The outcome of orthodontic treatment is often compromised by the loss of anchorage. Yet surprisingly, forces acting on the anchorage unit that bring about the loss have received very little interest. This paper discusses the biologic background for anchorage control; specifically, the impact of the orthodontic force systems and of occlusal forces on the cellular responses of periodontal tissues supporting the anchorage teeth. Also discussed is the influence of various anchorage devices on the interaction between vertical and sagittal directions of dentofacial development. The importance of taking the vertical forces into consideration is stressed. A rational approach to orthodontic anchorage is suggested. We advocate the use of intra-oral and extra-dental devices when possible, as well as rigid appliances that stimulate the patient's sensation of occlusion. Clinical cases are presented to demonstrate the clinical application of this new approach.
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Melsen et al. (2000) studied this question.