Anchorage in Orthodontics

ANCHORAGE IN ORTHODONTICS
CONTENTS
• INTRODUCTION
• CLASSIFICATION OF ANCHORAGE
• INTRAORAL SOURCES OF ANCHORAGE
• EXTRAORAL SOURCES OF ANCHORAGE
• TYPES OF ANCHORAGE
• USE OF IMPLANTS OR TEMPORARY ANCHORAGE
DEVICE(TAD)
• ANCHORAGE PLANNING
• LOSS OF ANCHORAGE
DEFINITION
• Graber has defined anchorage in orthodontics as the nature

and degree of resistance to displacement offered by an
anatomic unit for the purpose of effecting tooth movement.
• According to White and Gardiner, anchorage is the site of

delivery from which a force is exerted.
CLASSIFICATION OF ANCHORAGE
• ACCORDING TO MANNER OF FORCE

APPLICATION(BY MOYER’S)
1. Simple anchorage
2. Stationary anchorage
3. Reciprocal anchorage
• ACCORDING TO JAWS INVOLVED

1. Intra maxillary
2. Inter maxillary
• ACCORDING TO THE SITE OF ANCHORAGE
1. INTRAORAL
2. EXTRAORAL
A. Cervical
B. Occipital
C. Cranial
D. Facial
3. MUSCULAR
• ACCORDING TO THE NUMBER OF ANCHORAGE
UNITS:
1. Single or primary anchorage
2. Compound anchorage
3. Multiple or reinforced anchorage

INTRAORAL SOURCES OF ANCHORAGE
• The teeth
• Alveolar bone
• Basal bone
• Musculature
THE TEETH
• Whenever some teeth are moved orthodontically , the remaining
teeth of the oral cavity can act as anchorage or resistance units.
• The anchorage potential of teeth depends on a number of factors

such as root form, root size, number of roots, root length and
root inclination.
ALVEOLAR BONE
• The alveolar bone that surrounds the tooth offers resistance to
tooth movement up to a certain amount of force.
• When the force applied exceeds a certain limit, the alveolar

bone permits tooth movement by bone remodelling.
BASAL BONE
• Certain areas of the basal jawbones are available intra-orally as sources of
anchorage.
• These areas include the hard palate and the lingual surface of the mandible
in the region of the roots.
• These intraoral hard areas of basal bone can be used to augment intra-
maxillary or inter-maxillary anchorage.
MUSCULATURE
• The normal tonus of the facial and masticatory muscles plays an
important role in the normal development of dental arches.
• Dental anchorage may be increased by making use of hypertonic labial

musculature as in the case of a lip bumper.
EXTRAORAL SOURCES OF ANCHORAGE
• CRANIUM (OCCIPITAL OR PARIETAL ANCHORAGE)

:-
Extraoral anchorage can be obtained by using headgears that
derive anchorage from the occipital or parietal region of
the cranium.
• BACK OF THE NECK (CERVICAL ANCHORAGE) :-

Extraoral anchorage can alternatively be obtained from the
neck or cervical region. Such a type of headgear is called
cervical headgear.
• FACIAL BONES :-
The frontal bone and the mandibular symphysis offer anchorage

during face mask therapy in order to protract the maxilla.
TYPES OF
ANCHORAGE
1. SIMPLE ANCHORAGE :-
It is defined as dental anchorage in
which 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. Thus the
resistance of the anchorage unit
to tipping is utilized to move
another tooth or teeth.
STATIONARY
ANCHORAGE
It is defined as dental
anchorage in which the
manner and application
of force tends to displace
the anchorage unit
bodily in the plane of
space in which the force
is being applied.
RECIPROCAL
ANCHORAGE
The term refers to the
resistance offered by
two malposed units
when the dissipation
of equal and opposite
forces tends to move
each unit towards a
more normal
occlusion.
INTRAORAL
ANCHORAGE
Anchorage in which all
the resistance units
are situated within the
oral cavity.
The teeth to be moved
and the anatomic
areas that offer
anchorage are all
within the oral cavity.
EXTRAORAL
ANCHORAGE
Anchorage in which
are situated outside
the oral cavity.
Various extraoral
anatomic units used
as sites of resistance
are occiput , back of
the neck, cranium and
face.
MUSCULAR
ANCHORAGE
The perioral
musculature is
employed as
resistance units.
Muscular anchorage
makes use of forces
generated by muscles
to aid in the
movement of teeth.
INTRA
MAXILLARY
ANCHORAGE
When all the units
offering resistance are
situated within the
same jaw.
The teeth to be moved
and anchorage units
are all situated either
entirely in the
maxillary or the
mandibular arches.
INTER
MAXILLARY
ANCHORAGE
Anchorage in which
situated in one jaw are
used to effect tooth
movement in the
opposing jaw.
It is also termed as
Baker’s anchorage.
SINGLE OR PRIMARY ANCHORAGE
• The resistance provided by a single tooth with

greater alveolar support is used to move
another tooth with lesser support.
• Eg. Molar being used to retract a premolar.

COMPOUND
ANCHORAGE
Anchorage where the
resistance provided by
more than one tooth
with greater support is
used to move teeth
with lesser support.
REINFORCED
OR MULTIPLE
ANCHORAGE
Anchorage in which
more than one type of
resistance unit is
utilized.
Methods of reinforcing
anchorage:-
1. Extraoral forces to
augment anchorage
2. Upper anterior
inclined plane
3. Use of transpalatal
arch and lingual arch
USE OF IMPLANTS OR TEMPORARY
ANCHORAGE DEVICE (TAD)
• These devices are especially useful in patients who have lost
lot of teeth or hypodontia.
• Endosseous implants are a valuable alternative for stable intra

oral anchorage.
• Temporary anchorage device also known by the terms such as

mini-implant, mini-screws, skeletal anchorage devices or
micro-screws.
.
• TAD is a device that is
temporarily fixed to the
bone for the purpose of
enhancing orthodontic
anchorage either by
supporting the teeth of
reactive unit or by
obviating the need for
reactive unit altogether.
INDICATIONS OF TEMPORARY ANCHORAGE
DEVICE
• Mesial and distal movement of buccal teeth.
• Lingual or labial movement of anterior teeth.
• Vertical intrusive movement of buccal or anterior teeth.
• In patients whose posterior teeth are missing .
• As anchorage for distalization of molars.

• For intrusion of maxillary teeth.
• Anterior open bite and deep bite.
• Source of anchorage for retraction of canine and anteriors.
• Correction of canted occlusal planes.
• As an aid in the treatment of class III malocclusion.

A. Maxillary molar
intrusion.
B. Anchorage during
distalization.
C .Retraction of anterior teeth.
D. Anchorage when posterior

teeth are missing.
E. Mesial movement of second
molar.
COMPLICATIONS OF TAD
• Contact with adjacent roots.
• Breakage of implant.
• Damage to anatomic structures.
• Soft tissue overgrowth.
• Implant loosening.
ANCHORAGE PLANNING
• Anchorage planning is of utmost importance for the success of

orthodonic treatment.
• It is essential to carefully assess the anchorage demands of an

individual case so that appropriate treatment modalities can be
executed.
• The anchorage requirement depends on a
number of factors which are listed below:-
1. Number of teeth being moved
2. Type of tooth movement
3. Duration of tooth movement
4. Duration of tooth movement
5. Skeletal pattern
6. Occlusal interlock
LOSS OF ANCHORAGE
Unplanned and unexpected movement of the anchor teeth during

orthodontic treatment.
Causes of loss of anchorage are:-

1. Poor appliance design.
2. Poor appliance adjustment.
3. Poor patient wear.

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ANCHORAGE IN ORTHODONTICS

• Graber has defined anchorage in orthodontics as the nature

• According to White and Gardiner, anchorage is the site of

• ACCORDING TO MANNER OF FORCE

• ACCORDING TO JAWS INVOLVED

3. Multiple or reinforced anchorage

• The anchorage potential of teeth depends on a number of factors

• When the force applied exceeds a certain limit, the alveolar

• Dental anchorage may be increased by making use of hypertonic labial

• CRANIUM (OCCIPITAL OR PARIETAL ANCHORAGE)

• BACK OF THE NECK (CERVICAL ANCHORAGE) :-

The frontal bone and the mandibular symphysis offer anchorage

• The resistance provided by a single tooth with

• Eg. Molar being used to retract a premolar.

• Endosseous implants are a valuable alternative for stable intra

• Temporary anchorage device also known by the terms such as

• Lingual or labial movement of anterior teeth.

• Vertical intrusive movement of buccal or anterior teeth.

• In patients whose posterior teeth are missing .

• As anchorage for distalization of molars.

• Anterior open bite and deep bite.

• Source of anchorage for retraction of canine and anteriors.

• Correction of canted occlusal planes.

• As an aid in the treatment of class III malocclusion.

D. Anchorage when posterior

• Contact with adjacent roots.

• Damage to anatomic structures.

• Soft tissue overgrowth.

• Anchorage planning is of utmost importance for the success of

• It is essential to carefully assess the anchorage demands of an

Unplanned and unexpected movement of the anchor teeth during

Causes of loss of anchorage are:-

2. Poor appliance adjustment.

3. Poor patient wear.

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