Nonsurgical Treatment & Clinical Validity

Skeletal Anchorage- A Blessing or a Curse?
Birte Melsen

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