Orthodontic anchorage : evidence-based evaluation of anchorage capacity and patients' perceptions

Orthodontic anchorage is the ability to resist unwanted reciprocal forces and reinforcement of anchorage by supplementary appliances, in or outside the mouth, is often needed to obtain successful results. In the last 10 years, interest in appliances that use implants has been growing. Successful orthodontic treatment demands effective methods and systematic evaluation of different treatment approaches is therefore essential. Several studies on the efficiency of various anchorage systems have been published, but a critical appraisal or interpretation of evidence that systematically considers validity, results, and relevance has not been made. Analysis of treatment modalities must also include patients’ perceptions and potential side-effects. The overall aim of this thesis was to evaluate a new anchorage technique that incorporates osseointegration and compare it with conventional methods concerning effects on tooth movements in adolescents and their acceptance and experience of the additional surgical procedures that osseointegration involves. The following anchorage systems were analyzed: Onplant system, Orthosystem implant, headgear and transpalatal bar. This thesis was based on four studies: Paper I systematically reviewed the efficiency of orthodontic anchorage systems and interpreted the methodological quality of the selected studies from an evidence-based perspective. The literature search spanned January 1966 – December 2004 and was later extended to July 2007