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Introduction
Introduction
Active components Generate forces In one direction Equal and opposite force Newtons third law of motion
Introduction
Desired tooth movement is inevitably asso with an opposing force. Anchorage units Anchorage loss Anchorage management
Definitions
Moyers : Resistance to displacement. Active elements and resistance elements. T.M. Graber : The nature and degree of resistance to displacement offered by an anatomic unit when used for the purpose of effecting tooth movement.
Definitions
Proffit :
Resistance to unwanted tooth movement. Resistance to reaction forces that is provided (usually) by other teeth, or (sometimes) by the palate, head or neck (via extraoral force), or implants in bone.
Definitions
Nanda :
The amount of movement of posterior teeth (molars, premolars) to close the extraction space in order to achieve selected treatment goals.
Reversal of anchorage
Classification
Nanda : 1. A anchorage : critical / severe 75 % or more of the extraction space is needed for anterior retraction . 2. B anchorage : moderate Relatively symmetric space closure (50%) 3. C anchorage : mild / non critical 75% or more of space closure by mesial movement of posterior teeth
Classification
Classification
Burstone Group A: Postr teeth contribute less than one quarter to total space closure Group B: Postr teeth contribute from one quarter to one half to total space closure Group C: Postr teeth contribute more than one half to total space closure
Anchorage value Teeth to be moved Active components Anchorage Extraoral vs intraoral anchorage
Surface area
Major determinant
For a tooth or group of teeth acting as anchorage unit, pressure within the pdl should be kept as low as possible
Heavy forces
Pressure Response Curve for Anchor Teeth (A) and Teeth to be Moved (M)
Second
Proffit Tipping 50-75 g Bodily - 100-150 g Intrusion - 50-75 g Extrusion - 50-75 g Rotation - 50-75 g Uprighting- 75- 125g
Tooth which is free to tip has a less anchorage value than a tooth which is restricted in tipping by the application of a force couple
3rd factor no. of roots and root morphology Multirooted > single rooted Longer rooted > shorter rooted Triangular shaped root > conical or ovoid root Larger surface area > smaller surface area
4th factor neighbouring structures Quality of the alveolar bone Traumatic extraction 2nd molars inclusion
Types of anchorage
Simple Anchorage: Dental anchorage in which the manner and application of force tends to displace or change the axial inclination of the teeth that form the anchorage unit in the plane of space in which the force is being applied.
Types of anchorage
Stationary Anchorage: Dental anchorage in which the manner and application of force tends to displace the anchorage unit bodily in the plane of space in which the force is being applied. Refers to the advantage that can be obtained by pitting bodily movement of one group of teeth against tipping of another
Types of anchorage
Eg: Retraction of mandibular incisors using first molars as anchorage Considerably more than Simple Anchorage
Types of anchorage
Reciprocal Anchorage: Anchorage in which the resistance of one or more dental units is utilized to move one or more opposing dental units Dissipation of equal and opposite forces Diastema closure
Types of anchorage
Types of anchorage
Types of anchorage
Multiple or Reinforced Anchorage: Multiple dental anchorage: Reduces pressure on the anchor units moving them down the slope of the pressure-response curve Tissue - borne anchorage:
Types of anchorage
Cortical Anchorage: Torquing the roots of posterior teeth outward against the cortical plate to inhibit their mesial movement
Types of anchorage
Types of anchorage
Intermaxillary anchorage/ traction Resistance units situated in one jaw are used to effect tooth movement in the other jaw
Class II traction
Bilateral expansion
Bilateral constriction
Symmetrical V- Bend
Required in non-extraction T/t To counter the M-Li rotations produced by space closing forces Before initiating head gear therapy
To decrease the arch perimeter To close any remaining posterior spaces To seat the molar properly for a classII molar finish Mesiolingual Rotations
Step bends
Principle use Forces derived from EOA Stabilize the position of the teeth Produce tooth movement Orthopedic changes
Mild cases Cases with severe crowding and overjet Severe cases additional space is required even after extraction
fig
Directional control Effects of EOF depends on Duration Direction Magnitude 1 ounce 30gms
undesirable
undesirable
Orthopedic effects
Inner bow passive Should not contact any teeth Ant. Segment between the lips Expansion distalization
Mandibular arch Use of class III intermaxillary traction with head gear
Nature of surface at the interface (rough or smooth, chemically reactive or passive, modified by lubricants) Independent of the apparent area of contact
2 other factors can affect the resistance to sliding Interlocking of surface irregularities Extent of plowing In clinical practice friction is largely determined by the shearing component