Implant-enhanced tooth movement: indirect absolute anchorage.

Four case reports demonstrate the effectiveness of indirect anchorage in orthodontics. These cases demonstrate the variety of situations in which absolute anchorage can be applied. A maxillary premolar extraction case illustrates the effectiveness of anterior retraction with this technique. A maxillary posterior protraction case shows the ease with which space closure can be achieved. Dual-arch capability is demonstrated through a four-premolar extraction case. Lastly, a case of severe dental mutilation devoid of any anchor units under conventional methods depicts how effectively distal driving can be accomplished. The technique involves the simple placement of a midpalatal endosseous implant that provides anchorage by indirect means to various teeth by virtue of a transpalatal arch soldered to its abutment. Once stabilized by such means, dramatic movements can be achieved in situations that would otherwise overtax anchor units and result in loss of anchorage. Teeth that would otherwise require stepwise and sequential movements can be mobilized en masse, greatly simplifying mechanotherapy and dramatically shortening treatment time. When no longer needed, the palatal implant is explanted and leaves no permanent deformation or defect after 2 or 3 weeks of healing.