Development of modular systems with skeletal anchorage for hybrid treatment with clear aligners

The range of malocclusions treatable with aligners has expanded, yet complex cases still often require auxiliaries or skeletal anchorage to achieve predictable results. Temporary anchorage devices are often used at different stages of treatment to achieve distinct objectives, a practice that typically requires multiple appliances. This, in turn, increases treatment costs, prolongs therapy due to interruptions while awaiting new devices, and introduces additional clinical challenges. We propose and describe an alternative approach: a modular orthodontic system based on skeletal anchorage, designed to perform multiple movements within a single framework. This system allows for sequential activation of components as needed, without the need for appliance replacement. To illustrate its characteristics, advantages, and limitations, we present two clinical case reports.