0

Anchoraco Conho

Gvkpwziom q{ zm{q{tivkm ioiqv{t °vlm{qzml twwtp uw§m1 (Fqo 915)2 Zpm t—xm wn uw§mumvt (qm0 tqxxqvo wz zwwt
umvt2 Ov uwlmzv wztpwlwvtqk{0 ivkpwziom lw{{ kiv bm i uw§mumvt)0 pw•m§mz0 lmnqvm{ tpm zmil kixikqt— wn tpm
{qovqnqkivt kwuxlqkitqwv l°zqvo tzmitumvt2 Zpmzmnwzm0 ivkpwziom wn i twwtp2 [vlmz tpm mnnmkt wn zwwt uw§m1
ivkpwziom kwvtzwl q{ iv quxwztivt q{{°m tpit vmml{ tw bm umvt0 tpm ivkpwziom §il°m wn i {qvolm1zwwtml twwtp (qm0
illzm{{ml zqopt nzwu tpm lm§mlqvo {tiom2 uixqlliz— kivqvm) kiv w§mzkwum tpit wn i uixqlliz—
[vkwvtzwllml tqxxqvo q{ tpm mi{qm{t twwtp uw§mumvt uwliz (qm0 tpm zw•bwit mnnmktA {mm kpixtmz 7)2 Ilqvqkill—0
tw ikkwuxlq{p •qtp wztpwlwvtqk ixxlqivkm{0 •pmzmi{ i{ niz i{ ivkpwziom q{ kwvkmzvml0 wvm {pw°ll vwt n°ll—
zwwt uw§mumvt q{ tpm uw{t lqnnqk°lt ivl kwuxlqkitml2 zml— wv tpm v°ubmz wn tmmtp ivl zwwt{0 b°t wv tpm nwzkm
Zpm kwvkmxt wn ivkpwziom xzmxizitqwv pi{ bmmv °{ml {—{tmu iktqvo wv tpmu2
nwz {m§mzil —miz{ qv tpm Z•mml tmkpvqq°m tw zmqvnwzkm iv1
kpwziom tpzw°op ivkpwziom bmvl{ bmnwzm ivtmzqwz zm1 The Nance appliance
tziktqwv2 Ov tpw{m ki{m{ •pmzmqv ivkpwziom bmvl{ izm
vwt {°nnqkqmvt0 tpm ivkpwziom tmmtp u°{t bm iktq§ml— zm1 Zpm Tivkm ixxlqivkm q{ iv i°xqlqiz— izkp °{ml qv kwv1
qvnwzkml •qtp i°xqlqizqm{2 Zpq{ ivkpwziom zmqvnwzkmumvt r°vktqwv •qtp nqxml ixxlqivkm{ qv uwlmzitm ivkpwziom
kiv bm ikpqm§ml qv {m§mzil •i—{2 ki{m{2 Zpm Tivkm ixxlqivkm pi{ iv ikz—lqk b°ttwv xlikml
ivtmzqwzl— it tpm lmmxm{t xwqvt wn tpm xilitm2 Zpm t•w
mvl{ wn tpm izkp izm mqtpmz {wllmzml tw tpm xilitil i{1
Intraoral Methods xmkt{ wn tpm uixqlliz— uwliz bivl{ wz izm qv{mztml qvtw
tpm xilitil t°bm{2 Zpm {pixm ivl lmxtp wn tpm xilitm
Increasing the number of teeth xli—{ iv quxwztivt zwlm qv tpm zmtmvtqwv wn tpm Tivkm
ixxlqivkm2 On tpm xilitm q{ {pillw• ivtmzqwzl—0 tpm ikz—lqk
Zpm {quxlm{t ivl uw{t xziktqkil •i— wn zmqvnwzkqvo iv1 b°ttwv ui— {lqlm wv tpm xilitil u°kw{i0 {w vizzw•mz
kpwziom q{ tw qvkzmi{m tpm v°ubmz wn tmmtp b— bqvlqvo ivl lmmxmz xilitm{ izm uwzm {°qtiblm nwz tpq{ t—xm wn
tpmu twomtpmz •qtp i nqo°zm1mqopt lqoit°zm2 Zpm v°ubmz zmtmvtqwv2 Zpm ikz—lqk b°ttwv {pw°ll bm xzmxizml •qlm
wn zwwt{ ivl tpm zwwt {°znikm izmi{ innmkt tpm ivkpwziom mvw°op tw kw§mz tpm ivtmzqwz xizt wn tpm xilitm2 G {uill
kixikqt— wn i twwtp2 Zpmwzmtqkill—0 i tpzmm1zwwtml twwtp b°ttwv •qll vwt xzw§qlm mvw°op ivkpwziom {°xxwzt ivl
pi{ uwzm ivkpwziom §il°m tpiv i {qvolm1zwwtml twwtp+ ui— x°vkt°zm tpm xilitil u°kw{i2

87
 9 I Anchorage Control

Fig 5-1 Anchorage values of various teeth.' (Redrawn from Proffit' Fig 5-2 Uprighting springs increase the resistance of premolars
with permission.) against mesially directed forces during molar distalization, and a clock-
wise moment by the uprighting spring creates distal crown movement
of the first premolar.

K§mv tpw°op tpm u°kw{i qv kwvtikt •qtp tpm ikz—lqk tw tpm uwliz2 Zpm umkpivqk{ wn tpq{ ixxlqivkm izm mx1
b°ttwv q{ zm{q{tivt ivl kw§mzml •qtp i tpqks smzitqv xliqvml qv lmtiql qv kpixtmz 82
li—mz0 qt uqopt vwt zm{q{t pqop0 kwvtqv°w°{ nwzkm{2 Ot pi{
bmmv {pw•v tpit kpzwvqk qvnliuuitqwv pi{ lm§mlwxml Cortical bone anchorage
wv tpm u°kw{i °vlmz tpm ikz—lqk b°ttwv l°m tw pmit ivl
liks wn p—oqmvm2+ Zpm nwzkm0 tpmzmnwzm0 {pw°ll bm wxtq1 Zpm xzqvkqxlm wn tpm kwztqkil bwvm umtpwl q{ bi{ml wv
uil0 ivl tpm Tivkm ixxlqivkm {pw°ll bm zmuw§ml i{ tpm bqwlwoqk lqnnmzmvkm{ bmt•mmv kwztqkil ivl tzibmk°1
{wwv i{ qt q{ vw lwvomz vmmlml nwz ivkpwziom2 liz bwvm2 Zmmtp uw§m uwzm mi{ql— qv tzibmk°liz bwvm
tpiv qv kwztqkil bwvm2 On tpm zwwt{ wn tpm ivkpwziom tmmtp
Uprighting springs izm qv kwztqkil bwvm0 tpmqz zm{q{tivkm tw uw§mumvt q{
qvkzmi{ml2 Xqksmtt{+ pi{ {°oom{tml x°ttqvo iktq§m lqvo°il
[xzqoptqvo {xzqvo{ izm °{ml tw zmqvnwzkm tpm zm{q{tivkm zwwt twzq°m wv uivlqb°liz kivqvm{ tw xlikm tpmu qv tzi1
wn tpm nqz{t xzmuwliz{0 •pqkp {mz§m i{ ivkpwziom qv bmk°liz bwvm bmnwzm lq{tilqzitqwv tw uism uw§mumvt
uwliz lq{tilqzitqwv •qtp i kwubqvitqwv wn {°xmzmli{tqk {uwwtpmz2
vqksml1tqtivq°u (TqZq) kwql {xzqvo{ ivl tpm Tivkm ixxlq1 Gktq§m b°kkil zwwt twzq°m kiv bm xlikml qv uwliz{ tw
ivkm2 _pmv tpm{m {xzqvo{ izm iktq§itml intmz bmqvo xlikml qvkzmi{m tpmqz ivkpwziom ioiqv{t um{qill— lqzmktml nwzkm{2
qv tpm §mztqkil {lwt{ wn tpm xzmuwliz bziksmt{0 tpm— ixxl— G tziv{xilitil izkp kiv bm °{ml nwz tpq{ x°zxw{m2 Hwtp
um{qil zwwt twzq°m0 kzmitqvo zm{q{tivkm ioiqv{t um{qill— mvl{ wn tpm izkp {pw°ll bm qv{mztml it mq°il ivolm{ qvtw
lqzmktml nwzkm{ b— tpm kwql {xzqvo{ (Fqo 916)2 tpm uwliz t°bm{ tw wbtiqv mq°il ivl wxxw{qtm uwumvt{
ivl i§wql §mztqkil bilivkqvo nwzkm{ (Fqo 917)2
Sliding jig
Transpalatal arch
G {lqlqvo rqo0 °{ml qv kwubqvitqwv •qtp qvtziuixqlliz—
ivl qvtmzuixqlliz— mli{tqk{0 kiv bm ikkmxtml i{ iv iv1 Zziv{xilitil izkpm{ zmqvnwzkm xw{tmzqwz ivkpwziom b— qv1
kpwziom zmqvnwzkmumvt i°xqlqiz—2 Iwv{q{tqvo wn i 42;1uu kwzxwzitqvo uixqlliz— zqopt ivl lmnt uwliz{ ({mm kpixtmz
•qzm •qtp i pwws0 tpm {lqlqvo rqo {lqlm{ ilwvo tpm uiqv 8)2 Xwwt4 {titml tpit qv i ki{m qv§wl§qvo i tziv{xilitil
izkp•qzm ivl tziv{uqt{ tpm Ili{{ OO mli{tqk nwzkm lqzmktl— izkp0 tpm ivkpwziom §il°m vmmlml tw kwzzmkt i uilwk1

84
 Ovtziwzil Smtpwl{

Fig 5 3 Cortical bone anchorage prevents the molars from moving mesially. A transpalatal arch moves the roots by reciprocal anchorage. (a) Ob-
-

taining equal and opposite moments is important to avoid vertical balancing forces. (b) Unequal moments may cause an imbalance in the occlusion.

Fig 5 4 The lip bumper reinforces anchorage of the mandibular mo-

-

lars using mentalis muscle force.

kl°{qwv qv tpm uivlqblm lmkzmi{m{ b— 5 uu qv ixxzwx1 qv tpm tziv{qtqwvil lmvtqtqwv2 Xmtziktqwv wn tpm umvtilq{
quitml— 5 —miz2 Sw—{il5 kliqu{ tpit tpm tziv{xilitil izkp ivl b°kkqvitwz u°{klm{ ki°{m{ iv mxxiv{qwv wn tpm
kiv bm iv iltmzvitq§m tw pmilomiz m§mv qv ki{m{ vmmlqvo uivlqb°liz izkp it tpm xzmuwliz ivl uwliz izmi ivl
{tzwvo ivkpwziom2 Nw•m§mz0 tpm tziv{xilitil izkp kiv1 xzwtz°{qwv wn tpm qvkq{wz{ b— tpm twvo°m nwzkm{2 Kxxiv1
vwt zm{q{t ivtmzwxw{tmzqwz nwzkm{ i{ mnnmktq§ml— i{ pmil1 {qwv wn tpm uwliz{ kiv il{w bm wbtiqvml b— •qlmvqvo tpm
omiz0 b°t qt kiv bm °{ml qv uwlmzitm ivkpwziom ki{m{2 izu{ wn tpm izkp2 Hmki°{m tpm nwzkm q{ ixxlqml lqzmktl—
wvtw tpm uivlqb°liz uwliz{0 qt pmlx{ zmqvnwzkm uwliz
Lip bumper ivkpwziom ivl m§mv pmlx{ °xzqopt tpmu (Fqo 918)2 G{
tpm ivtmzwxw{tmzqwz ivl tziv{§mz{m {qzm{ wn tpm uivlqb°1
Zpm lqx b°uxmz q{ °{ml tw zmqvnwzkm ivkpwziom wn liz izkp izm qvkzmi{ml0 uqll kzw•lqvo qv tpm qvkq{wz izmi
uivlqb°liz uwliz{ b— tisqvo {°xxwzt nzwu umvtilq{ kiv bm kwzzmktml {xwvtivmw°{l—26+7 Sqzm ivl {tibqlqt— wn
u°{klm iktq§qt—2 Ov nikt0 qt q{ i u—wn°vktqwvil ixxlqivkm izkp nwzu wbtiqvml •qtp tpm lqx b°uxmz kiv bm uiqv1
°{ml tw mlquqvitm tpm kwuxzm{{qvo mnnmkt wn tpm umvtilq{ tiqvml •qtp i lqvo°il izkp °vtql mz°xtqwv wn tpm xmzui1
u°{klm nwzkm{ wv tpm uivlqb°liz lmvtil izkp0 m{xmkqill— vmvt lmvtqtqwv2

89
 9 I Anchorage Control

I Extraoral Appliances °{ml bmki°{m tpm lqzmktqwv wn x°ll q{ biks•izl ivl

lw•v•izl2 Zpm §mztqkil kwuxwvmvt wn tpq{ nwzkm §mktwz
Kxtziwzil ixxlqivkm{ pi§m bmmv tpm {tzwvom{t ivl uw{t x°ll{ tpm uwliz{ lw•v0 ki°{qvo klwks•q{m zwtitqwv wn tpm
zmlqiblm ivkpwziom zmqvnwzkmumvt umtpwl nwz {m§mzil uivlqblm2 Zpq{ lmil{ tw bqtm wxmvqvo08 •pqkp q{ lm{qz1
—miz{2 Gxxzwxquitml— 744 tw 794 o q{ {°nnqkqmvt nwzkm tw iblm qv lw•1ivolm xitqmvt{2 Ov xitqmvt{ •qtp pqop kwvl—1
xzm§mvt tpm xw{tmzqwz tmmtp nzwu uw§qvo um{qill—28 Pi1 liz ozw•tp xwtmvtqil0 tpm mnnmkt wn kmz§qkil pmilomiz kiv
tqmvt kwwxmzitqwv q{ sm— tw tpm {°kkm{{ wn pmilomiz bm kwuxmv{itml nwz b— kwvl—liz ozw•tp215
tzmitumvt0 ivl pmilomiz tqumz{ kiv bm pmlxn°l qv tpit Ov pqop1ivolm ki{m{0 i pqop1x°ll wz §mztqkil1x°ll mx1
izmi29-11 tziwzil nwzkm0 •pqkp ixxlqm{ iv °x•izl x°ll0 u°{t bm
Kxtziwzil ixxlqivkm{ kiv bm kitmowzqzml i{ tpw{m tpit °{ml2 Zpm x°llqvo lqzmktqwv wn tpm{m ixxlqivkm{ q{ biks1
ixxl— nwzkm{ nzwu ivtmzqwz tw xw{tmzqwz qv Ili{{ OO ki{m{ •izl ivl °x•izl2 Zpq{ nwzkm lqzmktqwv xzw§qlm{ §mztqkil
ivl tpw{m tpit ixxl— nwzkm{ nzwu xw{tmzqwz tw ivtmzqwz kwvtzwl wn tpm xw{tmzqwz {moumvt b— xzm§mvtqvo mz°xtqwv
qv Ili{{ OOO ki{m{2 Zpq{ kpixtmz nwk°{m{ wv Ili{{ OO t—xm{ wn tpm uwliz{ ivl {wumtqum{ qvtz°lqvo tpmu2 Ov pqop1
tpit ixxl— nwzkm b— umiv{ wn i nikmbw•0 •pqkp q{ °{ml ivolm ki{m{0 tpq{ xzm§mvt{ klwks•q{m zwtitqwv wn tpm
qv uw{t ki{m{2 uivlqblm ivl m§mv xzwuwtm{ kw°vtmzklwks•q{m zwti1
tqwv2 Fwz tpq{ tw wkk°z0 pw•m§mz0 tpm xitqmvt u°{t pi§m
Zpm wbrmktq§m{ wn °{qvo mxtziwzil ixxlqivkm{ izm lq{tml
{°nnqkqmvt kwvl—liz ozw•tp xwtmvtqil2
°vlmz nq§m pmilqvo{?

52 Gvkpwziom zmqvnwzkmumvt Analysis in the sagittal plane

62 Izmitqvo iv wztpwxmlqk mnnmkt wv tpm ri•{
72 Pzw§qlqvo §mztqkil kwvtzwl wn tpm nikm Kxtziwzil nwzkm{ izm ixxlqml bmt•mmv mqtpmz tpm vmks wz
82 Ipivoqvo tpm wkkl°{il xlivm qvklqvitqwv lqnnmzmvt xizt{ wn tpm pmil ivl tpm w°tmz izu{ wn tpm
92 Zwwtp uw§mumvt nikmbw• ivl tziv{nmzzml tw tpm uwliz{ tpzw°op tpm qvvmz
izu{2 Zpm zmlitqwv{pqx bmt•mmv tpm lqvm wn iktqwv wn tpm
Anteroposterior force application nwzkm ivl tpm kmvtmz wn zm{q{tivkm wn tpm uwliz{ lmtmz1
uqvm{ tpm uw§mumvt{ wn tpm{m tmmtp2
Ov {smlmtil Ili{{ OO ki{m{0 tpm uiqv x°zxw{m wn mxtziwzil
nwzkm q{ tw kwvtzwl wz zmlqzmkt nwz•izl ivl lw•v•izl Cervical headgear
ozw•tp wn tpm uixqlli2 Hm{qlm{ qt{ {smlmtil mnnmkt{0 mxtzi1 Zpm ixxlqkitqwv wn kmz§qkil pmilomiz wv tpm uwliz t°bm{
wzil nwzkm il{w pi{ lmvtil mnnmkt{ {°kp i{ lq{tilqzqvo uix1 q{ {pw•v qv Fqo 9192 Zpm lqzmktqwv wn nwzkm q{ biks•izl
qlliz— uwliz{ tw oiqv {xikm wv tpm lmvtil izkp ivl zmqv1 ivl lw•v•izlA tpmzmnwzm0 tpm nwzkm pi{ pwzqzwvtil ivl
nwzkm tpm ivkpwziom2 Kxtziwzil ixxlqivkm{ kiv bm °{ml §mztqkil kwuxwvmvt{2 On tziv{litqwv wn tpm uwliz{ q{ qv1
mqtpmz wv tpmqz w•v wz kwubqvml •qtp nqxml ixxlqivkm{0 lqkitml0 tpm lqvm wn iktqwv wn tpm nwzkm {pw°ll xi{{
°{°ill— wv tpm uixqlliz— nqz{t uwliz{212-14 tpzw°op tpm kmvtmz wn zm{q{tivkm wn tpm uwliz{ (Fqo 919i)2
Kxtziwzil ixxlqivkm{ izm kli{{qnqml b— lqnnmzmvt i°tpwz{ On tpm lqvm wn iktqwv xi{{m{ bmlw• tpm kmvtmz wn zm{q{1
ikkwzlqvo tw tpmqz lqzmktqwv wn nwzkm0 lmvotp0 wz ivo°li1 tivkm0 tpm uwliz °vlmzowm{ klwks•q{m zwtitqwv i{ •mll
tqwv wn tpmqz w°tmz izu{2 Fikmbw•{ wn §izqw°{ lqumv1 i{ tziv{litqwv (Fqo 919b)2 Zpq{ •qll ki°{m tpm kzw•v tw
{qwv{ izm uiv°nikt°zml ikkwzlqvo tw lmvtil izkp {qzm{2 uw§m lq{till— •pqlm tpm zwwt{ uw§m um{qill—2 On tpm lqvm
Zpm{m izm °{ml •qtp {pwzt0 umlq°u0 wz lwvo w°tmz izu{0 wn iktqwv wn tpm nwzkm xi{{m{ ibw§m tpm kmvtmz wn zm{q{1
lmxmvlqvo wv tpm vmml{ wn mikp xitqmvt2 Zpm iqu pmzm tivkm (Fqo 919k)0 tpm uwliz zwtitm{ kw°vtmzklwks•q{m i{
q{ vwt tw xzm{kzqbm0 b°t zitpmz tw {titm tpm omvmzil umkpiv1 •mll i{ tziv{litm{2
qkil xzqvkqxlm{ wn mxtziwzil nwzkm{0 pmlxqvo wztpwlwvtq{t{
{mlmkt {°qtiblm ixxlqivkm{ nwz tpmqz xiztqk°liz xitqmvt{2 High pull headgear
-

Zpm uiqv kzqtmzqwv qv {mlmktqvo mxtziwzil ixxlqivkm{ Nqop1x°ll nwzkm xi{{qvo tpzw°op tpm kmvtmz wn zm{q{tivkm
q{ tpm §mztqkil ozw•tp xittmzv wn tpm nikm2 Ov lw•1ivolm ki°{m{ tziv{litqwv •qtp qvtz°{qwv (Fqo 916i)0 •pqlm nwzkm
ki{m{0 kmz§qkil1x°ll nwzkm{ (kmz§qkil pmilomiz) {pw°ll bm xi{{qvo bmlw• tpm kmvtmz wn zm{q{tivkm ki°{m{ klwks•q{m

86
 Extraoral Appliances

Fig 5-5 The direction of force in cervical headgear is backward and downward. (a) If the line of action of the force passes through the center of
resistance of the molar, translation occurs in the direction of the force. (b) If the force passes below the center of resistance of the molar, a clock-
wise moment occurs. (c) If it passes above the center of resistance, a counterclockwise moment occurs. Note that the molar movement is deter-
mined by its relation with the center of resistance rather than the length of the outer arms or their angulations. As seen in Fig 5-5b, the results ob-
tained with the short arm angled upward, the medium-length arm nonangulated, or the long arm angled downward are mechanically the same
because they are on the same line of action.

Fig 5-6 Direction of force in a high-pull headgear is backward and upward. (a) Force passing through the center of resistance causes translation.
(b) Force passing below the center of resistance causes clockwise rotation. (c) Force passing above the center of resistance causes counter-
clockwise rotation.

zwtitqwv (Fqo 916b)0 ivl nwzkm xi{{qvo ibw§m tpm kmvtmz b°t wv pqop1x°ll pmilomiz0 tpm xwqvt wn {°xxwzt kiv bm
wn zm{q{tivkm ki°{m{ kw°vtmzklwks•q{m zwtitqwv wn tpm uw§ml {lqoptl— °x•izl wz lw•v•izl2 Fwz mxiuxlm0 qv
uwliz{ (Fqo 916k)2 {smlmtil wxmv bqtm ki{m{0 qn uwliz qvtz°{qwv q{ lm{qzml0 tpm
§mztqkil §mktwz {pw°ll bm i{ pqop i{ xw{{qblm (Fqo 91;)0
Adjustment to the direction of force uw§qvo tpm xwqvt wn {°xxwzt pqopmz wv tpm pmil2 Ov tpq{
ki{m0 bmki°{m tpm §mztqkil kwuxwvmvt wn nwzkm q{ u°kp
Hmki°{m tpm kmvtmz wn zm{q{tivkm wn tpm uwliz q{ i {tiblm pqopmz tpiv tpm pwzqzwvtil0 tpm twwtp •qll uw§m °x•izl
xwqvt0 tw kpivom tpm lqzmktqwv wn tpm zm{°ltivt nwzkm wn iv zitpmz tpiv biks•izl2
mxtziwzil ixxlqivkm0 qt q{ vmkm{{iz— tw kpivom mqtpmz tpm On lq{til tziv{litqwv wn tpm uwliz{ q{ qvlqkitml0 tpm pwz1
xwqvt wn {°xxwzt (tpm vmks qv kmz§qkil pmilomiz ivl tpm qzwvtil §mktwz {pw°ll bm qvkzmi{ml2 Zw ikpqm§m tpq{0 tpm
xizqmtil bwvm qv pqop1x°ll pmilomiz) wz tpm lmvotp wz lqvm wn iktqwv wn tpm nwzkm u°{t xi{{ bmt•mmv tpm xizqmtil
ivolm wn tpm nikmbw•2 Ot q{ mi{qmz tw uism tpq{ kpivom wv bwvm ivl tpm vmks (tpm {°xxwzt xwqvt{ wn pqop1x°ll ivl
tpm pmil tpiv wv tpm vmks2 Ot q{ vmizl— quxw{{qblm tw kmz§qkil pmilomiz{)2 _pmv ixxl—qvo tpm{m t—xm{ wn mxtzi1
kpivom tpm xwqvt wn ixxlqkitqwv wn kmz§qkil pmilomiz0
wzil ixxlqivkm{ (killml z{yhino{ wuss wz jvtiiulk olhknlhy,,

87
 5 l Anchorage Control

Fig 5-7 In cases requiring vertical control or molar intrusion, it is nec- Fig 5-8 A straight-pull headgear, which is a combination of high-pull
essary to increase the vertical component of force applied by high- and cervical headgears, can be used when distal translation of the
pull headgear. To achieve this, the point of support should be moved molar is desired.
higher on the head.

Fig 5-9 When the molar tips distally, the front of the facebow moves Fig 5-10 Excessive distal tipping of the molars can cause extrusion
downward and presses upon the lower lip. of the incisors and change the inclination of the occlusal plane.

tpm zm{°ltivt wn tpm °x•izl ivl lw•v•izl nwzkm §mk1 ixxl—qvo i tpqv lqoit°zm •qzm bmt•mmv tpm w°tmz izu ivl
twz{ u°{t xi{{ tpzw°op tpm kmvtmz wn zm{q{tivkm wn tpm tpm xwqvt wn ixxlqkitqwv (qm0 tpm vmks nwz kmz§qkil pmil1
uwliz (Fqo 918)2 omiz ivl tpm wkkqxqtil bwvm nwz pqop1x°ll pmilomiz)
Ov xziktqkm0 tziv{litqwv wn uwliz{ q{ i niqzl— lqnnqk°lt •pqlm tpm nikmbw• q{ qv tpm uw°tp2 Ovtziwzil ilr°{tumvt
uw§mumvt bmki°{m wn tpm lqnnqk°lt— qv lmtmzuqvqvo i wn tpm nikmbw• kiv bm lwvm b— umi{°zqvo tpm lq{tivkm
twwtp+{ kmvtmz wn zm{q{tivkm0 •pqkp q{ tpmwzmtqkill— ik1 bmt•mmv tpm lqvm wn iktqwv (tpm lqoit°zm •qzm) ivl tpm
kmxtml tw bm it tpm tzqn°zkitqwv wn i tpzmm1zwwtml twwtp2 kmvtmz wn zm{q{tivkm wv tpm kmxpilwumtzqk nqlu2
Z•w xziktqkil umtpwl{ kiv bm {°oom{tml tw lmtmzuqvm K§mv qn tpm kmvtmz wn zm{q{tivkm kiv bm ikk°zitml— lm1
tpq{ xwqvt2 Zpm nqz{t wvm q{ tw uizs tpm xw{qtqwv wn tpm tmzuqvml °{qvo tpm{m umtpwl{0 tpm zmlitqwv{pqx bmt•mmv
uwliz wv tpm kpmms {quxl— b— §q{°il lmtmzuqvitqwv2 Zpm tpm lqvm wn iktqwv wn tpm nwzkm ivl tpm kmvtmz wn zm{q{1
{mkwvl q{ tw uizs qt wv tpm kmxpilwumtzqk nqlu tismv b— tivkm •qll kpivom (ivl {w •qll tpm nwzkm {—{tmu) {pwztl—

88
 Extraoral Appliances

Lqo 5-44 (a) High-pull headgear force (F) applied upward on the buccal aspect of the molars can cause buccal tipping. (b) Cervical headgear force
applied downward on the buccal aspect of the molars can cause palatal tipping and posterior crossbite. d, distance.

intmz tpm twwtp {tizt{ tw uw§m2 Ov xziktqkm0 kpmksqvo tpm Analysis in the frontal plane
uw§mumvt{ wn tpm uwliz{ wv i zmo°liz bi{q{ q{ m{{mvtqil
tw smmx tpm nwzkm ivl uw§mumvt °vlmz kwvtzwl2 Kxtziwzil nwzkm{ izm ixxlqml tw tpm uwliz{ tpzw°op tpm
Pziktqkill—0 tpm lqvm wn iktqwv wn tpm nwzkm kiv bm il1 mxtziwzil t°bm{ lwkitml wv tpm b°kkil i{xmkt{ wn tpm{m
r°{tml b— bmvlqvo tpm w°tmz izu{ wn tpm nikmbw• °x1 tmmtp2 Hmki°{m tpm{m t°bm{ izm ittikpml it i kmztiqv lq{1
•izl wz lw•v•izl0 lmxmvlqvo wv tpm xiztqk°liz vmml{ tivkm nzwu tpm kmvtmz{ wn zm{q{tivkm wn tpm uwliz{0 i uw1
wn tpm xitqmvt2 Zpm §mztqkil i{xmkt wn tpm nzwvt wn tpm umvt •qll wkk°z l°zqvo §mztqkil uw§mumvt{ (qm0 mxtz°{qwv
nikmbw• qvlqkitm{ tpm t—xm wn uw§mumvt wn tpm uwliz2 wz qvtz°{qwv)2 _pmv pqop1x°ll pmilomiz q{ °{ml0 b°kkil
G lw•v•izl uw§mumvt wn tpm nikmbw• ioiqv{t tpm mxxiv{qwv wn tpm uwliz{ l°m tw tpq{ uwumvt q{ i kwu1
lw•mz lqx qvlqkitm{ lq{til kzw•v tqxxqvo (Fqo 91>)2 Zpq{ uwv {qlm mnnmkt2 Swumtqum{ tpq{ mxxiv{qwv kiv m§mv
il{w qvlqkitm{ tpit tpm lqvm wn iktqwv wn tpm nwzkm xi{{m{ ki°{m i b°kkil vwvwkkl°{qwv++ (Fqo 9155i)2 J°zqvo b°k1
bmlw• tpm kmvtmz wn zm{q{tivkm wn tpm uwliz2 Zw kwzzmkt kil tqxxqvo wn uixqlliz— uwliz{0 tpm xilitil k°{x{ uw§m
tpq{0 bmvl tpm w°tmz izu{ {lqoptl— °x•izl2 Zw kpmks lw•v ivl ki°{m xzmuit°zm kwvtikt{ •qtp tpmqz uivlqb1
•pmtpmz tpq{ bmvl q{ kwzzmkt0 wb{mz§m tpm uw§mumvt wn °liz ivtiowvq{t{2 Ov pqop1ivolm ki{m{0 xzmuit°zm kwvtikt{
tpm nzwvt wn tpm nikmbw• •pmv nwzkm q{ ixxlqml2 _qtp ui— ki°{m klwks•q{m zwtitqwv wn tpm uivlqblm0 kwubqvml
kwzzmkt ivo°litqwv0 tpm nikmbw• •qll {pw• i {lqoptl— °x1 •qtp iv ivtmzqwz wxmv bqtm ivl i kwv§mx xzwnqlm2 Ov {°kp
•izl lmnlmktqwv intmz nwzkm q{ ixxlqml2 On tpq{ ki{m{0 °{m wn i tziv{xilitil izkp tw xzw§qlm b°kkwlqvo°il
lmnlmktqwv q{ mxkm{{q§m0 tpm ivo°litqwv q{ tww pqop2 Uv kwvtzwl wn tpm uwliz{ q{ zmkwuumvlml2 G tziv{xilitil
tpm wtpmz pivl0 qn tpm uwliz q{ tqxxml um{qill—0 tpm izkp kiv il{w pmlx kwvtzwl uwliz §mztqkil uw§mumvt{ b—
nikmbw• •qll uw§m °x•izl ivl tw°kp tpm °xxmz lqx2 Zw tziv{nmzzqvo tpm §mztqkil xzm{{°zm ixxlqml b— tpm twvo°m
kwzzmkt tpq{0 bmvl tpm w°tmz izu{ lw•v•izl nwz tpm lqvm l°zqvo {•illw•qvo ({mm kpixtmz 8)2
wn iktqwv wn tpm nwzkm tw xi{{ bmlw• tpm kmvtmz wn Uv tpm wtpmz pivl0 i lw•v•izl nwzkm §mktwz nzwu
zm{q{tivkm2 _pmv nwzkm q{ ixxlqml tw tpm bw•0 qt u°{t kmz§qkil pmilomiz ki°{m{ tpm uwliz{ tw mxtz°lm ivl
lmnlmkt {lqoptl— lw•v•izl2 Fwzkm ivl uw§mumvt tqx xilitill—0 •pqkp ui— lmil tw xw{tmzqwz kzw{{bqtm (Fqo
kwvtzwl {pw°ll bm illzm{{ml zmo°lizl— tw i§wql 9155b)2 Zw mlquqvitm tpq{ il§mz{m mnnmkt0 tpm qvvmz izu{
mxkm{{q§m uwliz tqxxqvo0 bmki°{m qt kiv innmkt tpm wn tpm nikmbw• {pw°ll bm •qlmvml {lqoptl— bmnwzm qv1
qvklqvitqwv wn tpm uixqlliz— wkkl°{il xlivm (Fqo 9154)2 {mztqvo qvtw tpm t°bm{A qt q{ m§mv uwzm mnnmktq§m tw °{m i
tziv{xilitil izkp2

8>
 5 I Anchorage Control

_111......

/ \
I
I 1
P I
► I
a b oli) t - ---->
gerr,
P Q
LI v Lr 4
F F
left right
DI v Dr

'..,C1 ..•
• I

Fig 5-12 In a symmetric headgear appliance, the magnitudes of the Fig 5-13 If the joint between the inner arch and outer arms of the
right (F right) and left (F left) forces are equal. Because the lateral facebow is not rigid enough, lateral force components may deflect the
components of the resultant forces (LI and Lr) are equal, they balance inner arch, causing constriction of the maxillary dental arch and pos-
each other out. Therefore, only the distal forces (P and Q) are effec- terior crossbite.
tive on the molars. Dr and DI, right and left resultant distal force vec-
tors; Y, central line of the facebow; a and b, two equal sections of the
intraoral arch; a and f3, angles that occur between Y and F left and F
right.

Analysis in the transverse plane tpmzm izm vw litmzil nwzkm{ wv tpm qvvmz izu{ wn tpm nikm1
bw•0 ivl wvl— tpm lq{till— lqzmktml W ivl P nwzkm{ ix1
_qlmvqvo wn tpm qvvmz bw• q{ il{w zmq°qzml tw xzm§mvt xlqml tw tpm uwliz{ zmuiqv qv tpm {—{tmu2
kzw{{bqtm i{ tpm uwliz{ uw§m qvtw i •qlmz xwztqwv wn tpm Ov i nikmbw• qv •pqkp tpm r°vktqwv wn tpm w°tmz izu{
izkp2 _qtp tpm pqop1x°ll pmilomiz0 pw•m§mz0 qt q{ vwt vmk1 ivl tpm qvvmz izkp q{ vwt zqoql0 i{ tpm w°tmz izu{ lmnlmkt
m{{iz— tw •qlmv tpm qvvmz izu{ bmki°{m tziv{§mz{m mx1 •qtp tpm mnnmkt wn tpm nwzkm0 tpm qvvmz izkp kwvtzikt{ ivl
xiv{qwv •qll wkk°z i{ i zm{°lt wn tpm qvtz°{q§m nwzkm2 Fqo1 ki°{m{ tpm lmvtil izkp tw vizzw• (Fqo 9157)2 Zpm r°vk1
°zm 9156 {pw•{ i {—uumtzqk mxtziwzil ixxlqivkm tpit tqwv bmt•mmv tpm w°tmz izu{ ivl qvvmz izkp0 tpmzmnwzm0
ixxlqm{ nwzkm{ •qtp mq°il uiovqt°lm{ wv tpm w°tmz izu{ u°{t bm zqoql mvw°op tw i§wql tpq{ °vlm{qzml {qlm mnnmkt2
wn tpm nikmbw•2 Ov {°kp i nikmbw•0 •pw{m w°tmz izu{
izm i{{°uml tw bm nqzul— {wllmzml tw tpm qvvmz bw•0 tpm
Application of extraoral forces to the entire
zqopt ivl lmnt zm{°ltivt nwzkm{ (F zqopt ivl F lmnt) qvtmz{mkt
dental arch
it tpm kmvtzil lqvm (a) wn tpm nikmbw•0 ivl tpm qvtziwzil
izkp q{ {mxizitml qvtw t•w mq°il {mktqwv{ (i ivl b)2 Hm1 Sw niz0 tpm mxtziwzil nwzkm{ lq{k°{{ml qv tpq{ kpixtmz
ki°{m tpm lmvotp{ wn tpm w°tmz izu{ izm mq°il0 tpm i ivl pi§m bmmv ixxlqml wvl— tw tpm uixqlliz— nqz{t uwliz{2
(7 ivolm{ tpit wkk°z bmt•mmv F zqopt ivl F lmnt ivl a Hmki°{m i nqxml ixxlqivkm kwv{q{t{ wn u°ltqxlm bziksmt{0
izm il{w tpm {ium2 Zpm litmzil kwuxwvmvt{ bilivkm mikp i xqkt°zm lqnnmzmvt nzwu tpm nwzmowqvo q{ mxxmktml2
wtpmz bmki°{m tpm— izm mq°il ivl wxxw{qtmA i{ i zm{°lt0

>4
 Extraoral Appliances

Fig 5-14 The center of resistance in the maxilla

is located between the roots of the premolars. The
relationship of this center to the extraoral force de-
termines the type of movement of the whole arch.
If backward and upward movement is indicated, the
line of action of the extraoral force should pass
through the center of resistance (F2). A force pass-
ing above the center of resistance (Fl ) causes the
whole dental arch to rotate counterclockwise. If the
force passes below the center of resistance (F3), it
will cause clockwise rotation.

Ov i uixqlliz— lmvtil izkp qvkwzxwzitml •qtp i {tqnn Application of asymmetric forces

zmktivo°liz izkp•qzm0 tpm kmvtmz wn zm{q{tivkm q{ lwkitml
G{—uumtzqk mxtziwzil nwzkm q{ vmmlml qv Ili{{ OO {°b1
bmt•mmv tpm zwwt{ wn tpm nqz{t ivl {mkwvl xzmuwliz{ (Fqo
lq§q{qwv ki{m{ tw lq{tilqzm tpm Ili{{ OO {qlm ivl wbtiqv i
9158)2 Kxtziwzil nwzkm q{ ioiqv ixxlqml tw tpm uixqlliz—
Ili{{ O zmlitqwv{pqx2 Zpmzm izm §izqw°{ t—xm{ wn mxtzi1
uwliz{2 Zpm zmlitqwv{pqx wn tpm mxtziwzil nwzkm tw tpm
wzil ixxlqivkm{ tpit ixxl— i{—uumtzqk nwzkmA wvl— tpm
kmvtmz wn zm{q{tivkm wn tpm uixqlliz— "blwks" lmtmzuqvm{
uw{t mnnmktq§m ivl xziktqkil t—xm{ izm lq{k°{{ml pmzm2
tpm t—xm wn uw§mumvt wn tpm •pwlm lmvtil izkp2 On tpm
nwzkm xi{{m{ tpw°op tpm kmvtmz wn zm{q{tivkm wn tpm lmv1 Extraoral appliances with asymmetric arms
til izkp (F6)0 qt •qll tziv{litm biks•izl ivl °x•izl2 Zpq{ Ov mxtziwzil ixxlqivkm{ qv •pqkp wvm izu q{ lwvomz tpiv
q{ tpm lm{qzml t—xm wn uw§mumvt nwz uw{t {smlmtil Ili{{ tpm wtpmz (Fqo 9159)0 tpm i2 ivl 57 ivolm{0 nwzuml b— tpm
OO xitqmvt{ •qtp i vwzuil §mztqkil xittmzv2 mq°il F lmnt ivl F zqopt zm{°ltivt nwzkm{ •qtp tpm kmvtzil
On tpm lqvm wn iktqwv wn tpm nwzkm xi{{m{ ibw§m tpm kmv1 lqvm a0 lqnnmz2 Hmki°{m tpm 57 ivolm q{ uitpmuitqkill—
tmz wn zm{q{tivkm (F5)0 tpm lmvtil izkp •qll bm °vlmz tpm pqopmz tpiv tpm ll! ivolm0 tpm uiovqt°lm wn tpm W nwzkm
qvnl°mvkm wn i kw°vtmzklwks•q{m uwumvt0 •pqkp zm{°lt{ iktqvo wv tpm zqopt uwliz •qll bm pqopmz tpiv tpit iktqvo
qv mxtz°{qwv wn tpm uwliz{ ivl qvtz°{qwv wn tpm qvkq{wz{2 wv tpm lmnt uwliz2 F°ztpmzuwzm0 tpmzm izm lqnnmzmvkm{ bm1
Swliz mxtz°{qwv •qll ki°{m tpm bqtm tw wxmv •qtp klwks1 t•mmv tpm litmzil kwuxwvmvt{ Rz ivl Rl wn tpm F zqopt
•q{m zwtitqwv wn tpm uivlqblm2 Zpq{ ixxzwikp q{ qvlq1 ivl F lmnt zm{°ltivt nwzkm{2 Zp°{0 i litmzil nwzkm §mktwz tw
kitml qv {smlmtil Ili{{ OO0 lw•1ivolm ki{m{ •qtp ivtmzqwz tpm lmnt •qll wkk°z wv tpm zqopt uwliz i{ i zm{°lt wn tpq{
lmmx bqtm2 Fwzkm xi{{qvo bmlw• tpm kmvtmz wn zm{q{tivkm lqnnmzmvkm217
•qll ki°{m tpm lmvtil izkp tw zwtitm klwks•q{m0 zm{°ltqvo
_pmv qt q{ vmkm{{iz— tw ixxl— iv i{—uumtzqk mxtziw1
qv uwliz qvtz°{qwv ivl qvkq{wz mxtz°{qwv (F7)2 Zpq{ q{ tpm
zil nwzkm0 tpm w°tmz izu wv tpm {qlm •pmzm uwzm nwzkm q{
xzmnmzzml ixxzwikp nwz pqop1ivolm ki{m{ •qtp ivtmzqwz
vmmlml u°{t bm smxt lwvomz tpiv tpm wtpmz w°tmz izu2
wxmv bqtm2

91
 5 Anchorage Control

i 1 P
V.IP WO
0
LI

r
■
131

)•*----.0.
355."
§
--

Fig 5-15 In asymmetric headgear appliances, one of the outer arms Fig 5-16 Bending one of the outer arms laterally has only a small ef-
is longer than the other. The magnitude of the distal force (C) effec- fect on the asymmetric force vector. Y, central line of the facebow; a
tive on the molar by the long arm is higher than that applied by the and p. erkpew xlex sggyv fex{eer \ erh xle pejx erh vmklx vewypxerx jsvgew0 *
short arm (P). Because the lateral component (Lr) of the resultant Pshmjmeh jvsq Rswxlym°er ex epp" {mxl pevqmwwmsr0+
force applied to the side of the long arm is greater than the lateral
component (LI) of the short arm, there is a strong palatal force in ef-
fect on the longer-arm side, carrying the risk of forcing the molar on
that side into crossbite while it is being moved distally. Y, central line
of the facebow; a and _5. erkpew xlex sggyv fex{eer \ erh xle pejx erh vmklx
vewypxerx jsvgew0 *Pshmjmeh jvsq Rswxlym°er ex ep) 7 with permission.)

Fig 5-17 The force of Class II elastics from the canine hooks of the
facebow both increases the effect of the extraoral force and elimi-
nates the extrusive effect of conventional Class I I elastics on the max-
illary anterior teeth.

92
 Extraoral Appliances

Fig 5-18 With reverse headgear, because the force is applied to the
hooks (usually located at the level of the lower lip), the magnitude of
the force applied to the chin is higher than that applied to the fore-
head.

K§mv tpw°op qt uqopt bm pmlxn°l tw mxxivl tpm lwvomz • Ssmlmtil Ili{{ OOO ki{m{ •qtp uixqlliz— zmtz°{qwv wz
w°tmz izu litmzill—0 tpq{ •qll pi§m uqvquil mnnmkt (Fqo uqkzwovitpqi
9156)2 Ov i{—uumtzqk nwzkm ixxlqkitqwv0 tpmzm q{ i kwv1 • Sqvqu°u ivkpwziom ki{m{
{tzqktqwv tmvlmvk— wv tpm uwliz {qlm tpit zmkmq§m{ tpm
uwzm lq{til nwzkm2 Zp°{0 tpq{ uwliz kw°ll {pqnt qvtw kzw{{1 Zpm qlmi wn xzwtz°lqvo tpm uixqlli (qvtzwl°kml b—
bqtm •qtp tpm mnnmkt wn tpq{ litmzil nwzkm2 On wvm tzqm{ tw Uxxmvpmqu qv 5>88) •i{ mnnmktq§ml— bzw°opt tw lqnm •qtp
smmx tpm qvvmz izkp •qlmz tw i§wql tpq{ il§mz{m mnnmkt0 iv wztpwxmlqk nikmui{s lm§mlwxml b— Jmliqzm it tpm
tpm wtpmz uwliz ui— mxxivl qvtw b°kkil vwvwkkl°{qwv2 mvl wn tpm 5>64{2 Zpq{ ixxlqivkm •i{ tpmv °{ml qv lqn1
Ov {°kp ixxlqkitqwv{0 mxkm{{q§m nwzkm{ u°{t bm i§wqlml nmzmvt nwzu{ b— §izqw°{ zm{mizkpmz{ •qtpw°t iv— iltmz1
ivl tpm °{m wn i tziv{xilitil izkp q{ zmkwuumvlml nwz itqwv qv qt{ n°vliumvtil umkpivq{u2+>0"
bmttmz uwliz kwvtzwl2"+" Jmliqzm+{ wztpwxmlqk nikmui{s0 •pqkp q{ it xzm{mvt tpm
uw{t kwuuwvl— °{ml zm§mz{m pmilomiz0 kwv{q{t{ wn
Canine hooks tpzmm uiqv {mktqwv{ (Fqo 9158)?
Nwws{ {wllmzml wv tpm nikmbw• it tpm lm§ml wn tpm ki1
vqvm{ (killml canine hooks) izm °{ml tw ikkmxt Ili{{ OO • G {mktqwv tisqvo {°xxwzt nzwu tpm nwzmpmil
mli{tqk{ tw qvkzmi{m tpm lq{tilqzitqwv mnnmkt wn tpm mxtziw1 • G {mktqwv tisqvo {°xxwzt nzwu tpm tqx wn tpm kpqv
zil nwzkm wv tpm uixqlliz— uwliz ivl tw pmlx i§wql tpm • G xzmlibqil izkp tw •pqkp nwzkm q{ ixxlqml
mxtz°{q§m mnnmkt wn kwv§mvtqwvil Ili{{ OO mli{tqk{ xlikml
wv tpm uixqlliz— ivtmzqwz tmmtp (Fqo 915;)2 Gxxzwxquitml— 844 tw 50944 o wn nwzkm kiv bm ixxlqml
tw ikpqm§m iv wztpwxmlqk mnnmkt nzwu zm§mz{m pmilomiz{2
Reverse headgears Zw ixxl— nwzkm{ wn {°kp pqop uiovqt°lm0 tpm uixqlliz—
Xm§mz{m pmilomiz{ izm il{w svw•v i{ protraction head- tmmtp u°{t bm tqml twomtpmz tqoptl— b— umiv{ wn zmktiv1
gears wz orthopedic facemasks. Zpm— izm xzqvkqxill— °{ml o°liz •qzm wz ki{t qv i uixqlliz— {xlqvt26+
qv tpm nwllw•qvo {qt°itqwv{?

93
 9 P Anchorage Control

Fig 5-19 In reverse headgear applications, if the line

of action of the force passes below the center of re-
sistance of the upper dental arch (a), it causes coun-
terclockwise rotation of the whole arch. This results in
extrusion of the molars and an anterior open bite. To
avoid this adverse effect, the force must be applied to
the power hooks between the canines and lateral in-
cisors so that the line of action passes through the
center of resistance or above it (b).

Sw{t xitqmvt{ •qtp uixqlliz— zmtz°{qwv wz uqkzwo1 izkp ivl ki°{m{ kw°vtmzklwks•q{m zwtitqwv wn tpm •pwlm
vitpqi mxpqbqt {mzqw°{ uixqlliz— kwv{tzqktqwv2 Ov tpm{m izkp0 zm{°ltqvo qv mxtz°{qwv wn tpm uwliz{ ivl wxmvqvo wn
ki{m{0 qt q{ vmkm{{iz— tw mxxivl tpm uixqlli °{qvo zixql tpm bqtm (a qv Fqo 915>)2 Zw i§wql tpq{0 tpm lqvm wn iktqwv
uixqlliz— (wz xilitil) mxxiv{qwv bmnwzm xzwtziktqwv •qtp wn tpm nwzkm {pw°ll xi{{ tpzw°op wz {lqoptl— ibw§m tpm
zm§mz{m pmilomiz2 _qtp zixql uixqlliz— mxxiv{qwv0 kmvtmz wn zm{q{tivkm wn tpm uixqlliz— izkp b— •i— wn
xwqvt G q{ mxxmktml tw kwum {lqoptl— nwz•izl222,23 Zpm xw•mz pwws{ xlikml bmt•mmv tpm kivqvm{ ivl litmzil qv1
wztpwxmlqk nwzkm{ wn zm§mz{m pmilomiz kiv bm ixxlqml kq{wz{ ivl ivo°litml ixxzwxquitml— 74 tw 89 lmozmm{ tw
wv mqtpmz tpm pwws{ wn i ki{t zixql1mxxiv{qwv ixxlqivkm tpm uixqlliz— wkkl°{il xlivm (bin Fqo 915>)2
wz wv pwws{ kzquxml (wz {wllmzml) wv i {tqnn G{ tpm uixqlliz— ivtmzqwz tmmtp uw§m nwz•izl qv zm1
zmktivo°liz izkp•qzm2 §mz{m pmilomiz ixxlqkitqwv0 tpm uivlqb°liz qvkq{wz{
_qtp zm§mz{m pmilomiz0 tpm uixqlli uw§m{ nwz•izl b— tmvl tw uw§m lqvo°ill— •qtp tpm kpqv kix xzm{{°zm228 Zw
zwtitqvo kw°vtmzklwks•q{m izw°vl i xwqvt lwkitml vmiz xzm§mvt xw{{qblm uivlqb°liz qvkq{wz kzw•lqvo0 {wum
tpm nzwvtwuixqlliz— {°t°zm2 J°zqvo tpq{ xzwkm{{0 tpm lqvo°il zwwt twzq°m kiv bm ixxlqml tw tpm{m tmmtp2 Iwv1
uixqlliz— lmvtil izkp il§ivkm{ wv tpm bi{il bwvm qv i §mz{ml—0 libqil zwwt twzq°m kiv bm oq§mv tw tpm uixqlliz—
uivvmz killml drawer movement. 570" K§mv tpw°op tpm qvkq{wz{ qn tpm klqvqkqiv lwm{ vwt •ivt tw qvkzmi{m tpmqz
•pwlm lmvtil izkp q{ tqml •qtp i {tqnn zmktivo°liz izkp1 ixqil qvklqvitqwv{2 Fmvv2° ivl S°btmlv—" pi§m {°oom{tml
•qzm ivl °vlmzowm{ iv wztpwxmlqk mnnmkt0 qt q{ quxw{{q1 tpit tpq{ twzq°m qvkzmi{m{ tpm tpqksvm{{ wn tpm kwztqkil
blm tw i§wql {wum lmvtil kpivom{2 Pzwtziktqwv wn tpm li—mz ivl tpm lm§mlwxumvt wn xwqvt G ivl il{w xzm§mvt{
uixqlliz— qvkq{wz{ q{ xiztqk°lizl— kwuuwv2 °vlm{qzml mxtz°{qwv wn tpm uixqlliz— qvkq{wz{2
J°zqvo xzwtz°{qwv wn tpm uixqlli0 kmztiqv kpivom{ il{w Ov uqvqu°u ivkpwziom ki{m{0 zm§mz{m pmilomiz kiv
wkk°z qv tpm uivlqblm2 U•qvo tw tpm lq{til nwzkm ixxlqml bm ixxlqml tw tpm uivlqb°liz xzmuwliz{ wz uwliz{2 Ov
tw tpm tqx wn tpm kpqv0 tpm uivlqblm zwtitm{ klwks•q{m024-27 tpm{m ki{m{0 tpm lqvm wn iktqwv wn tpm nwzkm {pw°ll bm
lmilqvo tw w§mzbqtm zml°ktqwv ivl i kwv§mx {wnt tq{{°m nwz•izl ivl {lqoptl— °x•izl tw i§wql qzzqtitqwv wn tpm
xzwnqlm2 Zpq{ mnnmkt q{ vwt lm{qzml qv pqop1ivolm ki{m{2 lw•mz lqx2
Zpmzmnwzm0 qv zm§mz{m pmilomiz ixxlqkitqwv{0 tpm §mztqkil _qtp pmilomiz ixxlqkitqwv0 iv ikk°zitm tzmitumvt xliv0
nikqil xittmzv wn tpm xitqmvt u°{t bm tismv qvtw kwv{ql1 tquqvo0 ivl xitqmvt kwwxmzitqwv izm ill §qtil tw {°kkm{{2
mzitqwv2 Ov xiztqk°liz0 ixxlqkitqwv{ qv pqop1ivolm ki{m{ Gv wztpwxmlqk mnnmkt kiv bm bm{t ikpqm§ml bmnwzm klw1
{pw°ll bm i§wqlml2 {°zm wn tpm uixqlliz— {°t°zm{ ivl kwuxlmtqwv wn tpm
_pmv zm§mz{m pmilomiz q{ °{ml qv ki{m{ •qtp i pqop1 x°bmztil ozw•tp xmzqwl2 Zp°{0 tpm zm{°lt{ ikpqm§ml intmz
ivolm tmvlmvk—0 tpm xwqvt wn ixxlqkitqwv ivl tpm lqzmk1 tpq{ xmzqwl (qv —w°vo il°ltpwwl wz il°ltpwwl) •qll bm
tqwv wn tpm nwzkm izm m§mv uwzm quxwztivt2 _pmv tpm uw{tl— lmvti52201-33 Hmki°{m twvo°m xw{qtqwv kiv ki°{m
nwzkm q{ ixxlqml tw tpm uwliz{0 tpm lqvm wn iktqwv xi{{m{ zmlix{m intmz zm§mz{m pmilomiz ixxlqkitqwv0 i n°vktqwvil
bmlw• tpm kmvtmz wn zm{q{tivkm wn tpm uixqlliz— lmvtil twvo°m ziq{mz0 qv tpm nwzu wn iv ikz—lqk xlitm0 kiv lqzmkt

94
 Temporary Anchorage Devices

tpm twvo°m nwz•izl ivl °x•izl ivl pmlx mv{°zm xmz1 • [vlqsm lmvtil quxlivt{0 ZGJ{ kiv pi§m wztpwlwvtqk
uivmvt zm{°lt{278 nwzkm ixxlqml {pwztl— intmz qv{mztqwv0 •pqkp {i§m{ tqum
it tpm klqvqk2

I Temporary Anchorage Devices • Sqkzwquxlivt ivkpwziom umkpivqk{ pmlx kwzzmkt

{m§mzil kpillmvoqvo xzwblmu{0 {°kp i{ wxmv bqtm0 lmmx
bqtm0 i{—uumtz—0 uwliz °xzqoptqvo0 ivl {kq{{wz{ bqtm2 Ot
Hmki°{m ivkpwziom xli—{ {°kp iv quxwztivt zwlm qv wz1 mviblm{ klqvqkqiv{ tw nwk°{ lqzmktl— wv tpm uiqv xzwb1
tpwlwvtqk umkpivqk{0 i zmlqiblm {w°zkm wn ivkpwziom nwz lmu •qtpw°t {xmvlqvo tqum wv lm§mlqvo ivl ilqovumvt2
mnnqkqmvt twwtp uw§mumvt pi{ lwvo bmmv {w°opt2 Gl1 Fwz mxiuxlm0 qv i pqop1ivolm ki{m •pmzmqv tpm uiv1
tpw°op pmilomiz pi{ bmmv tpm uw{t zmlqiblm ivl xw•1 lqb°liz uwliz{ pi§m tqxxml um{qill— bmki°{m wn lw{{ wn
mzn°l {w°zkm wn ivkpwziom0 tpq{ lm§qkm q{ lmxmvlmvt wv xzmuwliz{0 uwliz °xzqoptqvo vmml{ tw bm ikkwuxlq{pml
xitqmvt kwuxlqivkmA {pw°ll tpit kwwxmzitqwv bm liksqvo0 b— qvtz°{qwv—i niqzl— kwuxlqkitml xzwkml°zm zmq°qzqvo
tpm {°kkm{{ wn tzmitumvt •w°ll bm it zq{s2 Zmuxwziz— pqop ivkpwziom ivl pmi§— izkp•qzm{ qv tpm ivtmzqwz
ivkpwziom lm§qkm{ (ZGJ{)0 il{w killml tijyvitwshu{z, zm1 {moumvt2 Rm§mlqvo bmnwzm °xzqoptqvo °{°ill— kwu1
kmvtl— qvtzwl°kml tw tpm •wzll wn wztpwlwvtqk{0 {mmu tw xzq{m{ i lmvotp— xwztqwv wn tpm w§mzill tzmitumvt tqum2
bm zmlqiblm qvtziwzil {w°zkm{ wn ivkpwziomA tp°{0 tpm— [{qvo uqkzwquxlivt ivkpwziom umkpivqk{0 pw•m§mz0
pi§m bmkwum i kwuuwv tzmitumvt twwl qv uiv— klqvqk{ uwliz °xzqoptqvo kiv bm xmznwzuml qvlmxmvlmvt wn
•wzll•qlm2 G v°ubmz wn {t°lqm{ {°oom{t tpit ZGJ{ xzw1 wtpmz xizt{ wn tpm lmvtil izkp •qtpw°t tpm vmml nwz
l°km {°nnqkqmvt ivkpwziom ioiqv{t wztpwlwvtqk nwzkm{27918+ ivkpwziom xzmxizitqwv2
Zpmqz {tibqlqt— ivl klqvqkil mnnqkqmvk—0 pw•m§mz0 pi§m
bmmv tpm twxqk{ wn {m§mzil illqtqwvil {t°lqm{2 Ov tpq{ Stability of microimplants
{mktqwv0 tpm xzqvkqxlm{ wn uqkzwquxlivt ixxlqkitqwv ivl
tpmqz bqwumkpivqkil kwv{qlmzitqwv{ izm mxiuqvml2 Uvm wn tpm uw{t quxwztivt zmq°qzmumvt{ wn uqkzwqu1
xlivt °{m q{ {tibqlqt— l°zqvo tzmitumvt2 Zzmitumvt {°k1
Rationale for use of microimplants km{{ •qtp ZGJ{ pi{ bmmv qvkzmi{qvo lziuitqkill— tpivs{
tw k°ttqvo1mlom tmkpvwlwo— ivl quxzw§ml uitmzqil{0 lm1
Zpmzm izm i v°ubmz wn zmi{wv{ uqkzwquxlivt{ izm bmqvo {qov0 ivl qv{mztqwv tmkpvqq°m{2 Guwvo tpm niktwz{ tpit
•qlml— ikkmxtml b— klqvqkqiv{0 qvkl°lqvo? innmkt uqkzwquxlivt {tibqlqt—0 tpqksvm{{ ivl §wl°um wn
tpm kwztqkil bwvm izm tpm uw{t quxwztivt2 Rqsm•q{m0
• ZGJ{ xzw§qlm ib{wl°tm ivkpwziom {quqliz tw iv ivs—1
tpqksvm{{ ivl lmvotp wn tpm quxlivt0 iuw°vt wn nwzkm
lw{ml twwtpA tp°{0 °vlm{qziblm uw§mumvt qv zmiktqwv
ixxlqml0 qvnliuuitqwv wn xmzq1quxlivt tq{{°m{0 ivl uiv1
tw ixxlqml nwzkm kiv bm i§wqlml286
lqb°liz xlivm ivolm vmml tw bm tismv qvtw kwv{qlmzitqwv
• Zpm— lw vwt zml— wv xitqmvt kwwxmzitqwv2
l°zqvo ixxlqkitqwv28+087 Zpm lmvotp wn tqum intmz uqkzw1
• Hmki°{m wn tpmqz {uill {qzm0 tpm— kiv mi{ql— bm qv{mztml
quxlivt qv{mztqwv •i{ vwt nw°vl tw bm i{{wkqitml •qtp
iv—•pmzm qv tpm uw°tp •pmzm tpmzm q{ ilmq°itm bwvm
{tibqlqt—0 b°t {m§mzil {t°lqm{ {°oom{t tpit tpm
{°xxwzt2 Zpm qv{mztqwv zmq°qzm{ wvl— i {quxlm {°zoqkil
ixxlqkitqwv wn nwzkm kiv bm i niktwz28+189 S°nnqkqmvt
xzwkm{{0 •pqkp kiv bm xmznwzuml °vlmz klqvqkil kwv1
umkpivqkil qvtmzlqoqtitqwv bmt•mmv kwztqkil bwvm ivl tpm
lqtqwv{2
ZGJ q{ iv quxwztivt kwuxwvmvt tpit innmkt{ {tibqlqt—2
• Zpm— kiv mi{ql— bm zmuw§ml •pmv ivkpwziom q{ vw Gkkwzlqvo tw Z{°vwzq mt i586 ivl Si{°uwtw mt i508; xitqmvt{
lwvomz vmmlml2 •qtp pqop uivlqb°liz xlivm ivolm{ izm it pqopmz zq{s nwz
• Zpm nikt tpit uqkzwquxlivt{ kiv bm qv{mztml iv—•pmzm qv{tibqlqt— wn uqkzwquxlivt{ bmki°{m tpm— pi§m tpqvvmz
qv tpm uw°tp wnnmz{ i §izqmt— wn umkpivqkil kwubqvi1 kwztqkil bwvm qv tpm uivlqb°liz nqz{t uwliz zmoqwv tpiv
tqwv{2 Fwz mxiuxlm0 mv ui{{m zmtziktqwv qv i uixqu°u xitqmvt{ •qtp lw• uivlqb°liz xlivm ivolm{2 Zpm— {°oom{t
ivkpwziom ki{m0 •pqkp q{ mxtzmuml— kpillmvoqvo •qtp tpm °{m wn uqkzwquxlivt{ •qtp i lqiumtmz lizomz tpiv
kwv§mvtqwvil umkpivqk{0 kw°ll bm mi{ql— xmznwzuml 627 uu wz uqvqxlitm{ qv pqop1ivolm ki{m{2
°{qvo uqkzwquxlivt ivkpwziom umkpivqk{2

95
 5 I Anchorage Control

Biomechanical considerations kwvtziqvlqkitml •pmv mxtz°{qwv q{ vmkm{{iz—2 Twz q{

tziv{§mz{m kivtqvo wn tpm wkkl°{il xlivm lm{qziblm0 i{ qt
Zpm {ium bqwumkpivqkil xzqvkqxlm{ ixxl— nwz uqkzwqu1 q{ lqnnqk°lt tw kwzzmkt •qtp kwv§mvtqwvil umkpivqk{286
xlivt ivkpwziom i{ nwz kwv§mvtqwvil umkpivqk{2 G{ Zpm lwkitqwv wn tpm uqkzwquxlivt uqopt lquqt twwtp
umvtqwvml mizlqmz0 tpm nikt tpit ZGJ{ kiv bm qv{mztml uw§mumvt0 i{ qv uwliz lq{tilqzitqwv2 On tpm {mkwvl xzm1
iv—•pmzm qv tpm uw°tp—tpmzm q{ vw ivitwuqkil wz xmzq1 uwliz zwwt kwvtikt{ tpm ZGJ0 tpm littmz {pw°ll bm zmqv1
wlwvtil zm{tzqktqwv—{quxlqnqm{ {xmkqnqk umkpivqk{0 •pqkp {mztml klw{m tw tpm uwliz zwwt{2
mviblm{ wztpwlwvtq{t{ tw xmznwzu uwzm mnnqkqmvt tzmit1 Zpm ZGJ q{ °{°ill— •mll twlmzitml b— tpm xitqmvt0 b°t
umvt qv i {pwztmz tqum kwuxizml •qtp kwv§mvtqwvil qt ui— bm °vkwunwztiblm qv tpm uivlqb°liz kivqvm ivl
tmkpvqq°m{2 qvkq{wz izmi2 Rqsm•q{m0 qvnliuuitqwv wn tpm {wnt tq{{°m{
Ov uqkzwquxlivt ivkpwziom umkpivqk{0 tpm zmlitqwv1 bmki°{m wn qzzqtitqwv q{ kwuuwv qn tpm ZGJ q{ qv{mztml
{pqx bmt•mmv tpm lqvm wn iktqwv wn tpm nwzkm ivl tpm kmv1 bm—wvl tpm ittikpml oqvoq§i2
tmz wn zm{q{tivkm lmnqvm{ tpm t—xm wn twwtp uw§mumvt2 Sqkzwquxlivt ivkpwziom uism{ lwvo1zivom twwtp
Fwzkm{ xi{{qvo tpzw°op tpm kmvtmz wn zm{q{tivkm ki°{m uw§mumvt{ {°kp i{ n°ll uixqlliz— izkp lq{tilqzitqwv
tziv{litqwv0 ivl tpw{m xi{{qvo wnn kmvtmz ki°{m zwtitqwv xw{{qblm2 Nw•m§mz0 qvlq§ql°il wz mv ui{{m twwtp uw§m1
wz tqxxqvo ({mm kpixtmz 5)2 Zpmzmnwzm0 tpm lwkitqwv wn tpm umvt{ izm lquqtml b— ivitwuqkil ivl bqwlwoqk {tz°kt°zm{2
quxlivt kiv bm lmtmzuqvml ikkwzlqvo tw tpm lm{qzml um1 Gv— ittmuxt tw x°{p tpm bw°vlizqm{ wn tpm bwvm kiv
kpivqk{2 ki°{m lmpq{kmvkm wz zwwt zm{wzxtqwv2

Limitations of microimplant anchorage

References
Jm{xqtm qt{ il§ivtiom{ w§mz kwv§mvtqwvil tmkpvqq°m{0
uqkzwquxlivt ivkpwziom pi{ kmztiqv lquqtitqwv{ tpit 52 Pzwnnqt _X2 Iwvtmuxwziz— Uztpwlwvtqk{2 St Rw°q{? Sw{b—0
vmml tw bm kwv{qlmzml l°zqvo tzmitumvt xlivvqvo2 Gb1 5>86?665076817;;2
{wl°tm ivkpwziom lwm{ vwt zm{wl§m ill wztpwlwvtqk xzwb1 62 Zw{°v a2 Nq{twlwoqkil {t°l— wn tpm mnnmkt wn Tivkm ixxlqivkm wv
lmu{2 Ov ill ki{m{0 •pit q{ m{{mvtqil q{ kwvtzwllqvo tpm tpm xilitil u°kw{i2 Z°zs Uztwlwvtq Jmzo 5>>6A9?7;1842
72 Xqksmtt{ XS2 Hqwxzwozm{{q§m Zpmzix—2 Jmv§mz? Xwks— Sw°vtiqv
iuw°vt ivl lqzmktqwv wn nwzkm2
Uztpwlwvtqk{0 5>;>?5442
Sqkzwquxlivt ixxlqkitqwv pi{ {°zoqkil ivl wztpwlwv1 82 Xwwt ZR2 Zpm lm§ml ivkpwziom {—{tmu2 Ov? Mzibmz ZS0 S•iqv
tqk kwuxwvmvt{2 Zpw°op qt zmq°qzm{ wvl— uqvwz {°zomz—0 HF (ml{)2 Uztpwlwvtqk{? I°zzmvt Pzqvkqxlm{ ivl Zmkpvqq°m{2 St
quxwztivt ivitwuqkil {tz°kt°zm{ {°kp i{ tpm {qv°{m{0 Rw°q{? Sw{b—0 5>89?68516672
92 Sw—{il S2 Iwuxizitq§m St°l— wn tpm Gvkpwziom Smkpivq{u{
xilitqvm vm°zw§i{k°liz b°vllm0 umvtil nwziumv0 ivl
•qtp Sixqlliz— Kxtziktqwv Ii{m{ Zzmitml •qtp Stziqopt _qzm ctpm1
uivlqb°liz ivl lqvo°il vmz§m{A ivitwuqkil §izqitqwv{A
{q{e2 Ozuqz0 Z°zsm—? Gmomiv [vq§0 5>>82
ivl lq{tivkm bmt•mmv zwwt{ lquqt tpm lwkitqwv{ nwz uq1 62 _mzvmz SP0 Spq§ix°ri PQ0 Nizzq{ KF2 Ssmlmtwlmvtil kpivom{ qv
kzwquxlivt qv{mztqwv2 Hmki°{m zwwt{ izm kwvqkil0 tpm lq{1 tpm ilwlm{kmvt ikkz°qvo nzwu °{m wn tpm lqx b°uxmz2 Gvolm Uz1
tivkm bmt•mmv tpmu qvkzmi{m{ tw•izl tpm ixmx2 Ov il1 tpwl 5>>8A68?571642
lqtqwv0 tpm il§mwliz kzm{t q{ vwt i owwl lwkitqwv nwz ZGJ ;2 Gtioqqv I2 Gxxlqkitqwv ivl Knnmkt{ wn Rqx H°uxmz qv Ili{{ OO35
Ii{m{ ctpm{q{e2 Ozuqz0 Z°zsm—? Gmomiv [vq§0 5>>52
qv{mztqwv2 Gxqkill—0 ittikpml oqvoq§i q{ i {°qtiblm lwki1
82 Zw{°v a2 Iwuxizitq§m St°l— wn tpm Knnmkt{ wn Imz§qkil ivl Nqop
tqwv nwz xitqmvt kwunwzt2
P°ll Nmilomiz{ wv Jmvtw1Izivqw1Fikqil Stz°kt°zm{ wn Ili{{ OO35
Sqkzwquxlivt bqwumkpivqk{ q{ il{w lquqtml b— ivit1 Ii{m{ qv tpm Zziv{qtqwvil Jmvtqtqwv ctpm{q{e2 Ozuqz0 Z°zsm—?
wu—2 Hmki°{m tpm ZGJ q{ qv{mztml bmt•mmv tpm zwwt{0 Gmomiv [vq§0 5>8>2
{wum•pmzm klw{m tw tpm kmvtmz wn zm{q{tivkm wn tpm tmmtp >2 M°zi— K0 Uzpiv S2 Smlk°s t—xm pmilomiz1tqumz (SZNZ)—Ovtzw1
wz lmvtil izkp0 tpm lqzmktqwv wn nwzkm q{ °{°ill— qvtz°{q§m l°ktqwv ivl tm{tqvo wn qt{ zmlqibqlqt—2 Pizt O? Ribwzitwz— •wzs2
Z°zs Uztwlwvtq Jmzo 5>>8A;?686168;2
zitpmz tpiv mxtz°{q§m2 Zpq{ q{ iv il§ivtiom qv uiv—
542 M°zi— K0 Uzpiv S2 Smlk°s t—xm pmilomiz1tqumz (SZNZ)—
ki{m{0 b°t qt vmml{ tw bm uwvqtwzml tpzw°opw°t tzmit1
Ilqvqkil ixxlqkitqwv ivl qt{ mnnmkt wv kwwxmzitqwv2 Pizt OO?
umvt bmki°{m qt ui— ki°{m i{—uumtz—0 lq{twzt tpm lmv1 Ilqvqkil qv§m{tqoitqwv2 Z°zs Uztwlwvtq Jmzo 5>>8A;?68816972
til izkp0 wz kpivom tpm kivt wn tpm wkkl°{il xlivmA qt q{

96
 References

552 Mizi— K0 Uzpiv S2 Smlk°s t—xm pmilomiz1tqumz (SZNZ)2 Gu P 752 Iwzzivq M2 Kxtziwzil tziktqwv ivl Ili{{ OOO tzmitumvt2 GuP Uz1
Uztpwl Jmvtwnikqil Uztpwx 5>>;A555?8;1>62 tpwl 5>85A84?67816942
562 [lomv S2 Imz§qkil pmilomiz ivl qt{ umkpivq{u wn mnnmkt2 O{tiv1 762 Ni{smll HS0 Fizuiv GM2 Kxxlwqtitqwv wn tpm zm{ql°il xzmuixql1
b°l [vq§ Jq{pmsqu Fis Jmzo 5>;;A55?567156>2 liz—1uixqlliz— {°t°zm {qtm qv uixqlliz— xzwtiktqwv1Gv p—xwtpm1
572 Zw{°v a0 O§qs{il K2 St°l— wn tpm mnnmkt{ wn pqop x°ll pmilomiz ix1 {q{2 Gvolm Uztpwl 5>89A99?54>155>2
xlqkitqwv wv lmvtw1kzivqw1nikqil {tz°kt°zm{ wn Ili{{ OO35 ki{m{ qv 772 Jwoiv S0 Kztqqzs T2 Ritm {tiom m§il°itqwv wn tpm {smlmtil Ili{{ OOO
tpm tziv{qtqwvil lmvtqtqwv2 Z°zs Uztwlwvtq Jmzo 5>>5A8?941982 ki{m{ tzmitml •qtp wztpwximlqk nikm ui{s2 Z°zs Uztwlwvtq Jmzo
582 Sqitw•{sq X2 Zpm zwlm wn pmilomiz qv Ili{{ OO lmvtil ivl 5>>4A7?57815872
{smlmtil kwzzmktqwv{2 Ov? Tivli X (ml)2 Hqwumkpivqk{ qv Ilqvqkil 782 Uztqqzs a0 Qqpkwol° N2 Gxxlqkitqwv wn n°vktqwvil twvo°m ziq{mz
Uztpwlwvtqk{2 Ppqlilmlxpqi? Si°vlmz{0 5>>;?5752 qv Ili{{ OOO ki{m{ tzmitml •qtp Jmliqzm ui{s2 Z°zs Uztwlwvtq
592 Skp°l— FK2 Vmztqkil ozw•tp §mz{°{ ivtmzw1xw{tmzqwz ozw•tp i{ Jmzo 5>>4A7?55>15682
zmlitml tw n°vktqwv ivl tzmitumvt2 Gvolm Uztpwl 5>68A79?;91 792 Spmz•wwl QN0 H°zkp PM0 Zpwux{wv _P2 Ilw{qvo ivtmzqwz wxmv
>72 bqtm{ b— qvtz°lqvo uwliz{ •qtp tqtivq°u uqvqxlitm ivkpwziom2
562 Mqql—°zt S2 Kxtziwzil Gxxlqivkm{ (Nmilomiz ivl Ipqv Iix)2 Gu P Uztpwl Jmvtwnikqil Uztpwx 6446A566?9>716442
Kzz°z°u0 Z°zsm—? Gtittqzs [vq§mz{qt— Fik°lt— wn Jmvtq{tz—0 Jm1 762 Pizs NS0 Him SS0 Q—°vo NS0 S°vo PN2 Sqkzw1quxlivt iv1
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