Microimplant screws for Anchorage in Orthodontics:Dawn of a New Era

[drsushant]

 Why Anchorage should be an issue in Orthodontics

 Why Anchorage should be an issue in Orthodontics

Anchorage continues to be an issue ever since the orthodontics came into being. Why ? Some teeth should move while others should remain stable. Proclination, crowding, intrusion, distalisation etc need to be achieved without getting Newton 3rd law into action. In the past it was a dream to think of absolute anchorage or ZERO anchorage loss in a case. But that is changed for ever now on. So far we must also depend on patient cooperation to optimize anchorage management and Lack of patient compliance is one of the biggest limiting factors in ortho treatment- Moyers, Biomechanics becomes far too complex just for the sake of efficient preservation of anchorage. With the advent of these microimplants the concept of ‘absolute anchorage’ has become a reality.

 

Difficult situations like, distalisation, intrusion, molar extraction cases etc need not give you sleepless nights anymore. Jump in the microimplant bandwagon and you are sure to experience new heights of orthodontic excellence. Microimplants help you to Stretch the boundaries of orthodontics beyond

And help you Taking teeth where no tooth has gone before,

with the help of MI we are now able to see results which almost resemble results obtained with orthognathic surgery. MI helps to expand the envelope of tooth movement.

 

With the use of Microimplants your orthodontic treatment need not be "MOLAR CENTRIC", you can completely focus on giving your patient the BEST SMILE. Many cases that we refused can now be taken up for treatment. It has helped to improve quality of your treatment and patients are happy because they don’t need to have those "unwanted" gadgets/elastics etc.

 

The concept of metal components being screwed into the maxilla and mandible to enhance orthodontic anchorage was first published in 1945 by Gainsforth and Higley, they used vitallium screws to effect tooth movement in dogs. Two decades later, Linkow described the endosseous blade implant for orthodontic anchorage, but did not report on the long-term stability. Roberts used conventional, two-stage titanium implants in the retromolar region, to help reinforce anchorage whilst successfully closing first molar extraction sites in the mandible. So friends FORGET about TPA, Head gears or ANCHOR bends, come and join the revolution or you will surely REGRET. Attend a two day hands on course on microimplants to get you started, Contact us today to book your seat to change your future.

        

[Anonymous]

 

Microimplant/Skeletal Anchorage in orthodontics

Anchorage problems have given us many sleepless nights, have compromised results in many cases and lead to many case failures. Not ANYMORE, now the REVOLUTION has begun with the introduction of microimplants.

These devices have been called by various names

some of the popular ones are:

• Mini implants- MI
• Microimplants- MI
• Skeletal anchorage- SAS
• Temporary anchorage device- TAD

We prefer to use the term microimplant for orthodontic screws as it is most appropriate. Term temporary is true for all anchorage devices.

 

Best location for screw placement is in Maxilla between II pm and first Max molar, and this is the place to start for the beginners. This is also the most needed point of force delivery as most our cases have class II type pattern. But after you gain experience you can place in other locations.

        

[Anonymous]

 Advantages of Microimplants

Use of these devices leads to:

• 24 X 7 Force delivery
• simplified mechanics,
• improved results,
• drastic reduction (upto 40%) in treatment timing,
• reduction in number of extractions
• Minimal dependence on patient co operation

Disadvantages of Microimplants

• High Cost of the devices
• Failure of about 10% fixures
• Problem in site selection in patients with poor Bone quality
• Patient acceptance may be an issue in some cultures

Common Indications for placement of Temporary Anchorage devices/mini implants

Every case is not suited for microimplants. Minimal anchorage cases now can be treated non extraction with MI, many other average extraction cases we found that treatment objectives are achieved and extraction space is still remaining. Hence the cases where you need molars to come forward to occupy some of the ext space, are better done without MI or done with caution.

1. Mini implants are used most beneficially where three dimensional stable anchorage is needed, some of these situations are: 
2. Where you can not afford any movement of reactive units (maximum anchorage case)
3. Patient with several missing teeth making it difficult to engage posterior units
4. For difficult tooth movements, eg intrusion of anterior and posterior segments and ditalisation
5. Where asymmetrical tooth movement is needed
6. To treat borderline cases with non extraction method
7. Doing extreme ortho when patient is not willing to undergo orthognathic surgery

Common SITES OF PLACEMENT-see pic below

MAXILLA: 

• Infrazygomatic crest area.
• Tuberosity area.
• Between 1st and 2nd molars buccally.
• Between 1st molar and 2nd premolar buccally.
• Between canine and premolar buccally.
• Between incisors facially.
• Mid palatal Area.

MANDIBLE:

• Retromolar Area.
• Between 1st and 2nd molars buccally.
• Between 1st molar and 2nd premolar buccally.
• Between canine and premolar buccally.

        

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