Anchorage

By,
Ayesha Khan
Ambreen Thobani
WHAT IS ANCHORAGE ???

“Resistance to unwanted tooth movement.”

“Resistance to the reaction forces that is provided by other

teeth, (sometimes) by he palate, head or neck (via extraoral
forces) and by the anchors screwed to the jaws.”

FOR EVERY (desired) ACTION, THERE IS AN EQUAL AND

OPPOSITE REACTION
 Every action has an equal an opposite reaction

 If we are discussing support for orthodontic

tooth movement, then forces that are applied
between or across teeth will act on all of the
dental units involved, perhaps resulting in
unintended tooth movement of the so-called
"anchor" teeth. The extent of this movement
and also the countermovement depends upon
the anchorage support derived from the
individual teeth. In other words, dental
anchorage is based on the number of teeth, the
length of their roots, the root surface areas, and
the structure of the supporting bone surrounding
the teeth
Anchorage value

The anchorage value of any tooth is its resistance to

movement, roughly equivalent to its root surface area which
is same as PDL area
Larger the root , greater the area over which a force
can be distributed, and vice versa.
Hence tooth with a larger root surface area is more resistant
to displacement than one with a smaller root surface area.
“Divide and conquer”

An obvious strategy for anchorage

control is to concentrate the force
needed to produce tooth movement
where it is desired,
& to dissipate the reaction force to as
many other teeth as possible, keeping
the pressure in pdl of anchor teeth as
low as possible.
Pressure response curve
Let us consider the response of anchor teeth (A) & teeth to
be moved (M) in three circumstances.

In each case, the pressure in the Pdl of (A) is less than that
of (M) because there are more teeth in the anchor unit.

In the first case(A1-M1), the pressure for the teeth to be

moved is optimal, where as the pressure in anchor unit is
suboptimal --- Anchor teeth moved less

In the second case(A2-M2), both are on the plateau of the

pressure response curve. The anchor teeth can be expected
to move as much as the teeth that are desired to be moved.

With extremely high force(A3-M3), the anchor teeth might

move more than the teeth it was desired to move.
Although this is theoretic & may not be encountered
clinically.
Classification

1.Acc. to the manner of force

application
2.Acc. To jaws invovment
3.Acc. To the site of anchorage
4.Acc. To the no. of anchorage units
According to the manner of force
Application

•Stationary anchorage
•Reciprocal anchorage
Stationary Anchorage
This refers to the advantage that can be obtained
by pitting bodily movement of one group of teeth
against tipping of another.
For eg. If the appliance were arranged so
that the anterior teeth could tip lingually
while the posterior teeth could only move
bodily,
the optimum pressure for the anterior
segment would be produced by abt. 1/2 as
much force as if the anterior would be to be
retracted bodily.
This would mean that the reaction over the
post teeth would be reduced by ½, so these
teeth would move ½ as much.
Reciprocal Anchorage
Refers to resistance offered by two malposed units when
the dissipation of equal & opp. forces tends to move
each unit towards a more normal occlusion.
Two teeth or two group of teeth of equal anchorage
value are made to move in opp. direction.
Classification according to jaws involvment

Intra maxillary Anchorage

Inter maxillary Anchorage
Intra maxillary Anchorage

All the resistance units are situated in the same jaw.

Inter maxillary Anchorage

Anchorage in which resistance units situated in one

jaw are used to effect tooth movement in the
opposing jaw.
Also termed Baker’s anchorage
Class II inter max elastics
Class III inter max elastics
Classification according to the site of Anchorage

Intraoral
• Teeth
root form,
size and number of roots,
root length,
ankylosed teeth
•Alveolar bone
•Cortical bone
 Root form

 Cross sections of root can be of 3 types:

 Round roots- can resist horizontally
directed forces
 Flat roots –can resist movements in
mesiodistal direction
 Triangular roots – maximum resistance to
displacement
Size and number of roots
Multirooted teeth with large roots have
greater ability to withstand stress as
compare to single rooted teeth.
 ROOT LENGTH

the longer the root

The deeper it is embedded in bone

The greater the resistance to its

displacement
 Ankylosed teeth
Ankylosed teeth are directely fixed to the
alveolar bone and hence LACK A
PERIODONTAL LIGAMENT.
 thus orthodontic treatment of such teeth
are not possible and they can therefore
serve as excellent anchors whenever
possible.
 Alveolar bone
 Alveolar bone offers resistance upto a
certain limit,when the force applied
exceeds the certain limit, the alveolar
bone permits tooth movement by bone
remodelling.
Cortical Anchorage

Cortical bone is more resistant to resorption, and thus

tooth movement is slowed when a root comes in contact
with it
• torquing the roots of posterior teeth outward against the
cortical plate inhibits their movement mesially when
extraction spaces are to be closed. This cortical anchorage
can be used for reinforcing anchorage.

•Disadvantage : if a root is persistently forced against the

cortical plate. Tooth movement is greatly slowed, root
resorption is likely, and eventual penetration of the cortical
bone may sometimes occur.
 Extra oral

 Cervical
 Occipital
 variable
A neck strap. An occipital (high pull) A variable pull
(cervical)
A reverse, or protraction headgear
Classification acc. to no. of anchorage units
utilized

•Single Anchorage

•Compound Anchorage

•Multiple/ Reinforced Anchorage

Single or primary anchorage

Where the resistance provided by a single tooth with

greater alveolar support is used to move another
tooth with less alveolar support
Compound Anchorage

Here the resistance provided by

more than one tooth with greater
support is used to move teeth with
lesser support
Reinforced Anchorage
More than one type of resistance unit is
utilized
Refers to augmentation of anchorage by
various means
-- extraoral forces
-- adding 2nd molars to the post unit to
augment post achorage
Skeletal (Absolute) Anchorage

When structures other than the teeth could be made to serve

as anchorage, it would be possible to produce tooth
movement or growth modification without unwanted side
effects.
Implants can be used as anchorage for orthodontic tooth
movement, and they made it possible to do things that
previously were considered impossible, for e.g, intrusion of
max post teeth in the treatment of anterior open bite.
ABSOLUTE ANCHORAGE MEANS :
NO TOOTH MOVEMENT EXCEPT WHAT WAS DESIRED
Other options for absolute anchorage:
Titanium screws , bone anchors
They are also known as TADS ( TEMPORARY ANCHORAGE DEVICES )
THANKYOU.