In orthodontic treatment, we are fortunate to have several different resources to address a variety of malocclusion. Since the 1980’s TAD’s (temporary anchor devices) were introduced as a tool in orthodontics. They allow us to use an anchorage system that widens the scope of treatment plans.
Similar to many other tools in orthodontics, TAD’s are primarily used with fixed appliances to facilitate different corrections. Direct or indirect anchorage setups can be combined with braces. In an aligner practice, the use of TAD’s also becomes an option and can serve to increase the ability of the orthodontist to setup patient care for success. Consider we can use the force systems and the strengths of a TAD, to enhance aligner therapy.
There are many options for integrating TAD’s with aligner systems. I am not an expert with them, but I want to share my experience in using this orthodontic tool to better serve patients. I have found TAD’s help broaden the range of applicability in complex, aligner treatment.
TAD’s can be placed and supported by elastics or chain to intrude posterior teeth in combination with an aligner system. Usually buccal and lingual TAD’s with elastics will support the intrusion. If lingual TAD’s are considered, add a significant amount of expansion to counteract the lingual component in the intrusion.
Pontics and TAD’s
The use of aligners allows for custom pontics to be placed in edentulous regions. This allows for the pontic and the aligners to be seamlessly integrated with a TAD supported, pontic crown. The temporary crowns can be used as an anchorage system to facilitate mesial or distal movement where insufficient posterior support is present.
Sometimes, the use of limited, fixed appliances are best suited for significant root movements or tooth translation. Segmental mechanics with a TAD supported appliance allows for challenging movements in localized areas. A TAD supported pontic with bracket segments can be used along side aligner therapy.
TAD’s and Power Arms
In some cases, tools available in the Invisalign system can be combined with TAD’s to broaden the range of movements. Power arms can be used to support significant mesial movements and root control in an otherwise challenging aligner force system.
These are but a few examples of the integration of TAD’s into aligner therapy. These tools offer many creative options when we allow our imagination to develop treatment plans for our patients.