Skeletal Anchorage in Orthodontic Arch Alignment: Clinical Principles for Oral & Maxillofacial Surgeons

The concept of absolute anchorage has been the topic of extensive investigations in orthodontics. Oral and maxillofacial surgeons who receive referrals for surgical placement of orthodontic anchorage devices need to understand the principles underlying this concept and develop a customized surgical protocol for ideal placement of the implants. Detailed and coordinated communications with referring orthodontists are crucial in the proper placement of the orthodontic anchorage, very similar to the communications with the restorative dentists who determine the ideal location and axial inclination of the endosseous implants in the esthetic zone. Surgical techniques and axial inclinations of the microimplants are the important factors in establishing functional and stable anchorage. Improper placement will result in failure of implants, encroachment on vital anatomic structures and ultimately a failure to provide a stable anchorage for the planned orthodontic movements of the teeth.