Temporary anchorage devices (TADs) have become integral in contemporary orthodontic biomechanics, providing reliable skeletal anchorage independent of dental support or patient compliance. This narrative review synthesizes the current evidence regarding TADs classification, design parameters, biomechanical principles, clinical insertion protocols, complication management, and technological innovations. We reviewed foundational literature and recent clinical studies with emphasis on factors affecting primary and secondary stability, including insertion torque, angulation, cortical bone characteristics, and soft-tissue considerations. Self-drilling techniques are generally preferred for maxillary sites, while pre-drilling remains indicated in dense mandibular bone to reduce thermal risk and torque overload. Clinical success is optimized when insertion torque is maintained between 5 and 10 N·cm and site-specific anatomy is respected. Reported survival rates exceed 85–95% when proper protocols are followed. While TADs are associated with relatively low complication rates, failures are usually early and linked to excessive torque, poor hygiene, or inflammation. New technologies such as cone-beam computed tomography-guided placement, 3D-printed surgical guides, and AI-based planning tools offer promising avenues for safer and more individualized treatment. In conclusion, TADs represent a predictable and versatile option for skeletal anchorage in orthodontics, provided that mechanical design, biological adaptation, and clinical handling are coherently integrated into patient-specific strategies.

Background/Objectives: Dental malocclusions are highly prevalent worldwide, negatively impacting patients’ quality of life and leading to complex, often costly, orthodontic treatments. In Romania, the economic status of patients and the limited public funding for orthodontic care significantly influence treatment accessibility and choices. Advanced technologies, such as mini-implants (MIs), offer improved anchorage and treatment efficiency but are often underutilized due to financial constraints and variability in clinical training. In this context, there are limited data regarding the use and preferences of MI among orthodontists in Romania. This study aims to explore the characteristics, preferences, and challenges of Romanian orthodontists in their use of MI systems. Methods: A survey was conducted between June and September 2024, targeting orthodontists across Romania. The questionnaire, distributed via social media platforms, consisted of 24 items addressing professional experience, MI system preferences, insertion methods, and complications. Statistical analyses were conducted using IBM SPSS Statistics 25. Fisher’s Exact Test and Pearson’s Chi-Square Test were employed to evaluate relationships between categorical variables. When appropriate, logistic binomial univariable regression models were applied to predict key dependent variables (e.g., MI placement zones, MI experience, and MI complications) based on independent variables such as specific MI system usage and frequency of MI usage. A significance threshold of α = 0.05 was used for all tests. Results: Out of 105 participants, 85.7% reported using mini-implants (MIs) in their orthodontic practice, with the Dual Top and Benefit systems being the most frequently used (60% and 43.3%, respectively). The interradicular area was the most common placement site (60%), while the palatal and retromolar regions showed significant correlations with the Benefit system (p = 0.008). Practitioners with more than 10 years of experience reported a significantly higher frequency of MI use (p = 0.001), with frequent use being observed in 60.9% of these practitioners. Complications were common, with MI mobility reported by 92.2% and soft tissue damage by 57.8%. The midpalatal area was significantly associated with higher complication rates compared to other sites (p < 0.001). The success rates of MI usage ranged from 76% to 100% in 57.8% of respondents, with higher success rates being associated with infrazygomatic placements (p < 0.05). Conclusions: MI usage is prevalent among Romanian orthodontists, with experienced practitioners utilizing them more frequently. Despite high success rates, common complications highlight the need for improved insertion techniques and post-operative care. Further research and training are recommended to optimize MI application and reduce complication rates.

Background/Objectives: Orthodontic mini-implants have become indispensable in modern orthodontics due to their ability to provide absolute anchorage, independent of patient compliance. Our research aims to illustrate the versatility of mini-implants in addressing diverse biomechanical challenges across different planes of tooth movement (sagittal, transverse, and vertical) based on a retrospective clinical analysis. Methods: A retrospective analysis of orthodontic treatments performed with mini-implants (Dual Top and JS systems) was conducted, focusing on predefined biomechanical objectives and outcomes. The analysis encompassed distinct biomechanical applications, including incisor retraction and space closure using sequential direct and indirect anchorage; transverse and vertical correction of adult open bite through mini-implant–assisted rapid palatal expansion (MARPE) and molar intrusion; deep bite correction via simultaneous upper and lower incisor intrusion; and unilateral molar distalization using palatal skeletal anchorage. Results: Mini-implants provided stable, reproducible anchorage in all cases, enabling complex three-dimensional tooth movements with minimal side effects. Sequential reuse of the same mini-implants for both indirect and direct anchorage reduced treatment invasiveness and enhanced anchorage efficiency. Combined skeletal expansion and posterior intrusion allowed improved transverse and vertical control in adult open-bite presentations. Pure incisor intrusion was achieved without molar extrusion or incisor proclination, while unilateral molar distalization was effectively managed using palatal skeletal anchorage. Across all cases, mini-implants enhanced treatment efficiency, reduced the need for auxiliary appliances, and ensured predictable outcomes. Conclusions: Orthodontic mini-implants represent a highly versatile and minimally invasive anchorage system adaptable to a broad range of biomechanical situations. Their ability to provide stable, reusable, and site-specific anchorage supports efficient correction of complex malocclusions and reinforces their pivotal role in contemporary orthodontic practice.