Implant Anchorage in Orthodontic Practice: The Straumann Orthosystem

Conventional means of achieving orthodontic anchorage have a number of shortcomings. To some extent, these shortcomings can be overcome through the use of orthodontic anchorage. The Straumann Orthosystem implant system offers a method for achieving absolute anchorage. Surgical placement of these implants involves the potential for violating certain contiguous structures such as the floor of the nasal cavity. Knowledge of the anatomy of the area and careful planning are essential to avoid postoperative morbidity. The use of a preoperative lateral cephalometric radiograph is recommended, although other imaging modalities may offer advantages over this modality and may someday supplant it. Care must be taken during osteotomy preparation and insertion of the implant to avoid introducing mechanical instability. It may be wise to use the 4-mm implant (in lieu of the 6-mm version) whenever possible. Placement of the implants should, in most cases, be limited to the region contiguous with a line bisecting the contralateral first premolars. Although the influence of ossification of the suture on implant integration is not established definitely, it may be prudent to place the implant slightly lateral to the suture (especially in younger individuals). The clinical experience of the Divisions of Periodontology and Orthodontics at the University of Kentucky suggests that these implants may be a valuable adjunct to conventional orthodontic tooth movement. Care in planning and execution has resulted in a high degree of success with minimal morbidity.