Factors Predisposing to Maxillary Anchorage Loss: A Retrospective Study of 1403 Cases

Abstract

Anchorage loss is very disturbing for orthodontists and patients during orthodontic treatment, which usually results in bad treatment effects. Despite the same treatment strategy, different patients show different tendencies toward anchorage loss, which influences the treatment results and should preferably be predicted before the treatment is begun. However, relatively little research has been conducted on which patients are more likely to lose anchorage. The mesial tipping of the first molar marks the onset of anchorage loss, and changes in the angulation of the first molar are closely related to anchorage loss. This cross-sectional study aimed to determine how the mesiodistal angulation of the upper first molars changes during general orthodontic treatment and to identify the individual physiologic factors leading to these changes in a large sample of 1403 patients with malocclusion. The data indicate that the upper first molars tend to be tipped mesially during orthodontic treatment, and this constitutes a type of anchorage loss that orthodontists should consider carefully. Compared to treatment-related factors, patients' physiologic characteristics have a greater influence on changes in the angulation of the upper first molars during orthodontic treatment. The more distally tipped the upper first molars are before treatment, the more they will tip mesially during treatment. Mesial tipping of the upper first molars, and therefore, anchorage loss, is more likely to occur in adolescents, males, patients with class II malocclusion and patients who have undergone maxillary premolar extraction. This finding is of clinical significance to orthodontists who wish to prevent iatrogenic anchorage loss by tipping originally distally tipped upper molars forward, and provides a new perspective on anchorage during orthodontic treatment planning.

Delaying Premolar Extraction for Conservation of Anchorage: A Prospective Case Control Study

“…In delayed extraction dental cast distance of point According to the study done by Su et al maxillary first molars have tendency to tip mesially, and if the molars are distally tipped before treatment, the more they will tip mesially during treatment. 18 Moreover, mesial movement of first maxillary molar during orthodontic treatment is seen more commonly in class II malocclusion and in the premolar extraction cases.…”

Does anchorage loss differ with 0.018-inch and 0.022-inch slot bracket systems?

“…1 Anchorage loss is an unfortunate consequence of leveling and aligning, overjet reduction or space closure and is usually greater in the maxillary than mandibular arch. 2 This complicates treatment, and when anchorage preparation is not adequately planned, molar distalization may be required during treatment.…”

“…Treatment-related factors, such as extractions versus non-extraction, site of extraction, high frictional resistance appliances, type of tooth movement (bodily movement or torque), the use of intraoral or extra-oral anchorage devices and the use of heavy and uncontrolled forces can also play a role in increasing anchorage loss. 2,3 Anchorage loss has been investigated with different orthodontic fixed appliance systems. In their retrospective study, Geron et al 3 found that anchorage loss was significantly greater with labial edgewise appliances compared with lingual edgewise appliances.…”

Evaluation of physical stability and drug content of zoledronate bisphosphonate gel

“…In orthodontic treatment, undesirable tooth movement of the anchorage unit and the relapse of moved teeth to their original positions are important problems [1,2]. Various mechanical appliances have been used to reinforce the anchorage in such cases, such as the transpalatal arch, Nance holding arch, temporary anchorage device, and headgear.…”