Table 3. Advantages and disadvantages of skeletal anchorage according to the studies reviewed.

ADVANTAGES

DISADVANTAGES

Fewer unwanted dental effects than with dental anchorage [14,19–24] Greater maxillary advancement [14,19–21,24,25] Greater skeletal effect [19,22,23] The force vector passes through the centre of resistance of the maxilla [19] Less anti-clockwise [US: counterclockwise] rotation of the maxilla [19] Intermaxillary elastic bands with skeletal anchorage can be worn 24h a day [19] Greater facial profile improvement [19] Intermaxillary elastics with skeletal anchorage do not require as much cooperation as with dental anchorage [19] Vertical changes do not appear in any of the craniofacial structures [21] Greater improvement in overjet and molar relation [14] Lower traction force needed with elastics (up to 250 g per side) [22,23] Possible to achieve maxillary advancement in older patients than with dental anchorage [24] Less clockwise rotation of the mandible [24] Dental alignment can be performed simultaneously [24]<0}

Invasive surgical procedure [20] Two surgical procedures: placement and removal of miniplates [20,22] More expensive [19] Requires general anaesthetic or sedation [19] Possibility of failure of the skeletal anchorage (miniplates or miniscrews) [23,27]