Compound anchorage
Anchorage involving two or more teeth
 Reinforced anchorage
Addition of non dental anchorage sites

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 Intraoral anchorage makes use of the teeth, the
biologic reaction of bone, and the influence of
musculature.

 Extraoral anchorage depends upon the cranium

and the neck for its source.

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INTRAORAL SOURCES
 Teeth –
a) Roots – Resistance offered by the teeth vary
greatly due to the variations in the,

• form
• size
• number
• length
• position
• inclinations of the roots
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 Form-
o The premolar teeth with their small round roots resist
horizontally directed force equally from any
directions.
o Flat roots of mandibular molars and incisors resists
force best in mesiodistal direction.
o Triangular form of the roots of canines, maxillary
incisors provide greater anchorage.

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Size and number-
o The size and number of the roots of each tooth are
another indication of the tooth’s ability to withstand
stress since the greater the surface area, the more
periodontal membrane fibers that can support to
increase its stability.

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o Multirooted maxillary molar has a tripod arrangement of
roots. The large palatal root resists extrusion. Flattened and
more diminutive mesiobuccal root resists intrusion and
mesiodistal stresses.
o Mandibular molars resists mesiodistal stresses more than the
maxillary molars.

Length-
o The length of the root indicates the depth to which
the tooth is embedded in the bone. The deeper it is
embedded, the stronger is its resistance to
dislodgement.
o Maxillary canine is an example of deeply embedded
tooth.

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Position in the dental arch -
o Mandibular second molars is located between two
high ridges of basal bone, mesial to the retromolar
fossae of the mandible.
o Hence it offers more resistance to bodily movement
than any other tooth in the mouth.

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Inclination -
o When the axial inclination of the teeth is in a
direction opposite the force acting on it, it offers
greater resistance to dislodgement.

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b) Good intercuspation also leads to greater
anchorage potential.

c) Ankylosed tooth-
Being fused directly to the alveolar bone, is without a
periodontal membrane attachment and cannot be
moved orthodontically. Hence in some cases ,its
presence can be exploited as a source of anchorage

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Teeth in diminishing order of resistance-
Mandibular molars
Maxillary canines
Mandibular canines
Maxillary molars
Maxillary central incisors
Mandibular premolars
Maxillary premolars
Maxillary lateral incisors
Mandibular lateral and central incisors

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 Alveolar bone –

 Alveolar bone has a mechanism for resisting the

movement of the teeth. When force is applied to a
tooth to move it ,it stimulates a rearrangement of the
alveolar trabeculae in a direction to offer a greater
resistance to the new force.

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 When the force exceeds this amount, the bone
yields, permitting the teeth to move.

 Alveolar bone yields strategically in that, while

permitting a teeth to move, it still resists.

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 Basal bone anchorage -
 Some areas of hard basal bone are available
intraorally as bearing areas to augment anchorage
like the hard palate.

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A steep palatal vault is a useful
source of anchorage

Shallow palatal vault provides

less anchorage

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Pendulum for distalisation 24
 Cortical anchorage
 Response of cortical bone is different compared
to medullary bone.
 Cortical bone is more resistant to resorption and
tooth movement is slowed down when a root
contacts it.
 The cortical bone is characterized by being more
dense and laminated, with a very limited blood
supply.

 The blood supply in the bone is the key factor in

tooth movement

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EXTRAORAL SOURCES

o Extraoral anchorage is that form which dissipates equal

and opposite reaction to a force upon areas outside the
mouth.

o The use of facial, cranial, occipital and cervical areas to

bolster the intraoral resistance units is one of the oldest
forms of orthodontic therapy.

o The anchorage obtained by these extraoral sources is

considered to be absolutely stable.

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 In maximum anchorage situations, where the position
of molar has to be maintained, headgear provides
excellent reinforcement of posterior anchorage, if it is
applied consistently and for long duration.

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Before

After

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Headgear for growth modification
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Reverse pull headgear

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 MUSCULAR ANCHORAGE
o Perioral musculature is employed as resistence units.
o Makes use of forces generated by muscles to aid in
the movement of teeth.
o The stability of the anchorage of a dental arch may be
increased by the temporary utilisation of hypertonic
musculature.

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ANCHORAGE VALUE
o Conceptually, the “anchorage value” of a tooth, that is,
its resistance to movement, can be thought of as a
function of its root surface area, which is the same as
its periodontal ligament area.
o The larger the root, the greater the area over which a
force can be distributed, and vice versa.

Freeman’s anchorage value diagram

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 The combined root surface area of the upper
incisors and upper canines is around the same as
that of the first molar and premolars.

 This factor should be carefully considered in

planning anchorage requirements and tooth
movement.

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ANCHOR LOSS
• This is defined as the unplanned and
unexpected movement of the anchor teeth
during orthodontic treatment.

• In extraction cases, based on the anchor loss

that is permissible anchorage demand is
classified into 3 groups.
1. Maximum anchorage (1/4)
2. Moderate anchorage (1/2)
3. Minimum anchorage (3/4)

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According to Nanda
Group A anchorage : critical / severe
75 % or more of the extraction space is needed for
anterior retraction.

Group B anchorage : moderate

Relatively symmetric space closure (50%)

Group C anchorage : mild / non critical

75% or more of space closure by mesial movement
of posterior teeth

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 ANCHORAGE PLANNING 37

Methods to increase anchorage potential

I . By increasing the resistance to
displacement

II. By decreasing the displacement potential

ANCHORAGE PLANNING 38

Increasing the resistance to displacement

Reinforcement - Anchorage is said to be reinforced
when more than one type of resistance units are utilized, thus
augmenting the anchorage
ANCHORAGE PLANNING 39

1. Increasing no. of teeth in anchor unit - For

significant tooth movement, the ratio of PDL area in anchorage
unit to PDL area in tooth movement unit should be at least 2:1
without friction and 4:1 with friction. Anything less will
produce something close to reciprocal movement.
ANCHORAGE PLANNING 40

2. Intermaxillary traction - using elastic from upper

posterior to lower anterior unit, thus pitting forward
movement of entire upper arch against distal movement of
lower anterior segment
ANCHORAGE PLANNING 41

3. Extraoral traction - The reaction force from headgear

is dissipated against bones of cranial vault, thus adding
resistance to anchorage unit.
ANCHORAGE PLANNING 42

4. Palatal , lingual arches , Nance’s button

Connecting bilateral buccal segments offer significant benefits.
Incorporation of anterior vault of palate enhances post.
anchorage.
ANCHORAGE PLANNING 43

Cortical anchorage control - Moving the roots of

anchor molar into the cortex increases their resistance
to displacement
ANCHORAGE PLANNING 44

Muscular forces - Can be used to augment anchorage such

as through use of lip bumper.
Muscular forces transmitted onto the molars in a distal
direction would discourage forward movement of molars.
ANCHORAGE PLANNING 45

Moments – Moments can be generated through tip back bends

applied to the anchor teeth. This creates distal tipping forces,
which does not allow anchor teeth to tip mesially, thereby
increasing its anchor value
ANCHORAGE PLANNING 46

Implants or ankylosed teeth – perfect examples

of stationary anchorage.
ANCHORAGE PLANNING 47

Decreasing the displacement potential

Reduce forces
Reduce friction
Sequential loading
ANCHORAGE PLANNING 48

Reduce forces - The optimum force for orthodontic

tooth movement is the lightest force that produces a
maximum or near maximum response. Forces
greater than that , though equally effective in
producing tooth movement, would be unnecessarily
traumatic & stressful to the anchorage.
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Reduce friction
- Using frictionless mechanics
- Use of optimal clearance between bracket & arch wire.
- Optimal leveling to reduce binding effect
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Sequential loading - Gradual progression towards stiffer slot

filling arch wires
Conclusion

AN IMPORTANT ASPECT OF TREATMENT

IS MAXIMISING THE TOOTH MOVEMENT
THAT IS DESIRED, WHILE MINIMISING
UNDESIRABLE SIDE EFFECTS.

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THANK YOU