Efficacy of vertical control by using mini-implant anchorage in maxillary posterior buccal area for Angle class Ⅱ extraction patients / 北京大学学报(医学版)

OBJECTIVE@#To investigate the efficacy of vertical control by using conventional mini-implant anchorage in maxillary posterior buccal area for Angle class Ⅱ extraction patients.@*METHODS@#Twenty-eight Angle class Ⅱ patients [9 males, 19 females, and age (22.6±2.8) years] were selected in this study. All of these patients were treated by using straight wire appliance with 4 premolars extraction and 2 mini-implant anchorage in maxillary posterior buccal area. In this study, the self-control method was used to measure and analyze the lateral radiographs taken before and after orthodontic treatment in each case, the main cephalometric analysis items were related to vertical changes. The digitized lateral radiographs were imported into Dolphin Imaging Software (version 11.5: Dolphin Imaging and Management Solutions, Chatsworth, California, USA), and marked points were traced. Each marked point was confirmed by two orthodontists. The same orthodontist performed measurement on the lateral radiographs over a period of time. All measurement items were required to be measured 3 times, and the average value was taken as the final measurement result.@*RESULTS@#Analysis of the cephalometric radiographs showed that, for vertical measurements after treatment, the differences of the following measurements were highly statistically significant (P < 0.001): SN-MP decreased by (1.40±1.45) degrees on average, FMA decreased by (1.58±1.32) degrees on average, the back-to-front height ratio (S-Go/N-Me) decreased by 1.42%±1.43% on average, Y-axis angle decreased by (1.03±0.99) degrees on average, face angle increases by (1.37±1.05) degree on average; The following measurements were statistically significant (P < 0.05): the average depression of the upper molars was (0.68±1.40) mm, and the average depression of the upper anterior teeth was (1.07±1.55) mm. The outcomes indicated that there was a certain degree of upper molar depression after the treatment, which produced a certain degree of counterclockwise rotation of the mandibular plane, resulting in a positive effect on the improvement of the profile.@*CONCLUSION@#The conventional micro-implant anchorage in maxillary posterior buccal area has a certain vertical control ability, and can give rise to a certain counterclockwise rotation of the mandible, which would improve the profile of Angle Class Ⅱ patients.

CBCT study on the safe location of palatal microscrew implant anchorage nail between maxillary first and second molars / 口腔疾病防治

Objective@#Conebeam CT (CBCT) was used to measure the palatine between the maxillary first and second molars. The proximal and distal palatal widths of the maxillary first and second molar and the palatal mucosal thickness and bone tissue thickness when microscrew implant anchorage nail were implanted at different angles provided a reference for the clinical selection of microscrew implant placement.@* Methods@#The image data of 90 adult patients were selected as the research object, and the jaw bone was reconstructed by scanning. In maxillary palatine, selection of distances at 12 mm, 14 mm, 16 mm, and 18 mm from the palatal apex of maxillary first molar between the maxillary first and second molar were used as measurement, measured the proximal and distal palatal widths of maxillary first and second molar and the palatal mucosal thickness and bone tissue thickness when microscrew implant anchorage nails were implanted at 30 °, 45 °, 60 °, and 90 °. SPSS 26.0 software was used for one-way ANOVA and LSD pair comparison. @*Results@#The larger the angle of the microscrew implant anchorage nail was, the smaller the proximal and distal medial widths between the maxillary first and second molar, and the difference was statistically significant (P < 0.05). Compared with the 90° direction, the proximal and distal medial widths of the microscrew implant anchorage nail were larger in the 60° direction. The greater the angle of implantation, the smaller the mucosal thickness and the greater the bone tissue thickness, and the results showed a significant difference (P < 0.001). Compared with the direction of 30° and 45°, the mucosal thickness at the direction of 60° was smaller, and the bone tissue thickness was larger. The higher the position of the microscrew implant anchorage nail, the greater the width of the proximal and distal medial, and the difference was statistically significant (P < 0.05). Compared with the positions 12 and 14 mm from the palatal tip, the proximal and distal medial widths of the microscrew implant anchorage nail were larger. The higher the implant position was, the greater the mucosal thickness and the smaller the bone tissue thickness. The results showed a significant difference (P < 0.001). Compared with the position of 18 mm from the palatal tip of the maxillary first molar, the mucosal thickness was smaller and the bone tissue thickness was larger.@*Conclusion@#It is most appropriate to implant microscrew implant anchorage nail at least 10 mm in length in the direction of 60° at the palatal apex 16 mm from the maxillary first molar in palatine between the first and second molar.

Anclaje esquelético para el tratamiento de las anomalías de clase II y mordida abierta anterior: informe de un caso / Skeletal anchorage for the treatment of class II anomalies and anterior open bite: report of a case

El reporte de este caso tiene como objetivo demostrar la utilidad de los anclajes esqueléticos temporarios como son las miniplacas cigomáticas y los microimplantes "buccal shelf" en el tratamiento ortodóncico, en una paciente de 17 años 10 meses de edad, clase II vertical, dólicofacial, con mordida abierta anterior y aumento de la altura facial inferior. Después de la primera fase de tratamiento, siguiendo la secuencia de arcos para completar la alineación, se utilizaron anclajes esqueléticos extrarradiculares con una mecánica de intrusión con fuerzas elásticas durante 10 meses. Se intruyeron sus piezas posteriores superiores e inferiores y se distalizó la arcada superior, corrigiéndose la oclusión. El mentón retrognático y su perfil convexo mejoraron con la autorrotación de la mandíbula (AU)

The objective of this report case is to demonstrate the usefulness of temporary skeletal anchors such as zygomatic miniplates and buccal shelf microimplants in orthodontic treatment, in a 17-year-old 10-month-old, vertical class II, dollicofacial patient with anterior open bite and increased lower facial height. After the first treatment phase, following the arch sequence to complete the alignment, extra-radicular skeletal anchors were used with intrusion mechanics with elastic forces for 10 months. Its upper and lower posterior pieces were intruded and the upper arch was distalized, correcting the occlusion. e retrognathic chin and its convex profile improved with autorotation of the jaw (AU)

Time efficiency and operator convenience of using a micro-screw in image registration for guided implant surgery / 대한치과보철학회지

PURPOSE: The image registration of radiographic image and digital surface data is essential in the computer-guided implant guide system. The purpose of this study was to examine the effects of using micro-screw on the working time and convenience of operators in the process of image matching for guided implant surgery. MATERIALS AND METHODS: A mandibular dental model was prepared in partial edentulism for Kennedy class I classification. Two micro-screws were placed on the each side of retromolar area. Radiographic and scan images were taken using computed-tomography and digital scanning. The images were superimposed by 12 operators in software in two different conditions: using remaining teeth image alone and using teeth and micro-screws images. Working time, operator convenience and satisfaction were obtained, and analyzed using the Mann-Whitney U test (α=.05). RESULTS: The working time was not statistically different between image registration conditions (P>.05); however, operator convenience and satisfaction were higher in the teeth and micro-screw assisted condition than in the teeth-alone assisted condition (P<.001). CONCLUSION: The use of microscrew for the image registration has no effect in working time reduction, but improves operator convenience and satisfaction.

Stability of the anterior arm of three different Hyrax hybrid expanders: an in vitro study

ABSTRACT Introduction: The force applied to the teeth by fixed orthopaedic expanders has previously been studied, but not the force applied to the orthodontic mini-implant (OMI) used to expand the maxilla with Hyrax hybrid expanders (HHE). Objective: The aim of this article was to evaluate the clinical safety of the components (OMI, abutment and double wire arms) of three different force-transmitting systems (FTS) for conducting orthopaedic maxillary expansion: Jeil Medical & Tiger Dental™, Microdent™ and Ortholox™. Methods: For the realization of this in vitro study of the resistance to mechanical load, three different abutment types (bonded, screwed on, and coupling) and three different OMIs' diameters (Jeil™ 2.5 mm, Microdent™ 1.6 mm and Ortholox™ 2.2 mm) were used. Ten tests for each of these three FTS were carried out in a static lateral load in artificial bone blocks (Sawbones™) by a Galdabini universal testing machine, then comparing its performance. Comparisons of loads, deformations and fractures were carried out by means of radiographs of FTS components in each case. Results: At 1- mm load and within the elastic deformation, FTS values ranged from 67 ± 13 N to 183 ± 48 N. Under great deformations, Jeil & Tiger™ was the one who withstood the greatest loads, with an average 378 ± 22 N; followed by Microdent™, with 201 ± 18 N, and Ortholox™, with 103 ± 10 N. At 3 mm load, the OMIs shaft bends and deforms when the diameter is smaller than 2.5 mm. The abutment fixation is crucial to transmit forces and moments. Conclusions: The present study shows the importance of a rigid design of the different components of HHEs, and also that HHEs would be suitable for maxillary expansion in adolescents and young adults, since its mean expansion forces exceed 120N. Furthermore, early abutment detachment or smaller mini-implants diameter would only be appropriate for children.

RESUMO Introdução: a força aplicada sobre os dentes por expansores ortopédicos fixos já foi estudada antes, mas não a força aplicada sobre os mini-implantes ortodônticos (MIOs) usados para expandir a maxila com expansores do tipo Hyrax híbrido (EHH). Objetivo: o objetivo desse artigo foi avaliar a segurança clínica dos componentes (MIO, abutment de fixação, e braços de fio duplo) de três sistemas de transmissão de força (STF) usados para expansão ortopédica da maxila: Jeil Medical & Tiger Dental™, Microdent ™ e Ortholox ™. Métodos: para realizar esse estudo in vitro sobre a resistência à carga mecânica, foram usadas três tipos de sistema de fixação (colado, aparafusado e coupling) e MIOs de três diâmetros diferentes (Jeil™ 2,5 mm; Microdent™ 1,6 mm e Ortholox™ 2,2 mm), com suas respectivas mecânicas de STF. Foram realizados 10 testes para cada STF, usando uma carga lateral estática em blocos de osso artificial (Sawbones™), com uma máquina universal de testes e, depois, comparou-se, por meio de radiografias, os desempenhos, levando-se em consideração as cargas, deformações e fraturas dos componentes de cada STF. Resultados: com a carga a 1 mm e sem exceder o limite de deformação elástica, os valores dos STFs variaram de 67 ± 13 N a 183 ± 48 N. Sob deformações maiores, o sistema Jeil & Tiger™ foi o que apresentou maior resistência às cargas elevadas, com valor de 378 ± 22 N; seguido pelo Microdent™, com 201 ± 18 N, e Ortholox™, com 103 ± 10 N. Com a carga a 3 mm, o eixo do MIO se dobrou e deformou quando seu diâmetro era menor que 2,5 mm. O abutment de fixação é crucial para a transmissão das forças e momentos. Conclusões: o presente estudo evidenciou a importância da rigidez no design dos diferentes componentes dos STFs dos EHH. Também revelou que eles são adequados para a expansão da maxila em adolescentes e adultos jovens, pois as forças de expansão, em média, excederam os 120N. Além disso, a desconexão precoce do abutment ou o uso de mini-implantes de menor diâmetro no design do STF seriam apropriados apenas em crianças.

CLINICAL APPLICATION OF MICRO -SCREW IMPLANT ANCHORAGE IN TREATMENT OF ANGLE'S CLASS II DIVISION 1 MALOCCLUSION WITH DEEP OVERBURDEN JAWS / 现代医院

Objective To assess theapplication values of self -tapping micro-screw implant anchorage in treatment of Angle's class II division 1 malocclusion with deep overburden jaws , compared with the traditional anchor-age.Micro-screw implantswere inserted in maxillary teeth of patients with Angle's class II division 1 malocclusion with deep overburden jaws tostrengthen anchorage .Changesin position of the maxillary incisor and the first molar were compared.Methods 68 cases of Angle's class II division 1 malocclusion with deep overburden jaws were selected and randomly divided into the research group and the control group .The research group wastreated with a self -tap-ping micro-screw implant as ananchorage .The control group was treated with Nance bow , transpalatal arch or in combination with face bow as strong anchorage .The total treatment time , line spacing and the angle differences be-tween the U1/SN of X-ray cephalometry before and after treatment were compared in two groups .Results ①The-self-tapping micro-screw implant kept stability without looseness .Thesoft tissue surrounding dental implants had no swellings or infections .Patients had no obvious discomfort .②The average periods of treatmentin the research group and the control group treatment were 20 months and 26 months, respectively.③The soft -tissue profilein the re-search group was improved significantly , with 4.26 mm and 4.54 mmof the adductions ofthe upper and lower lips rel-ative to aesthetic plane respectively .The angle of U1/SN was reduced 10.2°.Theadductionsof the upper and lower lipsin the control group relative to aesthetic plane were 2.88 mm and 3.01 mm respectively and there werestatistically significantdifferencesin two groups .There were no remarkableanteroposterior and verticalmovement after correction of maxillary first molars(p>0.05)but the anteroposterior incisor movement in the research group .The movements were statistically significant differences(p<0.01).Conclusion Compared with the traditional anchorage technique , mi-cro-screw implant anchorage can better control teeth movement and shorten the treatment time .

The Clinic Study on the Treatment of Maxillary Protrusion Malocclusion with Micro-Screw Palatal Implant Anchorage / 天津医药

Objective To investigate the clinic application of micro-implant anchorage in the treatment of maxil-lary protrusion malocclusion. Methods Twenty-two patients,aged 18 to 25 years old,with maxillary protrusion were divid-ed into two groups:experimental group and control group with 11 patients in each group. All patients were treated with ex-traction. Micro-screw palatal implant was used in the cases of experimental group as orthodontic anchorage ,and traditional anchorage composed of extraoral arch used in the cases of control. The cephalometric films were measured before and after treatment. Statistical methods were utilized to analyze the morphological changes of facial profile and hard tissues in both groups. Results The values of U1-NA(mm:3.08±1.18 vs 8.15±3.05) and U1-SN(101.90°±3.50° vs 117.90°±6.05°) were sig-nificantly decreased after treatment compared with those before treatment in the experimental group ( P<0.01). The value of U1-L1(123.98°±5.78°vs 103.89°±8.95°) was significantly increased after treatment (P<0.01). In control group, the values of U1-NA (mm:5.01±1.34 vs 9.12±2.13) and U1-SN(101.90°±3.97° vs 114.87°±7.69°)were significantly decreased after treat-ment. The values of U1-L1(126.01°±3.12°vs 112.98°±5.98°) and U6-PtPNS(mm:21.45±2.43 vs 18.36±2.19)were significant-ly increased after treatment (P<0.05). The value of U1-L1(19.48°±8.90° vs 13.01°±5.90°) was significantly changed in exper-imental group than that of control group, but the value of U6-PtPNS(mm:0.90±0.29 vs 3.78±0.12)was significantly changed in control than that of experimental group (P<0.01). Conclusion The maxillary protrusion malocclusion with micro-im-plant anchorage can be used as treatment for patients with maxillary protrusion that needs strong anchorage.

Perforación radicular asociada al uso de microtornillos en el anclaje ortodóncico: reporte de un caso / Root perforation associated with the use of micro-screws in orthodontic anchorage: a case report

Este reporte de caso describe el tratamiento quirúrgico de un primer molar maxilar como solución a la perforación iatrogénica de su raíz mesiovestibular tras la colocación de un microtornillo para el refuerzo del anclaje ortodoncico en un paciente adulto. El objetivo de este caso clínico es dar a conocer una de las posibles complicaciones asociadas a la colocación de microtornillos interradiculares asociados al refuerzo del anclaje en ortodoncia, su diagnóstico y tratamiento.

The aim of this publication is to present one of the possible complications associated with the placement of interradicular miniscrews for the reinforcement of anchorage in orthodontics. This case report describes the surgical treatment of a maxillary first molar as a solution for the iatrogenic perforation of its mesiobuccal root after the placement of a microscrew for the reinforcement of the orthodontic anchorage in an adult patient.

Applicatioin of micro-screw for mandibular incisors intrusion: a clinical and cephalometric study / 中华医学美学美容杂志

Objective To evaluate the effects of micro-screw on the intrusion of lower incisors and the leveling of curve of Spee in the process of orthotherapy.Methods Fifteen patients (5 males,10 females) with deep-bite were selected,aged from 11.3 to 28.8 years,with average of 17.2 years.All of them were Angle Class Ⅱ Classification 1 malocclusion and had a curve of Spee larger than 3 mm.Orthotherapy of extraction was adopted for the first premolars of two upper mandible and second premolars of two lower mandible.All these patients had micro-screws implanted at root apex area between lower lateral incisor and canine bilaterally,and when the 0.457 mm× 0.635 mm (0.018 in ×0.025 in) Ni-Tisquare wire was internalized,the strength of intrusion from micro-screws was used.Lateral cephalometric radiographs were taken before loading the micro-screw and immediately when the curve of Spee was leveled.Two linear and two angular measurements were selected for cephalometric analysis.Results The following results were noted: the lower incisors were significantly intruded for a mean of (4.10±0.98) mm; the mandibular molars were not significantly extruded for a mean of (0.91±0.69) mm; some lower incisors proclined and some lower incisors retroclined for a mean of (-0.09±4.12)°.After bite opening,the mandibular plane angle was minimally altered for a mean of (0.25±0.70)°; the ratio of lower incisor intrusioin to lower molar extrusion was 4.5: 1.0.Conclusions The combined use of micro screw with Ni-Ti wire is capable of enhancing the intrusion of lower incisors and leveling the curve of Spee,and it has minimal side effects on the posterior teeth.

Qualitative and quantitative evaluation of root injury risk potentially burdening insertion of miniscrew implants / 대한치과교정학회지

OBJECTIVE: Microscrew implants (MSIs) offer many advantages, but some complications are known to occur during their insertion. One of the most commonly reported complications is root injury. Our aim was to identify factors associated with root injury and to evaluate their qualitative and quantitative values. METHODS: Thirty-five orthodontists placed MSIs (AbsoAnchor(R), Dentos Co. Ltd, Daegu, Korea) in the upper jaw of typodonts, labially between the second premolar and the first molar, in low and high vertical positions. Root contacts were counted, and distances between MSI apices and roots were measured. Fear level of the orthodontists was surveyed before and after the experiment. Wilcoxon's test, chi-square test, and Mann-Whitney test were used for statistical analysis. RESULTS: Overall root contact rate of MSI insertion was 23.57%. The root contact rate was significantly higher in MSIs inserted at 90degrees (45.71%) than at 30degrees (1.43%). The distance between the dental root and MSI also increased significantly in MSIs inserted at 30degrees. Mean fear level before MSI insertion (4.6) significantly decreased after insertion (3.2); the causative factors were risk of injury to dental root and maxillary sinus or mandibular canal. CONCLUSIONS: Root injury is relatively rare, and oblique angulation reduces the risk of root and MSI contact.

Soft- and hard-tissue changes after extraction space closure with micro-screw implant / 复旦学报（医学版）

Objective To investigate the changes of soft and hard tissues after extraction space closure with micro-screw implant as orthodontic anchorage. Methods Twenty cases were selected randomly with the first premolars extraction. Micro-screw implant was used as orthodontic anchorage. Sliding technique was used to close the extraction space. The lateral cephalograms before and after the treatment were evaluated.Results The upper incisors moved 7. 15 mm palatelly, 1. 63 mm intruded. The upper first molar moved 0. 80 mm distally, 1. 80 mm intruded. The lower incisors moved 4. 65 mm distally, 0.48 mm extruded. The lower first molar moved 0. 18 mm mesially, 1.18 mm extruded. A point, B point, upper lip, lower lip showed distal movement. Conclusions Micro-screw implant can provide acceptable and reliable anchorage in the process of extraction space closure, and improve the profile. Besides, it produces skeletal change on the maxilla.

Effects of microscrew implant anchorage in extraction space closing by one step and retraction of anterior teeth / 实用口腔医学杂志

Objective: To investigate the effects and mechanism of microscrew implant anchorage (MIA) in speeding up the closure of extraction space by one step and retraction of anterior teeth. Methods: Twenty-three patients with teeth extraction and required strong posterior anchorage were treated with MIA to close the extraction space. The extraction spaces were closed by two methods respectively. The extraction spaces were closed by the method of one step and retraction of anterior teeth(Ni-Ti spring from MIA to the hook on the wire combined with the elastic pull from MIA to cuspid) on the experiment sides and by the traditional one step method(Ni-Ti spring from MIA to the hook on the wire alone) on the control sides. Which side treated as trial side or control side was selected at random. The period of the space closing, the way and position of anterior teeth movement were observed on each side and the period of the space closing of two sides were tested by paired t test. Results: ①The average period of the spaces closing which was (6.69±1.07) months on the trial side and (9.56±1.19) months on the control side was significantly different (P<0.05).② After the closure of extraction spaces, the cuspid achived better position on the trial side than the contral side on which cuspid presented distal-lingual rotation. Conclusion: The extraction spaces can be closed in all cases by two methods respectively. Using MIA to close the extraction space by one step and retraction of anterior teeth can not only shorten the period of space closing but also achieve nice outcome by moving the cuspid in spongy bone.

Histologic and biomechanical characteristics of orthodontic self-drilling and self-tapping microscrew implants / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to compare the histological and biomechanical characteristics of self-tapping and self-drilling microscrew implants. METHODS: 112 microscrew implants (56 self-drilling and 56 self-tapping) were placed into the tibia of 28 rabbits. The implants were loaded immediately with no force, light (100 gm), or heavy force (200 gm) with nickel-titanium coil springs. The animals were sacrificed at 3- and 5-weeks after placement and histologic and histomorphometric analysis were performed under a microscope. RESULTS: All microscrew implants stayed firm throughout the experiment. There was no significant difference between self-drilling and self-tapping microscrew implants both in peak insertion and removal torques. Histologic examinations showed there were more defects in the self-tapping than the self-drilling microscrew implants, and newly formed immature bone was increased at the interface in the self-tapping 5-week group. There was proliferation of bone towards the outer surface of the implant and/or toward the marrow space in the self-drilling group. Histologically, self-drilling microscrew implants provided more bone contact initially but the two methods became similar at 5 weeks. CONCLUSION: These results indicate the two methods can be used for microscrew implant placement, but when using self-tapping microscrew implants, it seems better to use light force in the early stages.

Early histological change in hard tissue from orthodontic force placed on microscrews in ovariectomized rats / 대한치과교정학회지

Most elderly women experience a decrease in their bone density due to a deficiency of calcium intake, ovariectomy, or menopause. This study evaluated the usability of the microscrew as a skeletal anchorage system in these orthodontic treatment cases, using rats as a research group. The 4 month old sprague-dawley species rats were divided into two groups, the OS (Ovariectomy Screw), and the SS (Sham operation Screw) group. In both the OS and SS groups, microscrews were implanted into the palatal bone between the upper molar teeth and two upper incisors were retracted using NiTi coil spring with 75 g of force. After 3 days, the again after 7 days, 7 rats in each group were sacrificed. Three days before they were sacrificed, Alizarin red S was intraperitoneally injected, and their maxillary bone, tibia and blood from their hearts were taken. The components of the extracted blood were biochemically analyzed and non-decalcified grinding resin sections for maxillary bone and tibia were made. The sections were examined with a polarization microscope, and fluorescent microscope. Smaller concentrations of Ca and P, the inorganic substances closely related to bone density, were found in the extracted blood of the OS group. Both OS and SS groups showed a possibility of bone remodeling with a high concentration of ALP after 7 days. An increase in bone density on the tension and compression sides of the microscrew and the tension side of the tooth for both OS and SS groups was confirmed with a polarization microscope. However, the bone density of the pressure side of the tooth and apical side was decreased. More deposits of Alizarin red S in the bone after 7 days rather than 3 days seen with a fluorescent microscope suggested the existence of new bone formation.

Clinical study on success rate of microscrew implants for orthodontic anchorage / 대한치과교정학회지

To provide some guideline for microscrew implants, 73 patients that received a total of 180 mini- or microscrew implants were scrutinized. The overall success rate was 93.3% (168 among 180 mini- or microscrew implants) and the mean period of utilization was 15.8 months. Microscrew implants in the UB group (maxillary buccal area) succeeded at a rate of 94.6% (87 among 92), mini- or microscrew implants in the LB group (mandibular buccal area) succeeded 96.6% of the time (56 out of 58), while microscrew implants in the UP group (maxillary palatal area) had a 100% success rate (11 out of 11), and mini- or microscrew implants in the LR group (retromolar area) succeeded in 73.7% of cases (14 among 19). This study might indicate that microscrew implants can be used successfully as orthodontic anchorage in daily orthodontic practice.

The skeletal cortical anchorage using titanium microscrew implants / 대한치과교정학회지

Anchorage plays an important role in orthodontic treatment. Endosseous implants may be considered adequate firm anchorage. However, chinicians have hesitated to use endosseous implants as orthodontic anchorage because of limited implantation space, high cost, and long waiting period before osseointegration occurs. Recently, some clinicains have tried to use titanium miniscrews and microscrews in treatment due to their many advantages such as ease of insertion and removal, low cost, immediate loading, and the ability to place microscrews in any area of alveolar bone. The author treated a case with skeletal cortical anchorage using titanium microscrew implants. During six months of orthodontic force application from skeletal cortical anchorage, the author could get 4mm bodily retraction and intrusion of upper anterior teeth. The most outstanding result was a 1.5mm posterior retraction of the upper posterior teeth. The titanium microscrew implants and remained firm and stabel throughout treatment. These results indicate that skeletal cortical anchorage might be a very good option.