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This paper presents the Orthosystem (Institute Straumann, Waldenburg/ Switzerland), a new endosseous orthodontic implant anchor system for palatal anchorage. The Orthosystem may replace compliance dependent extraoral anchoring aids for orthodontics and makes a bonding of well aligned mandibular dentition and it's use with class II elastics unnecessary. The fixture is designed for a one-stage application. It consists of an implant of pure titanium with a surface-treated, screw-shaped endosseous part of 3.3 mm diameter and lengths of 4 and 6 mm. Above the polished transmucosal neck follows as abutment where transpalatal arches made of rigid orthodontic wires (0.032 x 0.032 inch) are fixed by means of a clamp-cap. 6 patients with an angle class II malocclusion were implanted with the 6 mm fixture in the proximal midsagittal region of the palate during a pilot study. The treatment goal was extraction of the first maxillary premolars with subsequent retraction of the frontal dentition under maximal anchorage of the lateral teeth. For the implantation a simple surgical procedure of 10 min length was required while no further invasive action are needed until explantation. This way the strain on the patients was reduced to a minimum. They are now at varying stages of active treatment and the most advanced case is demonstrated here. The clinical and radiological findings after 12 months of treatment comprising 3 months of healing revealed no implant mobility or dislocation, favourable periimplant soft tissue conditions, and no marked mesial movement of the implant supported teeth. The frontal dentition was retracted by 8 mm with space closure occurring in a relatively short treatment period.

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In young adults fixed functional appliances are a treatment alternative to extraction therapy but to a lesser extent to orthognathic surgery. Because of their limited skeletal effects and minor changes in the profile they are indicated only in patients with a moderately severe Class II malocclusion. Pre-treatment proclined mandibular incisors limit the scope of indications for fixed functional appliances, as they can cause an increase in lower incisor proclination. Significant reductions in profile convexity are achievable only by combined orthodontic and surgical treatment of the malocclusion. When performing camouflage orthodontics in conjunction with maxillary premolar extractions in adults, an increase in the nasolabial angle, which is often esthetically undesirable, has to be discussed as a potential side effect and has to be taken into account when considering the different therapeutic approaches.