Indication and Success Rates of Skeletal Anchorage System in Orthodontics

Abstract

Skeletal anchorage systems, a pivotal innovation in orthodontics, involve the use of Temporary Anchorage Devices (TADs) or mini-implants, providing stable anchor points in the bone to facilitate precise tooth movements. This comprehensive review article aims to investigate the indications and success rates of skeletal anchorage systems in orthodontics. The research, initiated on November 2nd, 2023, involved an extensive examination of existing literature, utilizing databases like PubMed, Web of Science, and Cochrane. Various components, including mini-screws, mini plates, palatal, buccal shelf implants, and infrazygomatic implants, have enriched orthodontic diversity. Mini screws have displayed remarkable success rates, with most complications related to manageable soft tissue inflammation. Gingival health and smoking habits have been identified as influential factors in mini screw implant success. Mini plates offer sturdy anchorage with resistance to root damage and fracture, surpassing mini screws in overall success rate. Age, implantation site viability, and soft tissue characteristics influence their success. Palatal and buccal shelf implants provide exceptional stability, enhancing the results of fixed bracket appliances. The anterior palatal region is a preferred site for implantation. Infrazygomatic implants, while offering commendable stability, display failure rates within the range of 21-28%, with compromised oral hygiene, immediate loading, inflammation, tooth mobility, and a high mandibular plane angle as potential failure factor. These anchorage methods have expanded treatment possibilities, offering effective solutions for challenging orthodontic cases and ultimately improving patient outcomes.