Orthodontic Anchorage: Definition, Types, and Advantages

What is orthodontic anchorage?

Anchorage in orthodontics is a fixed point that provides the force needed to either prevent certain teeth movements or pull them in a certain direction.

Do you remember Newton’s third law? It says that for every action or force, there will be an opposite reaction. Ok this is exactly what you see that happens to teeth. When orthodontists want to move or align protruding teeth or fix our jaw irregularities, they use anchorage techniques to stop that reaction or opposite force that happens in the other teeth.

To have stable and firm braces or other orthodontic appliances in your mouth, anchorage is necessary. Depending on the type of treatment and force or pressure in an area of teeth or jaw, orthodontists plan an appropriate anchorage system.

Orthodontic anchorage can take many shapes and forms:

• TADs
• Molar teeth
• Dental implants
• Bridges
• Headgear (extraoral anchorage)
• Transpalatal arch
• Interach elastics
• Spring designs in braces
• Loop design in braces

What are the types of anchorage?

Orthodontists need a stable and not a fragile anchor to do the orthodontic treatment without any damage to other oral structures like teeth and gums. So, they try to use the most suitable anchorage type in or outside of your mouth.

Three types of orthodontic anchorage:

1- Extraoral anchorage

Extraoral anchorage is the type of anchorage that is fixed outside the mouth to hold the force of tooth movement during our orthodontic treatment. Orthodontists use external skeletal parts of the body like chin, neck, and head to fix the orthodontic appliance for aligning our jaw or teeth irregularities.

Headgear appliance in orthodontics is an extraoral anchorage appliance. Orthodontic headgears treat many jaw and teeth irregularities. By wearing headgear, based on different designs, the forces and pressure are spread well over the other skeletal parts of your body (head, neck or chin). So, there will not be any side effects of moving the protruding jaw or teeth during your orthodontics.

Cervical pull and high pull headgear are extra-oral devices for this purpose. They rely on the patient’s cooperation for a successful treatment.

2- Temporary anchorage devices (TADs) and osseo-integrated implants

In this type of orthodontic anchorage, orthodontists use bone in your oral structures to anchor your orthodontic appliance. Osseo-integrated implants and TADs are also called skeletal or bone anchorage. Orthodontists fix the anchors in the bone in different parts of your mouth, which provides a stable and tough anchorage for your treatment.

Bone density and maturation is a key factor for min-implants which are inserted into the bones surrounding your teeth. This is why skeletal anchorage or TADs is not recommended for children below 12 years old. You should have good quality bone to have TADs implanted.

3- Dental anchorage

Dentists or orthodontists make the most of teeth when it comes to holding orthodontic tools in your mouth. Therefore, orthodontists can use as many teeth into the anchorage to stabilize the orthodontic braces or other appliances in the mouth.

Teeth can distribute the force that is necessary to pull or push other teeth into the normal and fitted position. The best anchorage teeth are molars and canines because of the stable location or powerful root structures of these teeth.

What are temporary Orthodontic Anchorage Devices (TADs)?

Temporary anchorage devices or TADs are tools that are mechanically fixed into the bone in the mouth to act as anchors for your orthodontic appliance. TADs can be removed when your orthodontic treatment is over or when it is not necessary anymore.

TADs are screw-like devices that are implanted in the skeletal areas of the oral cavity. They have changed orthodontic treatment in a dramatic way. Before these devices, most orthodontic treatments required surgical procedures for treating complex irregularities in teeth. You had no choice but to do surgeries if you wanted to complete your orthodontics when irregularities in your teeth were severe.

The areas that TADs are placed should have bone density and bone maturation is needed. For orthodontic treatment of children, orthodontists wait for the appropriate age of the child when they get to 12 years of age or till their puberty periods. Then, they implant the TADs into the bony area. The alveolar bone, the rooftop of the mouth (palatal bone), lower and upper jaw bones and the zygomatic arch in the jaw are the skeletal structures for the implanting TADs anchorage in orthodontics.

What are the types of TADs?

In orthodontics today, different TADs are available to meet the needs of the amount of force and treatment time in each orthodontic treatment. Your braces are attached to these TADs with coil springs or elastics to stay in place. As a result, TADs provide a fixed base to help push, pull, or intrude teeth that are getting straightened by your braces. Unless your orthodontist has used other anchorage ways, you can look at the TADs and the locations of these anchorage devices that are inserted in your bones in the mouth.

The main types of TADs are:

• Mini-implants: Mini-implants, also known as mini-screws, are made of titanium and are highly efficient TADs. Their design allows the steel wires, elastics, or springs to pass through them and hold your braces or other orthodontic appliance to firm and stable in your mouth. They are easy to use for orthodontists and dentists and are mechanically applied by numbing the bone area first to prevent any pain. It doesn’t hurt and you don’t need to worry about the pain.
• Miniplates: Miniplates are TADs anchorage tools that consist of mini-implants and plates. The plate should be contoured to fit the bone area. In fact, miniplate application needs a little surgery but it can easily be done under local anesthesia. Orthodontists use this amazing temporary anchorage device to do complex teeth movement in orthodontics. Minipaltes have multiple screws that can withstand pressures and forces. In addition, they offer better orthodontic control and will not loosen during your treatment.

What are the advantages of TADs?

• TADs offer highly stable anchorage in your orthodontic treatment.
• They fix your braces firmly in place.
• There will not be any unwanted movement of your braces or other orthodontic appliances.
• No surgery is necessary to correct your teeth misalignment.
• It’s an alternative to headgear.
• TADs have made orthodontic time shorter.
• TADs are effective compared with other conventional anchorage systems.
• They are easy to apply.
• No damage to other teeth while pulling or pushing the other teeth.

Important tips on orthodontics anchorage:

Finally, it is a good idea to follow these tips to have a much more stable anchorage during your orthodontics:

• Do oral hygiene practices regularly.
• Use soft toothbrushes to brush your teeth or clean the area around mini-implants and other anchorage tools.
• Prevent plaque accumulation around the TADs.
• In case of any Orthodontic Anchorage breakage or loss, visit your orthodontist immediately.
• If you develop any sensitivity or irritation around the TADs, report that to your orthodontist.