Temporary anchorage devices (TADs) .pptx

Temporary anchorage devices (TADs) in orthodontic. The goal of anchorage in orthodontic is to maximize desirable movement and minimize undesirable movement.

1. Temporary Anchorage devices (TADS)

2. INTRODUCTION Anchorage is defined as the nature and degree of resistance to displacement offered by an anatomic unit when used for the purpose of affecting tooth movement

3. Temporary anchorage device (TAD) is one that is placed on the bone for a limited amount of time in order to improve anchorage in one of two ways: (i) by providing support for the teeth of the reactive unit (indirect anchorage) or (ii) by eliminating the need for the reactive unit (direct anchorage), and is then removed. TEMPORARY Anchorage devices

4. Orthodontic mini-implants are smaller in dimensions compared to prosthetic dental implants.

5. COMPONENTS OF TADS Head Neck Screw Part

6. he former are placed closer to the roots of the teeth. Intra-radicular placed further away from the roots in the infra-zygomatic regions of the maxilla and the BS regions of the mandible. Extra-radicular

7. INDICATION Indications include absolute anchorage in case of high angle backward maxillary plane (BMP), failed headgears, cases of missing teeth, first molars, difficult tooth movements, anterior/posterior intrusion, en masse distalization of U/L arches, molar uprighting, molar distalization, adult orthodontics, orthopedic traction.

8. CONTRAINDICATION In cases of systemic bone illnesses and other medically compromised states Patients under the age of 12 Mini-screws shouldn't be used in regions where the bone is reshaping itself, such as a mending socket or around a baby tooth. Mini-screws cannot be placed in bone with a cortical thickness of less than 0.5mm.

9. CLASSIFICATION Length: TADs range from 4 to 12 mm in length, (small, medium, or large). Diameter: TADs exhibit diameters of 1.15 to 2.5 mm, (small, medium, or large). Implant Size Classifications Mini-screw length is determined by buccolingual/buccopalatal dimensions of the alveolus or nasopalatal thickness of the palate, whereas the amount of interradicular bone available determines mini-screw diameter.

10. Head Type Classifications Small head Long head Circle head Fixation head Bracket head Hook head

11. Self-drilling: Self-drilling TADs incorporate a drill bit and can penetrate bone without pre-drilling. Self-tapping: Self-tapping TADs create threads as they are inserted, aiding in stable fixation. Screw Type Classifications

12. Thread-forming: Thread-forming TADs shape bone as they are inserted, optimizing implant stability. Thread-cutting: Thread-cutting TADs engage with bone threads to enhance anchorage.

13. TAD PLACEMENT PROTOCOL Intraoral radiographs of the prospective mini-screw site(s) After sterilizing the area, a local anesthetic is administered to ensure the patient's comfort. Using precise instruments, the orthodontist then inserts the TAD into the selected location, ensuring stability and proper positioning to facilitate the desired orthodontic mechanics.

14. INSERTION SITES

15. Buccal Shelf It is located between the roots of the maxillary first molar and the second molar. This site provides good stability.

16. Infra zygomatic crest (IZC)

17. Palate The palate, specifically the mid-palatal area, is another insertion site for TADs. It is particularly useful in cases where additional anchorage is required for the upper teeth.

18. Interdental Bone Interdental bone, between the roots of the teeth, provides a stable site for TAD placement. It is often utilized for intrusion, extrusion, or correction of tooth angulation.

19. CLINICAL APPLICATIONS Anterior Intrusion Positions of Implants for Direct Intrusive Force Application

20. Posterior Extrusion Occlusal Cant Correction

21. Maxillary orthopedic expansion Asymmetric Transverse Control

22. Anterior Extrusion

23. Posterior Intrusion Molar Intrusion

24. Immediate failure as loosening during the initial healing phase, improper insertion sites, rare cortical bone, recent extraction sockets, redundant overlying soft tissue, improper handling-wobbling, CHALLENGES AND FAILURES

25. Root damage if occurs then removal of the mini-screw should be done. Periodontal ligament (PdL) contact may not cause discomfort or pain.

26. Mini-screw fractures are more likely to occur when the diameter of the mini-screw is less than 1.5 mm.

27. THANK YOU Dr. Asawer Ahmed Fayyad