In the world of Orthodontics much of tooth movement revolves around anchorage. The teeth that are larger in size usually govern the direction of movement. Though, the movement is directional each side moves towards each other, much like a tug of war contest with the participants wearing socks on a polished glass floor. For routine treatments this type of compensatory movement (anchorage loss) is predictable and well accepted. However, for some treatments that are very challenging and the movement needs to be in only one direction additional anchorage needs to be used.
Aside from using appliances such as Head Gear, TADs have been used to better treat those challenging or impossible cases. A TAD is an auxiliary device that is placed in either of the jaws for a period not longer than 1 year. It is an alloy made of titanium or stainless steel and is not reactive to the surrounding tissues.
Orthodontic Treatment Plans where a TAD would be indicated
- Molar Uprighting
- Intrusion of individual teeth or groups of teeth
- Long distance space closure(Anterior or Posterior directional movements)
- Skeletal discrepancies
- Occlusal cants
The purpose of using TADs is to provide a better outcome for very difficult malocclusions. It is not necessarily an auxiliary device that will shorten treatment times however, patients are more satisfied that their treatment plans were finished without compromise and their occlusion is excellent.
What to expect if a TAD is to be placed:
Local Anesthetic is required, topical gel and/or liquid is used typically. The entire procedure of placing the TAD takes approximately 1 minute. Pressure is felt but no pain is experienced. After placement patients note that mild pressure is experienced in the area for up to a day after. No active force is placed on the TAD until approximately 6 weeks have passed. During the time that the patient has the TAD they must be careful to keep their teeth clean and gums healthy, inflammation at site of a TAD usually equates to failure (TAD will become loose and may fall out).
TAD Removal :
Very simple; back TAD out in the reverse direction it was placed. Sometimes some anesthetic is needed but 90% of the time removal is painless and the patients are at ease and comfortable.