ASK an honest question to yourself, how many of your cases outcome is compromised because of loss of anchorage ? How much of your energy/time/money  is wasted in planning anchorage ? Half of orthodontic learning involves how to manage anchorage. No more of these Headaches, After Edward Angle the NEXT revolution is here. Call it Microimplant screw anchorage, Skeletal achorage (SAS) or Temporary Anchorage devices (TAD), name does not matter, but it sure has revolutionised orthodontic treatment.

Sweden, Korea have done lots of work in this area, American are now realising and have started catching up. There have been lots of articles in JCO and AJODO and recent issue (march 2005) of Seminars in orthodontics is fully devoted to this topic, luckily this issue is available free of charge- to see this whole issue free of cost click on this link  Seminars in orthodontics volume 11, Issue 1 Another very useful article on this topic by Birte Melsen is also on JCO Sept 2005 issue (free access) Click on Link below

Melsen- OVERVIEWMini-Implants- Where Are We- The author describes the development of skeletal anchorage and compares current systems.

Use of these devices leads to:

• simplified mechanics,

• improved results,

• drastic reduction in treatment timing,

• reduction in number of extractions.

Hard to believe ? Click on the links in the right column to see the actual cases. Treatment time is reduced by 40%. There is no dependence on patient cooperation. There is an excellent book on this topic. To read the review click HERE

A very large percentage of our cases ( upto 80%) need premolar extractions, FEAR of loosing anchorage is always looming over our head.

Orthodontists have always been obsessed with planning of anchorage. Newton's III law always on our mind and we planned various tactics so as to keep Molars stable ( TPA or Nance arches, Head gears etc etc), frequently banding/bonding II molars. Any loss of anchorage meant treatment failure and guilt that precious premolar extraction space has been uselessly wasted. Many a time we used intermaxillary anchorage viz elastics    (eg Class II cases) and found that patient never complied as much we wished leading to treatment delays.

Difficult movements like intrusion had to be managed in limited way or ended as a compromise.

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.

Many efforts were made but significant advancement did not take place in this area, reasons being complicated methods and devices and time consuming/cumbersome procedures. Desire for early loading of implants used for orthodontic anchorage led Melsen to develop the Aarhus implant screw. Screw length being 6 mm it could be loaded immediately with Sentalloy springs (25-50 gms) and was suitable for placement in many locations. A useful write-up is also available on the link  Temporary Anchorage Devices - (TAD).

To see actual cases click here and to download instruction file in pdf format click here. You will see that it is as simple as ABC and anyone can do it in matter of minutes. Little care and knowledge will be enough. The dimension of screw we use most often is 1.3 mm diameter and 8 mm long. We find it suits majority of our cases.

What is the failure rate (screw becomes loose)? Well we could say about 8-10% at maximum, and what do you do after that, simple just place the screw again little far (about 1-2mm) from the old location and you are ready again. We have always loaded screws immediately and have found no problems. While removing you do not even need to give local anaesthetic.

So friends FORGET about TPA, Head gears or ANCHOR bends, come and join the revolution or you will surely REGRET.

To hold seminar/Lecture/ order screws/ Hands on program on this e mail to webmaster@HealthMantra.com