Temporary Anchorage Devices (TADs)
Advancements in orthodontics have allowed movements that were at one time thought impossible to become possible. Since their approval by the FDA in 2005, TADs have been widely used in orthodontics for several applications. TADs, sometimes called mini-implants, are very small screws made from titanium that can range from 6-12 mm in length and on average 1.5mm in diameter. Since they are very small they appear to be a small piercing in the mouth.
These small bio-compatible anchors are placed in your jawbone with topical anesthetic or sometimes local anesthetic. Only the gum where the TAD is being placed needs to be numb as the bone does not feel pain because there are no nerve endings. There maybe some pressure that is felt during placement and the procedure can be completed in about 1 min. The pressure eventually dissipates within a few hours to a few days.
The TAD itself does not move, but allows several types of tooth movement to be possible. For example they can be used to retract teeth, close large spaces, reduce gummy smiles, intrude teeth and help in palatal expansion for adults.
One way to visualize their use is to envision someone with severely protruding upper teeth. The orthodontist may recommend extraction of an upper tooth out on each side of the upper arch to create space for the upper teeth to be retracted back into the mouth. When closing the extraction sites, front teeth are pulled back against the teeth in the back of the mouth. The force that is placed causes the back teeth to move forward and the front teeth to move back. In this example, where you can’t afford to have the back teeth come forward because the protrusion will not be full corrected, then you need to have a mini-implant for additional anchorage to stabilize the back teeth to prevent them from moving forward.
When treatment with the TADs are completed, they are easily removed and often without anesthetic. Contrary to how the procedure may sound, it is minimally invasive procedure with significant benefits. If your orthodontist recommends a TAD as part of your treatment it is because they help deliver results that were once thought impossible. It may in certain circumstances negate the need for jaw surgery or extractions.
The benefits of TADs outweigh the risks. They have expanded the capabilities of clinicians and have allowed orthodontists to achieve more predictable outcomes. Embrace them if they are recommended as part of your orthodontic treatment.
