The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on mini/micro screw implantation for orthodontic anchorage.


This procedure is most commonly undertaken by orthodontists. Orthodontic mini- and microscrew systems have been developed from maxillofacial fixation techniques; they use mechanical retention for anchorage. They are small self-tapping titanium screws.

Under local anaesthesia a pilot hole is drilled into the maxilla or mandible and the screw is inserted through the bone cortex and into the alveolar bone using a screwdriver-like tool. More than one screw can be inserted if necessary.

Orthodontic loading can be achieved immediately after insertion, although it is often undertaken at a second visit. Following completion of the orthodontic treatment the screw(s) can be extracted and the incision site can be expected to heal spontaneously.

Coding recommendations

For insertion:

F14.6 Insertion of orthodontic anchorage

Includes: Insertion of orthodontic screw

Insertion of orthodontic mini screw

Insertion of orthodontic micro screw

For removal:      

F14.7 Removal of orthodontic anchorage

Includes: Removal of orthodontic screw

Removal of orthodontic mini screw

Removal of orthodontic micro screw