The development of temporary anchorage devices ( TADS) for use in orthodontics has increased the range of tooth movement possible without surgical intervention. TADS are a form of skeletal anchorage which, similar to headgear, can produce tooth movement and/or skeletal change without undesirable reaction forces on other teeth.
TADS are small screws, also called miniscrews or microanchorage, which can be inserted and are very well tolerated by most patients. Complications are rare. They are easily and atraumatically removed when no longer needed. Small bone plates, which are surgically placed beneath the alveolar mucosa with an orthodontic attachment extending into the oral cavity, are also temporary anchorage devices which have particular indications.
TADS have particular usefulness in adult treatment. Because adult patients are no longer actively growing, some orthodontic movements that can be accomplished in children are not possible in adults.
TADS provide the skeletal anchorage that makes these movements feasible.
Four major applications have been identified for skeletal anchorage in treatment of adults (ref: Proffit, Contemporary Orthodontics):
1. Intrusion of posterior teeth to close an anterior openbite; anterior open bite is frequently caused by excessive eruption of maxillary posterior teeth ( not infra-eruption of anterior teeth) and can sometimes be treated by posterior intrusion using TADS rather than surgery
2. Distal movement of maxillary molars (and the entire maxillary arch if needed)
3. Retraction and intrusion of protruding upper incisors
4. Positioning individual teeth when no other satisfactory anchorage is available
Recent research indicates a high success rate with TADS, as well as minimal discomfort for patients.
TADs are removed when they are no longer needed.
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