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FATHIMA SISINI
FINAL YEAR PART ONE
DEFINITION
• Anchorage in orthodontics as
the nature and degree of
resistance to displacement
offered by an anatomic unit for
the purpose of tooth
movement. (GRABER)
• Anchorage is the site of
delivary from which force is
exerted(White and Gardnier)
CLASSIFICATION(MOYERS)
• ACCORDING TO MANNER OF FORCE APPLICATION
SIMPLE STATIONARY RECIPROCAL
• ACCORDING TO JAWS INVOLVED
INTER MAXILLARY INTRA MAXILLARY
• ACCORDING TO SITE
INTRA 0RAL EXRAORAL MUSCULAR
• INTRA ORAL;-TEETH,ALVEOLAR
BONE,BASAL BONE
• EXTRA ORAL;-
CERVICAL,OCCIPITAL,CRANIAL,FACIAL
• MUSCULAR
• According to number of
anchorage units;-single or
primary,compound,multiple or
reinforced
CLASSIFICATION cntd….
INTRA ORAL ANCHORAGES
• 1) teeth
• 2)alveolar bone
• 3)basal bone
• 4)musculature
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
ROOT FORM
• FLAT-RESIST MOVEMENTS IN MESIO-DISTAL
DIRECTION,BUT LITTLE RESISTANCE
BUCCOLINGUALLY
EG;-MANDIBULAR INCISORS AND MOLARS,BUCCAL ROOT OF
MAXILLARY MOLARS
• ROUND:-RESIST HORIZONTALLY DIRECTED
FORCE IN ANY DIRECTION
EG;-BICUSPID,PALATAL ROOT OF UPPER MOLARS
• TRIANGULAR;-MAXIMUM ANCHORAGE
EG;-CUSPIDS,MAXILLARY CENTRALS AND LATERALS
SIZE AND NUMBER OF ROOTS
• MULTIROOTED TEETH HAVING THE
MAXIMUM SIZE HAVE MAX. ANCHORAGE
ROOT LENGTH;-DIRECTLY
PROPOTIONAL TO ANCHORAGE
AXIAL INCLINATION;-ANCHORAGE IS
MORE WHEN FORCE EXERTED IS OPPOSITE
TO THAT OF AXIS OF INCLINATION OF
TEETH
ANKYLOSED TEETH;-NO PDL, SO NO
MOVEMENT-EXCELLENT ANCHORAGE
ALVEOLAR BONE
• ALVEOLAR BONE RESIST TOOTH
MOVEMENT UP TO ITS LIMIT,BEYOND
THAT IT ALLOW TOOTH MOVEMENT
BY REMODELLING
• 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
• 1)CRANIUM(OCCIPITAL OR PARIETAL
ANCHORAGE:-ANCHORAGE OBTAINED FROM
OCCPITAL OR PARIETAL BONE
EG:-HEAD GEAR TO RESTRICT MAXILLARY GROWTH
• 2)CERVICAL:-ANCHORAGE FROM CERVICAL OR
NECK REGION
• EG:-CERVICAL HEAD GEAR
• 3)FACIAL BONES:-FACE MASK USED TO PROTRACT
MAXILLA TAKE ANCHORAGE FROM MANDIBULAR
SYMPHYSIS
REVERSE HEAD GEARS TAKE ANCHORAGE FROM
FOR HEAD AND CHIN
SIMPLE ANCHORAGE
• IS THE DENTAL ANCHORAGE SUCH THAT MANNER
AND APPLICATION OF FORCE IS SUCH THAT IT
TENDS TO CHANGE THE AXIAL INCLINATION OF
THE TEETH
• THE RESISTANCE OF ANCHORAGE UNITS TO
TIPPING IS USED TO MOVE OTHER TEETH
• THE COMBINED ROOT SURFACE AREA OF THE
ANCHORAGE UNIT MUST BE DOUBLE TO THAT OF
TEETH TO BE MOVED
• EG:-PALATALY PLACED PREMOLAR IS PUSHED IN
TO THE ARCH BY REST OF THE TEETH AS ANCHOR
UNITS
STATIONARY ANCHORAGE
• MANNER AND
APPLICATION OF FORCE
TEND TO DISPLACE THE
ANCHORAGE UNIT
• RESISTANCE PROVIDED
BY THE ANCHORAGE
UNITS IS AGAINST BODILY
MOVEMENTS(DISPLACEME
NT)
RECIPROCAL ANCHORAGE
• RESISTANCE OFFERED BY TWO
MALPOSED UNITS WHEN THE
APPLICATION OF TWO EQUAL AND
OPPOSITE FORCES TEND TO MOVE
EACH UNIT TO A MORE NORMAL
POSITION
• EG:-CLOSURE OF MIDLINE DIASTEMA
CROSS BITE ELASTICS,EXPANSION
APPLIANCES
INTRA MAXILLARY ANCHORAGE
• TEETH ARE TO BE MOVED AND THE
ANCHORAGE UNITS ARE IN THE SAME
ARCH
INTER MAXILLARY ANCHORAGE
• TEETH ARE TO BE MOVED IN ONE
ARCH AND RESISTRANCE UNITS ARE
IN OPPOSITE ARCH
• EG:-CLASS II ,CLASS III ELASTICS
SINGLE OR PRIMARY
ANCHORAGE
• SINGLE TEETH WITH MORE ALVEOLAR
SUPPORT USED TO MOVE ONE WITH
LESSER SUPPORT
COMPOUND ANCHORAGE
• ANCHORAGE PROVIDED BY MORE
THAN ONE TEETH WITH GREAT
SUPPORT TO MOVE TOOTH WITH
LESS SUPPORT
REINFORCED ANCHORAGE
• MORE THAN ONE TYPE OF RESISTANCE
UNIT IS UTILIZED
• EG:-A)TO AUGMENT THE INTRA ORAL
ANCHORAGE, EXTRA ORAL ANCHORAGES
TRANS PALATAL ARCH,AND LINGUAL
ARCHES IS USED
B)UPPER ANTERIOR INCLINED PLANE USED
FOR FORWARD MOVEMENT OF MANDIBLE
USES MUSCULAR ANCHORAGES
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:-
OPEN-HEAD IS EXPOSED TO ORAL CAVITY-USED
WHEN SOFT TISSUES ARE NOT MOVABLE
CLOSED-EMBEDED UNDER SOFT TISSUES-MOVABLE
TISSUES
• ACCORDING TO IMPLANT PLACEMENT
1)SELF TAPPING METHOD:-IMPLANT TAPPED
IN TO A PREVIOUSLY DRILLED HOLE-
SMALLER DIAMETER IMPLANTS
2)SELF DRILLING METHOD:-IMPLANT IS
ITSELF DRILLED IN TO THE BONE-LARGER
DIAMETER IMPLANT
• ACCORDING TO THE PATH OF INSERTION:-
1)OBLIQUE;-30=60DEGREES TO LONG AXIS OF
TEETH-WHERE INTER RADICULAR BONE IS
NARROW
2)PERPENDICULAR;-INSERTED
PERPENDICULAR TO THE BONE SURFACE-
WHEN SUFFICIENT INTER RADICULAR BONE
PRESENT
SITE OF PLACEMENT OF MICRO
IMPLANTS
• 1)MAXILLARY
TUBEROCITY
• 2)INFRA
ZYGOMATIC CREST
• 3)BUCALLY B/W
MAX 6 & 7
• 4)BUCALLY B/W
MAX 5&6
• 1)MAXILLRY
POSTERIORS
• 2)RETRACTION OF
MAX.ANTERIORS
&INTRUSION OF
MAX.POSTERIORS
• 3)SAME AS ABOVE
• 4)SAME AS ABOVE
&TO TIP BUCALLY
• 5)BUCALLY B/W
MAX 3&4
• 6)LABIALLY B/W
MAX. CENTRALS
• 7)PALATALLY B/W
MAX 5&6
• 5)DISTAL &MESIAL
MVMT OF
MAX.MOLARS AND
INTRUSION OF MAX
BUCCAL TEETH
• 6)INTRUSION AND
TORQUE CONTROL
OF INCISORS
• 7)RETRACTION OF
MAX ANTERIORS
AND INTRUSION OF
MAX MOLARS
• 1)RETROMOLAR PADS
• 2)BUCALLY B/W MAND.
6&7
• 3)BUCALLY B/W 4&5
• 4)BUCALLY B/W 3&4
• 5)MADIBULAR
SYMPHYSIS
• 1)UPRIGHTING&RETRA
CTION OF
MAND.TEETH
• 2)INTRUSION &DISTAL
MVMT OF MAND
MOLARS,RETRACTION
OF MAND.ANTERIORS
• 3)SAME AS ABOVE
• 4)PROTRACTION OF
MOLARS
• 5)INTRUSION OF
MANDIBULAR
ANTERIORS
SITES IN MANDIBLE
ANCHORAGE PLANNING
• FACTORS AFFECTING ARE:-
1)NO; OF TEETH BEING MOVED:-TO MOVE GREATER
NO;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-VICE VERSA
• 6)OCCLUSAL INTERLOCK:-GOOD
OCCLUSION=GOOD ANCHORAGE
• ANCHORAGE LOSS:-UNWANTED TOOTH
MOVEMENTS DURING ORTHODONTIC
THERAPY
• BASED ON THE ANCHORAGE LOSS THE
ANCHORAGE DEMAND OF THE
EXTRACTION CASES ARE OF THREE
TYPES
• MAXIMUM,MODERATE,MINIMUM
MAXIMUM ANCHORAGE CASES
• ANCHORAGE DEMAND IS VERY HIGH
• NOT MORE THAN 1/4TH
OF THE
EXTRACTION PLACE SHOULD BE
LOST BY ANCHORAGE LOSS
• SO AUGMENTATION OF ANCHOR
TEETH REQUIRED
MODERATE ANCHORAGE
CASES
• ANCHORAGE LOSS 1/2TH TO 1/4TH
OF
EXTRACTION SPACE
MINIMUM ANCHORAGE CASES
• ANCHORAGE LOSS CAN BE MORE
THAN 1/2TH OF EXTRACTION SPACE
BIBLIOGRAPHY
• TEXT BOOK OF ORTHODONTICS-S I
BHALAJI,PROFET
• WWW.FUNNYTOOTH.COM
• WWW.WIKIPEDIA.COM
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Anchorage in orthodontics

  • 2. DEFINITION • Anchorage in orthodontics as the nature and degree of resistance to displacement offered by an anatomic unit for the purpose of tooth movement. (GRABER) • Anchorage is the site of delivary from which force is exerted(White and Gardnier)
  • 3. CLASSIFICATION(MOYERS) • ACCORDING TO MANNER OF FORCE APPLICATION SIMPLE STATIONARY RECIPROCAL • ACCORDING TO JAWS INVOLVED INTER MAXILLARY INTRA MAXILLARY • ACCORDING TO SITE INTRA 0RAL EXRAORAL MUSCULAR
  • 4. • INTRA ORAL;-TEETH,ALVEOLAR BONE,BASAL BONE • EXTRA ORAL;- CERVICAL,OCCIPITAL,CRANIAL,FACIAL • MUSCULAR • According to number of anchorage units;-single or primary,compound,multiple or reinforced CLASSIFICATION cntd….
  • 5. INTRA ORAL ANCHORAGES • 1) teeth • 2)alveolar bone • 3)basal bone • 4)musculature
  • 6. 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
  • 7. ROOT FORM • FLAT-RESIST MOVEMENTS IN MESIO-DISTAL DIRECTION,BUT LITTLE RESISTANCE BUCCOLINGUALLY EG;-MANDIBULAR INCISORS AND MOLARS,BUCCAL ROOT OF MAXILLARY MOLARS • ROUND:-RESIST HORIZONTALLY DIRECTED FORCE IN ANY DIRECTION EG;-BICUSPID,PALATAL ROOT OF UPPER MOLARS • TRIANGULAR;-MAXIMUM ANCHORAGE EG;-CUSPIDS,MAXILLARY CENTRALS AND LATERALS
  • 8. SIZE AND NUMBER OF ROOTS • MULTIROOTED TEETH HAVING THE MAXIMUM SIZE HAVE MAX. ANCHORAGE ROOT LENGTH;-DIRECTLY PROPOTIONAL TO ANCHORAGE AXIAL INCLINATION;-ANCHORAGE IS MORE WHEN FORCE EXERTED IS OPPOSITE TO THAT OF AXIS OF INCLINATION OF TEETH ANKYLOSED TEETH;-NO PDL, SO NO MOVEMENT-EXCELLENT ANCHORAGE
  • 9. ALVEOLAR BONE • ALVEOLAR BONE RESIST TOOTH MOVEMENT UP TO ITS LIMIT,BEYOND THAT IT ALLOW TOOTH MOVEMENT BY REMODELLING • HEALTHY ALVEOLAR BONE-MORE ANCHORAGE
  • 10. BASAL BONE • CERTAIN AREAS ACT AS RESISTANCE AREAS-PROVIDE GOOD ANCHORAGE- HARD PALATE,LINGUAL SURFACE OF MANDIBLE
  • 11. MUSCULATURE • HYPERTONIC LABIAL MUSCULATURE USED FOR ANCHORAGE IN LIP BUMPER
  • 12. EXTRA ORAL • 1)CRANIUM(OCCIPITAL OR PARIETAL ANCHORAGE:-ANCHORAGE OBTAINED FROM OCCPITAL OR PARIETAL BONE EG:-HEAD GEAR TO RESTRICT MAXILLARY GROWTH • 2)CERVICAL:-ANCHORAGE FROM CERVICAL OR NECK REGION • EG:-CERVICAL HEAD GEAR • 3)FACIAL BONES:-FACE MASK USED TO PROTRACT MAXILLA TAKE ANCHORAGE FROM MANDIBULAR SYMPHYSIS REVERSE HEAD GEARS TAKE ANCHORAGE FROM FOR HEAD AND CHIN
  • 13.
  • 14. SIMPLE ANCHORAGE • IS THE DENTAL ANCHORAGE SUCH THAT MANNER AND APPLICATION OF FORCE IS SUCH THAT IT TENDS TO CHANGE THE AXIAL INCLINATION OF THE TEETH • THE RESISTANCE OF ANCHORAGE UNITS TO TIPPING IS USED TO MOVE OTHER TEETH • THE COMBINED ROOT SURFACE AREA OF THE ANCHORAGE UNIT MUST BE DOUBLE TO THAT OF TEETH TO BE MOVED • EG:-PALATALY PLACED PREMOLAR IS PUSHED IN TO THE ARCH BY REST OF THE TEETH AS ANCHOR UNITS
  • 15.
  • 16. STATIONARY ANCHORAGE • MANNER AND APPLICATION OF FORCE TEND TO DISPLACE THE ANCHORAGE UNIT • RESISTANCE PROVIDED BY THE ANCHORAGE UNITS IS AGAINST BODILY MOVEMENTS(DISPLACEME NT)
  • 17. RECIPROCAL ANCHORAGE • RESISTANCE OFFERED BY TWO MALPOSED UNITS WHEN THE APPLICATION OF TWO EQUAL AND OPPOSITE FORCES TEND TO MOVE EACH UNIT TO A MORE NORMAL POSITION • EG:-CLOSURE OF MIDLINE DIASTEMA CROSS BITE ELASTICS,EXPANSION APPLIANCES
  • 18.
  • 19. INTRA MAXILLARY ANCHORAGE • TEETH ARE TO BE MOVED AND THE ANCHORAGE UNITS ARE IN THE SAME ARCH
  • 20. INTER MAXILLARY ANCHORAGE • TEETH ARE TO BE MOVED IN ONE ARCH AND RESISTRANCE UNITS ARE IN OPPOSITE ARCH • EG:-CLASS II ,CLASS III ELASTICS
  • 21. SINGLE OR PRIMARY ANCHORAGE • SINGLE TEETH WITH MORE ALVEOLAR SUPPORT USED TO MOVE ONE WITH LESSER SUPPORT
  • 22. COMPOUND ANCHORAGE • ANCHORAGE PROVIDED BY MORE THAN ONE TEETH WITH GREAT SUPPORT TO MOVE TOOTH WITH LESS SUPPORT
  • 23. REINFORCED ANCHORAGE • MORE THAN ONE TYPE OF RESISTANCE UNIT IS UTILIZED • EG:-A)TO AUGMENT THE INTRA ORAL ANCHORAGE, EXTRA ORAL ANCHORAGES TRANS PALATAL ARCH,AND LINGUAL ARCHES IS USED B)UPPER ANTERIOR INCLINED PLANE USED FOR FORWARD MOVEMENT OF MANDIBLE USES MUSCULAR ANCHORAGES
  • 24.
  • 25.
  • 26. 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:- OPEN-HEAD IS EXPOSED TO ORAL CAVITY-USED WHEN SOFT TISSUES ARE NOT MOVABLE CLOSED-EMBEDED UNDER SOFT TISSUES-MOVABLE TISSUES
  • 27. • ACCORDING TO IMPLANT PLACEMENT 1)SELF TAPPING METHOD:-IMPLANT TAPPED IN TO A PREVIOUSLY DRILLED HOLE- SMALLER DIAMETER IMPLANTS 2)SELF DRILLING METHOD:-IMPLANT IS ITSELF DRILLED IN TO THE BONE-LARGER DIAMETER IMPLANT • ACCORDING TO THE PATH OF INSERTION:- 1)OBLIQUE;-30=60DEGREES TO LONG AXIS OF TEETH-WHERE INTER RADICULAR BONE IS NARROW 2)PERPENDICULAR;-INSERTED PERPENDICULAR TO THE BONE SURFACE- WHEN SUFFICIENT INTER RADICULAR BONE PRESENT
  • 28.
  • 29. SITE OF PLACEMENT OF MICRO IMPLANTS • 1)MAXILLARY TUBEROCITY • 2)INFRA ZYGOMATIC CREST • 3)BUCALLY B/W MAX 6 & 7 • 4)BUCALLY B/W MAX 5&6 • 1)MAXILLRY POSTERIORS • 2)RETRACTION OF MAX.ANTERIORS &INTRUSION OF MAX.POSTERIORS • 3)SAME AS ABOVE • 4)SAME AS ABOVE &TO TIP BUCALLY
  • 30. • 5)BUCALLY B/W MAX 3&4 • 6)LABIALLY B/W MAX. CENTRALS • 7)PALATALLY B/W MAX 5&6 • 5)DISTAL &MESIAL MVMT OF MAX.MOLARS AND INTRUSION OF MAX BUCCAL TEETH • 6)INTRUSION AND TORQUE CONTROL OF INCISORS • 7)RETRACTION OF MAX ANTERIORS AND INTRUSION OF MAX MOLARS
  • 31. • 1)RETROMOLAR PADS • 2)BUCALLY B/W MAND. 6&7 • 3)BUCALLY B/W 4&5 • 4)BUCALLY B/W 3&4 • 5)MADIBULAR SYMPHYSIS • 1)UPRIGHTING&RETRA CTION OF MAND.TEETH • 2)INTRUSION &DISTAL MVMT OF MAND MOLARS,RETRACTION OF MAND.ANTERIORS • 3)SAME AS ABOVE • 4)PROTRACTION OF MOLARS • 5)INTRUSION OF MANDIBULAR ANTERIORS SITES IN MANDIBLE
  • 32.
  • 33. ANCHORAGE PLANNING • FACTORS AFFECTING ARE:- 1)NO; OF TEETH BEING MOVED:-TO MOVE GREATER NO;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-VICE VERSA
  • 34. • 6)OCCLUSAL INTERLOCK:-GOOD OCCLUSION=GOOD ANCHORAGE • ANCHORAGE LOSS:-UNWANTED TOOTH MOVEMENTS DURING ORTHODONTIC THERAPY • BASED ON THE ANCHORAGE LOSS THE ANCHORAGE DEMAND OF THE EXTRACTION CASES ARE OF THREE TYPES • MAXIMUM,MODERATE,MINIMUM
  • 35. MAXIMUM ANCHORAGE CASES • ANCHORAGE DEMAND IS VERY HIGH • NOT MORE THAN 1/4TH OF THE EXTRACTION PLACE SHOULD BE LOST BY ANCHORAGE LOSS • SO AUGMENTATION OF ANCHOR TEETH REQUIRED
  • 36. MODERATE ANCHORAGE CASES • ANCHORAGE LOSS 1/2TH TO 1/4TH OF EXTRACTION SPACE
  • 37. MINIMUM ANCHORAGE CASES • ANCHORAGE LOSS CAN BE MORE THAN 1/2TH OF EXTRACTION SPACE
  • 38. BIBLIOGRAPHY • TEXT BOOK OF ORTHODONTICS-S I BHALAJI,PROFET • WWW.FUNNYTOOTH.COM • WWW.WIKIPEDIA.COM