Nonsurgical Treatment & Clinical Validity

Skeletal Anchorage- A Blessing or a Curse?

Birte Melsen

Birte Melsen graduated as a dentist from Aarhus University 1964, became a certified orthodontists 1971, Dr.Odont 1974 and Head of Department of orthodontics at the university of Aarhus Denmark i 1975. She retired from this position 2012 and is now affiliated with the University of West Australia Perth, NYU NewYork with the title of visiting Professor. From 1986-2020, she has been working part-time in a private practice in Lubeck, Germany (limited to adult orthodontics).She has authored more than 400 publications in the fields of growth and development based on research of human autopsy material, bone biology and clinical implant studies. In recent years her professional interests have focused primarily on the fields of Skeletal Anchorage, Virtual Imaging and Adult Orthodontic Treatment. In 2000 she received the Knighthood of Dannebrog 1st degree. She has received numerous awards; to mention a few: 1989 Recipient of the Louise Ada Jarabak Memorial International Orthodontic Teachers and Research Award, 1999 World SIDO prize, Rome, Italy, 1999. Recipient of the Ernest Sheldon Friel Memorial Award. 2009 Invited Presenter of the Northcroft Memorial Lecture. 2011 Recipient of the "Gloria" an honorary doctorate from the University of Krakow. Polen 2012 Recipient of the Ryu's Lecture Award, Coex Seoul, Korea, 2013 Recipient of the Brainerd F. Swain Award of Excellence, 2017 Recipient of the Frankel Award by the German Orthodontic Society Bonn Germany. 2018 Receiver of the Ketcham Award from the American Orthdodontic Association a AAO in Washington
E-mail: birte@melsen.com

Lecture Description

The skeletal anchorage, the TADs, were introduced in the nineties as a replacement of the "Zygoma ligatures" with surgical screws.

The blessing was that TADs made impossible treatments possible.They thereby widened the spectrum of orthodontics, but the curse was that they made careful biomechanical planning of appliances superfluous.

The blessing is that a distal molar relationship can be corrected by distalisation of the molar with TADs as Anchorage. The curse is that if the distal occlusion is of skeletal origin the molar will be moved distal to the "Key Ridge" and relapse following the treatment.

The blessing was that the TADs could be used as anchorage for arch widening of the maxilla. The curse was that long-term observation has demonstrated that the widening is not always compatible with the normal function.

The blessing was that TADS could be used as a semi-permanent replacement of missing teeth. The curse is that once removed, the alveolar bone will disappear if not replaced immediately with a dental implant.

It is often in situation of despair that a new invention is done. TADs are no exception. It was the increasing number of adult patients wanting orthodontics treatment as part of regeneration of a degenerated dentition that led to the need for a different anchorage and it was the surgeons idea to use a surgical screw which then became the "TAD"

Learning objective

to understand how TADs can be used as bone maintainers.
to avoid using TADS as standard anchorage