Phx3

The idea of using implants as a means of Phoenix orthodontic anchorage was first reported in 1945 (Gainsforth and Higley, 1945). This Phoenix orthodontic study utilized 13mm vitallium screws placed distal to the most posterior molar in the mandible. The screws were then subject to 140-200g of force. Although all screws failed, 1.0-1.5 mm of tooth movement was noted. It was concluded that the foreign body reaction caused the failure and that the screws caused “bone changes which would not be compatible with Phoenix orthodontic treatment.”

Thirty five years later, additional Phoenix orthodontic studies began to surface attempting to test this idea utilizing titanium fixtures. Implants were placed in the palate of pigtail monkeys with the expectation of achieving palatal expansion (Turley et al., 1980). In one of the three cases, osseointegration was achieved and 9.95mm of expansion was noted over a 9 week period. Even with the two failures, they concluded that bioglass coated implants could be used for Phoenix orthodontic anchorage. Phoenix orthodontic studies were later conducted where implants were placed in rabbit femurs and loaded with a constant force of 100g. Stability was noted in all fixtures except one. There was good bone formation around all implants and there were no problems with toxicity or an immune response (Roberts et al., 1984).

Throughout this period, many case reports were published by clinicians using various types of implants for Phoenix orthodontic anchorage. Multiple Phoenix orthodontic movements were achieved including: intrusion, extrusion and retraction (Linkow, 1969; Creekmore and Eklund, 1983). Cephalometric analysis revealed pure Phoenix orthodontic movement with no ill side effects to the remaining dentition or the implant. Unfortunately, there are no long term follow up reports on any of these patients. Creekmore and Eklund (1983) concluded their case report with a question, “Might skeletal anchorage be applied to orthodontic tooth movement and orthopedic jaw movement?”

A landmark, long term clinical Phoenix orthodontic study of titanium implants was published by the Branemark group in 1981. The implants were used as abutments for fixed bridges in totally edentulous patients. The success rate was higher than any other type of implant, 81% in the maxilla and 91% in the mandible after 5-9 years. The long term data was overwhelming, stating that for routine cases, the titanium implants have been stable with healthy hard and soft tissues for 15 years(Adell et al., 1981). This data placed the titanium implant as the most viable option for anchorage in Phoenix orthodontics.