Temporary Anchorage Device (TAD)

What is a temporary anchorage device (TAD)?

Temporary anchorage devices (TADs) or miniscrews are what an orthodontist uses as an anchor for braces. It helps move the teeth while patients are going through orthodontic care. The development of the TAD is one of the many important advances in the field of orthodontics that makes treatment more efficient and predicable.

Information about the temporary anchorage device (TAD).

TADs are made of a bio-compatible titanium alloy and act as miniature bone anchors which Dr. Danielle can painlessly insert into the mouth. This anchor is our leverage point and it’s how we can move teeth around. Before TADs, orthodontists who wanted to move specific teeth while keeping others still, or to achieve orthodontic movement in a mouth with missing teeth, had to rely on headgear or surgery.

Dr. Danielle placing a temporary anchorage device or TAD

Here, you can see a TAD in the patient’s back left and Dr. Danielle is placing another in the front.

Close up image of temporary anchorage device insertion

Here is an example of what one looks like on the palate (or roof of the mouth)

Temporary anchorage device on the roof of the mouth

Temporary anchorage devices are not a good recommendation for everyone, and in fact, only a small percentage of people will truly benefit from them. Please contact our office you would like to know more about TADs and how they can potentially assist in orthodontic treatment.

What does a temporary anchorage device cost?

Our fee varies depending the severity of the case. Sometimes they are fairly cheap because it makes the treatment so much easier but usually the mouths that need a TAD are difficult cases to treat and thus end up not being cheap.

Complications for a TAD?

Typically the only one we see is that the TAD comes loose.

Is the miniscrew insertion appointment painful?

The short answer is no. It is certainly much less than a tooth extraction that the TAD use is helping to avoid. Ganzer AngleOrtho 2016

What is a temporary anchorage device removal like? Does it hurt to remove a TAD?

Not much to say other than easy. It simply screws right out and we just use a little topical numbing gel in the area.

Research on the temporary anchorage device?

Reynders EBD 2017 found in their meta-analysis that the TAD is more effective than other types of anchorage reinforcement. Dual and single thread TADs have similar failure rates according to Durrani AJO 2017, which they found to be around 20%. However, others have success rate of over 90% and show some people are more prone to failures. Predictors of success include insertion torque and cortical bone thickness, as well as testing devices like the Periotest.

Class III malocclusion correction with TADs

This is one of the most exciting uses for a TAD. Jing 2013 AJO-DO Some will extract a lower second molar to aid in the process. Chen 2015 AJO-DO. The use of TADs is preferable in high-angle, long-face patients but Class III elastics for low-angle short face patients. Nakamura AJO 2017

Anterior intrusion with TADs

The ideal positioning according to McGrath 2018 AJO-DO is distal to canines, although it will depend on tissue and bone availability.

Ideal placement for TAD use for anterior intrusion.

Correction of AOB with temporary anchorage devices

We have an entire page on AOB corrections.

Exposure of impacted canines with a TAD

We have an entire page on impacted canines as well. Lee AJO 2017

Herbst treatment reinforced with miniscrews

Herbst appliance works better with miniscews but there is a high failure rate of 30%,according to Manni AJO 2019 . We find that to be too much of a hassle for the benefit.

Molar intrusion with TADs

This is often an AOB case as well but not always. This Kato AJO-DO 2018 case is both AOB and molar intrusion case.

Molar uprighting with orthodontic miniscrews

Magkavali-Trikka Prog Ortho 2018 shows in the systemic reviews that this works but the single fore may not be sufficient in some cases.

MARPE or miniscrew assisted rapid palatal expansion

We use MARPE in more stubborn cases where we need a lot of expansion or the bone is more resistant to change like in adults. In the MARPE protocol we use 4 TADs along with a palatal expander to expand the upper jaw. This procedure is also seen as MARME in the literature.

Buccal shelf temporary anchorage device placement

Ideal placement is adjacent to the distobuccal cusp of the second molar Elshebiny AJO-DO 2018. This finding is also what Chang shows.

Cool TAD cases found online

TAD lower molar case of uprighting TAD case of lower molar treatment