Osseointegrated Implant Anchorage in a Growing Adolescent

Temporary osseointegrated implants provide rigid orthodontic anchorage but may present problems in growing patients. The present case report of an adolescent male illustrates the successful use of a retromolar implant for anchorage to manage an asymmetric malocclusion. Following extraction of an ankylosed mandibular (Md) 1st molar and opposing maxillary (Mx) 1st molar, a retromolar implant was used for mesially translation of Md and Mx 2nd and 3rd molars to achieve a symmetrical Class I occlusion. Conclusions are: (1) the mandible is usually the critical arch for anchorage control relative to partially edentulous, acquired malocclusions, (2) indirect anchorage via retromolar implants is a reliable and versatile means for controlling the anterior limit of the dentition, (3) the anchorage wire extending from a retromolar implant in a growing patient should be positioned immediately beneath the brackets in the buccal segments, and (4) developing Md 3rd molars can be conserved by positioning the retromolar implant buccal and distal to the 3rd molar crypt.