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
Birte Melsen a pioneer used 2mm dia screws and called them mini, Korea -Park started using 1.2 mm dia screws and called them microimplants.
By the time Americans wake up they found it hard not to invent a new term of their own, TAD, but we know how misplaced it is, head gears, palatal arches etc etc
are all TAD, so this term should be discarded and Microimplant should be universally accepted gracefully by all. 1.2 dia implant is what is truely revolutionied and
made it easy for each one of us to use it on daily basis.
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:
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.
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.
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
dogs. Two decades later, Linkow
endosseous blade implant for orthodontic anchorage,
but did not
report on the long-term stability. Roberts used conventional,
titanium implants in the retromolar region, to help
anchorage whilst successfully closing first molar
in the mandible.
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
anchorage led Melsen to develop the Aarhus implant screw. Screw length being 6
mm it could be loaded
with Sentalloy springs (25-50 gms) and was suitable for placement in many
locations. A useful write-up is also available on the link
Devices - (TAD).
To see actual
and to download instruction file in pdf format
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
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
Some useful links to various manufactures websites: Finally Americans wake up and have tied up
with various companies to market MIA in USA, as you can see in the links below
Read a comprehensive Review on Published Articles on MIA
Download all 14 manuals for microimplant placement by various manufactures ( quite educative )
Pdf manual of Dual top of Korea
TITAN from Forestadent
Adin Implant Systems, Israel
Infinitas from Classone ortho
Dentos Korea the Masters
Orlus mini from Ortholution
Aarhus mini implant being sold by American ortho and Medicon
Dentaurum MIA, Tomas
Imtec Mini implant is with 3M UNITEK
Ancor pro from Orthoorganizers
Vector from Ormco
Cimplant from Korea
Mini implants from Leone of Italy
Lomas from Mondeal
Gainsforth BL, Higley LB. A study of orthodontic anchorage
possibilities in basal bone. Am J Orthod Oral Surg 1945; 31:
Linkow LI. The endosseous blade implant and its use in
orthodontics. Int J Orthod 1969; 18: 149–154
Roberts WE Marshall KJ, Mozsary PG. Rigid endosseous implant utilized as
anchorage to protract molars and close an atrophic extraction site. Angle
Orthod 1989; 60: 135–151.
Melsen B, Verna C. A rational approach to orthodontic anchorage. Progress
in Orthodontics 1999; 1: 10–22