Friday, April 02, 2010

TADs, Temporary Anchorage Devices in Orthodontics











In orthodontics we move teeth with basic mechanics. When you push on something (a tooth), you have to pull on something else. You "brace" yourself against a stronger object. When you are moving teeth, the thing you brace against is called the anchor-you know, like an anchor on a boat. Most of the time, anchorage is achieved by placing one force against a small tooth that you are trying to move, against another large tooth (or several teeth tied together, the "anchor"). The small tooth moves a whole lot more than the anchor. There are several instances in orthodontics where this anchorage is an elusive thing to acheive. TAD means Temporary Anchorage Device. These are basically very small screws inserted into bone. The TAD does not move, the tooth then can be moved against this fixed point. TADs are removed when they are no longer needed.

Wait, a screw? in bone? Ouch! doesn't that hurt? Well, --no. We even tried this on each other before using it on patients. Topical anesthetic does great for placement. Here is one of our docs with a TAD in place:


29 comments:

Anonymous said...

Without the braces it almost looks like a piercing. You guys may be trendsetters! :) Great post!

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Dr. Dean Brandon said...

Does look kind of "rad" doesn't it. I'd rather see a TAD in place for good reason than a pierced tongue stud for no good reason.

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Cosmetic Dentists Chandler said...

LOL, I can't imagine using RAD nowadays. But yeah, it does look cool.

endodontic dentist ohio said...

Hey that is so painful. But its better to get your teeth in level.

Dr. Dean Brandon said...

Actually it is not painful at all. with a littel topical anesthetic placement of a TAD is easy.

Anonymous said...

how much does it cost?

Dr. Dean Brandon said...

In our office this does not cost the patient anything additional. It's just part of the overall treatment. I do not know off hand how much it "costs" the dentist to get the devices and training, but I think no more than any other orthodontic device.

Joel said...

I think, invisalign braces are good because it looks more natural unlike the ordinary braces. Unfortunately not all people are candidates for invisalign. Before availing this dental services, you have to ask your trusted dentist if invisalign fits your dental needs.

In Chicago, dental implants and porcelain veneers (Chicago) are very popular dental services. Although those services are popular in making your teeth look more beautiful, I still asked my dentist if one of those services will fit my dental needs. I lost a tooth last year because of an accident. I want to replace my lost tooth and also I want to have whiter teeth. Maybe I can't avail those services at the same time but maybe one of them will fit my dental needs.

Pamela Waterman said...

Can you provide any references to read about success rates for permanently closing an open bite with the use of TADs?

Dr. Dean Brandon said...

I'll try for an article, but here is aquick answer from our orthodontist:
A. Depends on severity. More open=worse prognosis
B. Depends on etiology. Is it resolved? Large tongue, forward tongue posture/thrust, airway, etc. If the etiology is not resolved, then will recur no matter how you treat the symptom.
C. Too early to say "permanently" because TAD's have only been around maybe 10-15 yrs. Takes time to get #'s of patients for significance, treatment time, then long-term follow up.

Dr. Dean Brandon said...

When discussing this topic in Current Therapy in Orthodontics , Ravinda Nanda states, "Some treatment alternatives are innovative and promising, but the ability to establish true stability remains unclear. Future studies using these new devices will reveal this truth."

lorena said...

Dear Dr. Brandon, after removing a TAD from the place where it was install before, how is the cicatrization process, could be the possibility to be a hole in the area that was placed?
Is Ok to use for and open bite?

Dr. Dean Brandon said...

When TADS are removed the area heals back rapidly without any problem or residual effect. Open bites are difficult to treat. TADs may be of some use, but are not a panacea. I will have to check with our orthodontist if they use them much for that. I do know they use them for certain kinds of tooth movements that otherwise would be quite difficult.

Cristina said...

Hello. Lorena, yes when TAD is removed a hole is left but it'll close within a few days. I already had 2 and I had no problems with them. When you say it doesn't hurt, it's not exactly like that. My first one hurt so badly I couldn't even sleep because if I touched I felt an excruciate pain. After that one i put one more and it hurt less. Then I got those to out and put 3 more and they didn't hurt at all.

orthodontics las vegas said...

Pediatric dentists are also capable of repairing cavities and tooth decay in children and dealing with oral conditions that are caused by certain medical conditions including diabetes and congenital heart defect.

Anonymous said...

What are the risk if TADs are reccommended and not opted for? Is it purely cosmetic?

Dr. Dean Brandon said...

TADs are nearly another tool for tooth movement. Primarily for anchorage. Tads are usually used when other methods are not possible or are difficult. So, I suppose the risk is you can't move the teeth like you want to.

Anonymous said...

To claify the question about the risk. My son's orthodonist is using them because he says that his distance between his eyes on the left and right hand sides of his mouth is uneven. Is this a different application?

Anonymous said...

Further detail on question regarding risk. The way the orthodontist explained it to me was that they are using the TAD's because my son's L and R sides do not line up even with his L and R eyes. It seemed to be in addition to his braces. Also my dentist doesn't perform this and is sending up to an oral surgeon...so is this done before braces, during or after?

Dr. Dean Brandon said...

TADS can be used for various applications. It is like a fixed post which you can use to anchor something else or to push or pull against.

Anonymous said...

I had this done. The first screw didn't hurt. I just felt pressure. However, by the time my ortho got to the second one, the anesthetic wore off and I felt everything. It was so painful I was crying. So just be sure that the anesthetic is still working before starting to put in the next screw.

Nancy Tipa said...

I had about 5 of them. Mostly he gives me a shot of anasthetic. Last time I asked him not to. I lived, but I am still worried that the last one damaged my tooth. It hurts to bite and i felt he screwed it into something hard. Would I have felt if he screwed it into the root? (Only topical anasthetic)

Dr. Dean Brandon said...

These devices are no where near anything that should cause a long term problem.

anna Redwood said...

I have had my tads in for over a week, my problem is that mine are on the roof of my mouth, and my tongue is scraping up against it causing it to bleed. I put wax on it but it only stays on for a few minutes before it falls off!

Desiree Coronado said...

My teeth are really straight and all adult. I lost half of my 2nd premolar because of a no crown from a root canal (right hand side). Should I get a TAD?

Dr. Dean Brandon said...

I cannot say, but check with your orthodontist.

Anonymous said...

I might have to get a TAD but I'm scared and I don't want to get a injection or a TAD what should I do