THE USE OF PALATAL IMPLANTS FOR ORTHODONTIC ANCHORAGE - DESIGN AND CLINICAL-APPLICATION OF THE ORTHOSYSTEM

This paper presents the Orthosystem (Institute Straumann, Waldenburg/S witzerland), a new endosseous orthodontic implant anchor system for pa latal anchorage. The Orthosystem may replace compliance dependent extr aoral anchoring aids for orthodontics and makes a bonding of well alig ned mandibular dentition and it's use with class II elastics unnecessa ry. The fixture is designed for a one-stage application. It consists o f an implant of pure titanium with a surface-treated, screw-shaped end osseous part of 3.3 mm diameter and lengths of 4 and 6 mm. Above the p olished transmucosal neck follows an abutment where transpalatal, arch es made of rigid orthodontic wires (0.032x0.032 inch) are fixed by mea ns 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 front al dentition under maximal anchorage of the lateral teeth. For the imp lantation a simple surgical procedure of 10 min length was required wh ile no further invasive actions an 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 demon strated here, The clinical and radiological findings after 12 months o f treatment comprising 3 months of healing revealed no implant mobilit y or dislocation, favourable periimplant soft tissue conditions, and n o marked mesial movement of the implant supported teeth. The frontal d entition was retracted by 8 mm with space closure occurring in a relat ively short treatment period.