Orthodontics

Skeletal Anchorage in Orthodontics

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Skeletal Anchorage Indications
in Orthodontics Orthodontic tooth-moving procedures where
maximum stability is required
Introduction Patients in their permanent dentition
Patients where dental fixation is not possible
Anchorage control has always been a difficult and unpre-
(tooth or alveolar loss, trauma)
dictable challenge for orthodontists. Unlike tooth borne
appliances, which rely on patient compliance to achieve
tooth movement, (bone borne) implants provide true
stationary anchorage, allowing treatment to proceed more
rapidly with highly predictable results. Contra-indications
Patients without sufficient bone condition
Cases of abnormal mastication pattern or poor
oral hygiene
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1 Mixed dentition

25-301-02 1 25-301-05 1

In comparison to a single point anchorage with cylindrical

implants the micro-plate fixation with our new C-tube The C-Tube Plate
design offers additional benefits:
In cases of dental regulations a C-tube (Chung's
Immediate force loading microplate with tube) can be fixed in the lateral part
of the maxilla or mandible. The eyelet will remain
Easy fixation with Drill-Free or self tapping
in the buccal sulcus and serves to hold the dental
screws
arch wire.
Maximum retention force
Microplates are easy to adapt
Minimum irritation to the oral tissues

At the same time C-tube anchorage provides

Reduced risk of tooth damaging (root resorption,

tooth loosening, tooth tilting)
Precise control of desired tooth movement
Normal dental hygiene can be maintained
Minimized side effects
The use of titanium micro plates in implant quality
(TiAl6V4) provides perfect bio-compability and at the same
time ideal resistance with respect to bending or adaptation.

The principle of C-tube fixation in the lateral maxilla

Developed in cooperation with
Prof. Dr. Kyu Rhim Chung
Kyung-Hee University Hospital
Seoul, South-Korea

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Case 1
15- year old boy is presenting Class II Division 1 Severe teeth crowding in both upper and
malocclusion with permanent dentition. lower jaw and protrusion of the upper lip.
Maxillary first bicuspids extracted.

Pre-treatment intraoral view and lateral cephalogram

Dental situation of the maxilla The side view shows clear protrusion of the Patients lateral cephalogram
maxilla.

Intra-Operative approach

Small lateral incision with buccal mucosal The C-tube plate has been adapted and After suturing the eyelet remains in the
flap and periosteal elevation in order to is fixed with 2 Drill-Free screws 1.5 x 5 vestibulum.
place the C-tube plate or 7 mm between the 2 nd premolar and
the 1st molar.

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Initial stage of treatment

The eyelet serves as an anchorage point Occlusal view of the maxilla The C-tube plate fixed between the roots
for the dental arch wire. Elastic rubber with two miniscrews
applied to the cuspid for distal retraction.

3 months post operative

Side view Leveling of maxillary teeth is completed. Frontal view

8 months post operative

Side view Retraction of maxillary anterior teeth is Frontal view

started by Ni-Ti spring.

4
12 months post operative

Final result after 1 year The dental arch is completely formed Frontal view

Post-treatment intraoral view and lateral cephalogram

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The C-palatal plate:
The C-palatal plate is recommended in more severe
cases, where the orthognathic situation has to be
corrected and palatal traction is needed.
The palatal plate is designed to compensate more
complex and multidirectional traction forces.

The basic principle of C-palatal plate fixation: The dotted lines indicate the submucosal position of
The plate is fixed to the hard palate with three the C-palatal plate. Springs are attached to the
or two Drill-Free screws. exposed (red) part of the plate.

Post-operative situation Post-anterior retraction situation

Advantages of the C-palatal plate Indications

The surgical intervention is quick and simple
(Easy and fast surgical intervention)
Immediate force loading after surgery is possible
Simultaneous application of various force vectors
Good resistance against shear forces
Dentoalveolar disproportion
protrusion problem
Correction of teeth in the maxilla only
Malocclusion Class II and Class III

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Set Recommendation

Plates C-tube plate 25-301-02 1

1
1

Palatal plate 25-301-05 1

1
1

Screws Cross Drive Drill-Free 25-678-05 1.5 x 5 mm

25-678-07 1.5 x 7 mm
10
1

Screwdriver Handle 25-402-99

1
3
Screwdriver blade 25-483-97

Additionally: 2 Bending Pliers 25-412-12

(optionally) 1
4

Lindorf plateholding 25-435-15

1
instrument 4

Rose burr 51-535-66

1
Angled Screwdriver 50-900-00 4
with drill bit 50-920-07
with blade 50-915-15

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International Partners
in Oral, Plastic, and KLS
Craniomaxillofacial Surgery
10.03 . 90-125-02 . Printed in Germany Gebrder Martin GmbH & Co. KG Sales Organisation North America and Canada
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