Posts for tag: tads
As a basic orthodontic appliance, braces are what allows us to move teeth into better positions to improve a person’s bite. In certain cases, though, this treatment application gets a little assistance from Temporary Anchorage Devices (TADs) to improve accuracy and reduce treatment time.
Braces take advantage of our teeth’s natural ability to move. Teeth are held in place within the bone by the periodontal ligament, an elastic tissue that attaches to the teeth with microscopic fibers secured by a hardened substance called cementum. The periodontal ligament is constantly remodeling in response to changes in the mouth. As pressure is placed on a tooth, new bone, ligament and cementum are formed on the “pulling” side of the tooth; on the other side, the bone and ligament dissolve (resorb), allowing the tooth to move in that direction.
Braces allow this natural process to occur with controlled forces applied by thin flexible wires threaded through the small brackets attached to the front of the teeth and then affixed or “anchored” to other teeth. By attaching the teeth to the other teeth by wires running through all the brackets, “anchorage” is created to allow teeth to be moved where the dentist wants them to go. By adjusting the tension on the wires, we can apply light but constant pressure on the “unanchored” teeth to move them into a new desired position.
Teeth we do not want to move are referred to as the anchorage for teeth we do want to move. If, however, the situation calls for more precise isolation of teeth to be moved, TADs can be very useful. TADs are mini-implants imbedded in the bone to serve as anchorage at strategic locations in the mouth. In this way, the group of teeth to be moved receives forces that are applied through the additional anchorage provided by the TADs. That “tension” or “pressure” is applied only to them and not to adjacent teeth that should not move. This increases efficiency for tooth movement and helps reduce the treatment time.
TADs can be placed using local anesthesia and with little discomfort, and are removed when orthodontic treatment is completed. Although the procedure is pretty straightforward, it does require collaboration between orthodontist and surgeon to ensure correct positioning.
In the end, TADs increase our ability to control the forces that move teeth during orthodontic treatment. This lessens discomfort for the patient and helps ensure the end result — a more functional bite and a transformed smile.
If you would like more information on the use of TADs and other orthodontic appliances, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are TADs?”
Orthodontics shares a principle with the classic tug of war game: if you want things to move in the right direction you need a good anchor. Anchors help braces and other appliances apply constant pressure to misaligned teeth in the direction they need to go to correct a malocclusion (poor bite).
Orthodontic treatments work in cooperation with an existing oral mechanism that already moves teeth naturally in response to biting forces or other environmental factors. The key to this mechanism is an elastic tissue known as the periodontal ligament that lies between the tooth and the bone. Besides holding teeth in place through tiny attached fibers, the ligament also allows the teeth to move in tiny increments.
Braces’ wires laced through brackets affixed to the teeth exert pressure on them in the desired direction of movement –the periodontal ligament and other structures do the rest. To maintain that pressure we need to attach them to an “anchor”—in basic malocclusions that’s usually the back molar teeth.
But not all malocclusions are that simple. Some may require moving only certain teeth while not moving their neighbors. Younger patients’ jaws and facial structures still under development may also need to be considered during orthodontic treatment. That’s why orthodontists have other anchorage methods to address these possible complications.
One example of an alternate anchorage is a headgear appliance that actually uses the patient’s skull as the anchor. The headgear consists of a strap running around the back of the head and attached in front to orthodontic brackets (usually on molar teeth). The pressure it exerts can trigger tooth movement, but it can also help influence jaw development if an upper or lower jaw is growing too far forward or back.
Another useful anchorage method is a tiny metal screw called a temporary anchorage device (TAD) that is implanted into the jawbone above the teeth through the gums. Orthodontists then attach elastic bands between implanted TADs and specific braces’ brackets or wires to exert pressure on certain teeth but not others with pinpoint accuracy. After treatment the TADs can be easily removed.
Using these and other appliances allows orthodontists to customize treatment to an individual patient’s particular malocclusion. With the right anchor, even the most complex bite problem can be transformed into a beautiful and healthy smile.
If you would like more information on orthodontic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontic Headgear & Other Anchorage Appliances.”