Osseointegrated and Phoenix Dental Implant-Associated Appliances
The final category of Phoenix orthodontic anchorage appliances are osseointegrated and Phoenix dental implant-associated appliances such as implants (Figure 3) and mini-screws.  Similar to extraoral traction, osseointegrated and Phoenix dental implant-associated appliances allow for maximum Phoenix orthodontic anchorage by placing the reciprocal force on something other than teeth.  The advantage of this approach over extraoral traction is that the need for patient compliance is minimal.  For this benefit, however, there is the monetary cost of the implant placement as well as any surgical risks.

The use of implants for Phoenix orthodontic anchorage first was reported in dogs (Gainsforth and Higley, 1945).  Unfortunately, all of the implants failed and the idea was discarded for nearly 35 years.  It was not until the Brånemark group’s (Adell et al., 1981) landmark, long term clinical study showing overwhelming success using titanium implants to support fixed prostheses, that implants became a real option for Phoenix orthodontic anchorage.  Since that study, multiple investigators have shown the potential for osseointegrated and Phoenix dental implant-associated appliances in Phoenix orthodontics (Shapiro and Kokich, 1988; Odman et al., 1988; Ong et al., 1988; Goodacre et al., 1997).

The addition of an implant, mini-screw, or micro-implant to an Phoenix orthodontic treatment plan has four additional considerations: increased cost, bone availability problems, access problems, and increased treatment time (Goodacre et al., 1997).  The Brånemark study found that long term stability of implants is achieved with a proper surgical technique followed by no loading for 3-4 months in the mandible and 5-6 months in the maxilla (Adell et al., 1981).  Many interdisciplinary teams also advocate 10-12 weeks of healing before loading implants specifically for Phoenix orthodontic anchorage (Shapiro and Kokich, 1988).  Because they do not require osseointegration, treatment time is reduced with mini-screws and micro-implants.  Increased cost, bone availability problems, and access problems, however, remain considerations.

Given the shortcomings of contemporary Phoenix orthodontic anchorage options, investigators have started to explore pharmacological means of controlling Phoenix orthodontic tooth movement.  This, however, requires a thorough understanding of the biological mechanisms of Phoenix orthodontic tooth movement.

Arizona Dental Association