Orthodontists have long searched for the perfect anchorage to minimize undesired tooth movements. Headgear, elastics, adjacent teeth, and many applianceshave been suggested as anchorage; however, the maindrawback was that most relied on patient compliance to be successful.2What if the bone itself could be used as the anchorage unit? Skeletal anchorage, as this concept is called, evolved from 2 lines. One category originated as osseointegrated dental implants, which have a solidscientific base of clinical, biomechanical, and histologic studies3. Included in this category are the retromolar implants described by Roberts et al4 and palatal implants introduced by Wehrbein and Merz.5Both are used for indirect anchorage, meaning that they are connected to teeth that serve as the anchorage units.When the anchorage is enhanced by using forces thatoriginate from the actual implant, it is called direct anchorage.

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