Orthodontic anchorage is the ability to resist unwanted reciprocalforces and reinforcement of anchorage by supplementary appliances,in or outside the mouth, is often needed to obtain successful results.In the last 10 years, interest in appliances that use implants has beengrowing.Successful orthodontic treatment demands effective methods andsystematic evaluation of different treatment approaches is thereforeessential. Several studies on the efficiency of various anchorage systemshave been published, but a critical appraisal or interpretationof evidence that systematically considers validity, results, and relevancehas not been made. Analysis of treatment modalities must alsoinclude patients’ perceptions and potential side-effects.The overall aim of this thesis was to evaluate a new anchoragetechnique that incorporates osseointegration and compare it withconventional methods concerning effects on tooth movements inadolescents and their acceptance and experience of the additionalsurgical procedures that osseointegration involves. The followinganchorage systems were analyzed: Onplant system, Orthosystemimplant, headgear and transpalatal bar.This thesis was based on four studies:Paper I systematically reviewed the efficiency of orthodontic anchoragesystems and interpreted the methodological quality of theselected studies from an evidence-based perspective. The literaturesearch spanned January 1966 – December 2004 and was later extendedto July 2007.