The surgical-orthodontic approach is the most commonly used modality in patients with impacted teeth. It is also the most challenging. The prognosis of treatment is uncertain, treatment takes much longer and is more painful, and the enhanced biomechanical efforts required to bring the tooth to its ideal position frequently cause deleterious side effects to the remainder of the dentition. Skeletal anchorage is a useful aid in these cases. It can be judiciously exploited to assess the prognosis of canine movement, open adequate space for the canine, and build up a reliable anchorage unit that will allow the application of controlled directional forces with fewer side effects on the anchorage teeth. Treatment is facilitated and shortened because the resolution of the impaction may be performed separately before or even simultaneously with treatment of the remainder of the dentition, as 2 distinct force systems. The present article reviews some of the main indications for implant anchorage in treatment of impacted teeth.