Vol. 11, Issue 4, Part D (2025)

Anchorage control is a fundamental requirement in orthodontic biomechanics, ensuring that desired tooth movement occurs without adverse reciprocal effects. Traditionally, anchorage was obtained from teeth, oral musculature, and extraoral appliances; however, dental anchorage has inherent limitations such as anchorage loss, dependence on patient compliance, and biomechanical restrictions in complex malocclusions. The development of skeletal anchorage systems, particularly temporary anchorage devices (TADs), has revolutionized orthodontic therapy by offering near-absolute anchorage independent of the dentition. This review compares dental and skeletal anchorage with respect to biomechanics, indications, clinical efficiency, and limitations. Dental anchorage remains valuable for routine orthodontic tooth movement, whereas skeletal anchorage significantly enhances outcomes in cases requiring maximum anchorage, en-masse retraction, molar intrusion, and asymmetry correction. Skeletal anchorage also minimizes patient compliance issues and broadens the scope of non-surgical correction in challenging cases. A comprehensive understanding of both anchorage types and their indications enables orthodontists to select the most appropriate modality to optimize biomechanics and achieve predictable treatment outcomes.