The field of orthodontia has been witnessing numerous reforms in terms of treatment modalities through the years, under which the concept of absolute anchorage employing mini-implants can be well subsumed. The usage of orthodontic bone screws has witnessed growing popularity and has been deemed to revitalize the management of complex malocclusions. Orthodontic bone screws are larger in diameter (2 mm) in comparison with the average mini-implant and are placed in areas of high bone mineral density like the infrazygomatic crest in the maxilla and the buccal shelf area in the mandible. Owing to a difference in size, they are placed away from the roots and hence, the term extra-radicular implants seem a befitting one. With an expansion of the envelope of discrepancy to skeletal anchorage, the employment of these bone screws in practice will have to be appraised further in terms of biological limits. Orthodontic bone screws have been successfully utilized as an absolute anchorage system in well-chosen cases, pushing the realm of treatment possibilities further ahead in the sands of time. This chapter aims to provide you with a narrative insight into the salient features of orthodontic bone screws starting right from its inception to its contemporary usage in practice.
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