2014 AAO Winter Conf - Enhancing Anchorage in Adult Orthodontic Patients: Miniscrew (TAD’s) / Restorative/Prosthodontic Implants

Enhancing Anchorage in Adult Orthodontic Patients: Miniscrews (TAD’s)

The introduction of miniscrews in the last decade has significantly changed the way we treatment plan and execute mechanics in certain adult orthodontic patients. This presentation will describe mechanics associated with miniscrews to enhance anchorage in adult patients with missing posterior teeth, open and deep bites, collapsed posterior vertical dimension and canted occlusal planes. Case histories will be presented showing various stages of treatment.

Learning Objectives:

• Relate the type of adult patients who will benefit from miniscrews to enhance anchorage to achieve various tooth movements
• Analyze how direct and indirect anchorage can help achieve treatment goals with application of miniscrews in adult patients

Restorative/Prosthodontic Implants

The use of implants for anchorage in orthodontics has changed the way orthodontic treatment is planned and carried out – essentially a paradigm shift in managing the correction of dental malocclusions. Implants can provide anchorage to correct malocclusions in patients with debilitated dentitions that have compromised toothborne anchorage and/or require tooth movement that is not possible with conventional orthodontic mechanotherapy. These dentitions are typically characterized by having certain skeletal disparities that may have required orthognathic surgery in the past, multiple missing teeth with inappropriate spacing to facilitate prosthodontic treatment, periodontally compromised teeth, overerupted teeth, and/or lack of posterior support to maintain occlusal vertical dimension. Implants for orthodontic anchorage include two basic types of implants, those that are integrated with the surrounding bone and those that are not. Bone- or osseointegrated implants typically include cylindrically shaped implants that are normally used to replace missing teeth. Non-integrated implants, commonly known as temporary anchorage devices, typically include screws or screw-retained plates. This presentation will focus on the use of osseointegrated prosthodontic-type implants. The indications, use, advantages and disadvantages of these implants will be presented in some detail.

Learning Objectives:

• Illustrate the use of osseointegrated restorative/prosthodontic implants for anchorage to move teeth and facilitate corrections of malocclusions
• Plan for the use of osseointegrated restorative/prosthodontic implants for orthodontic purposes
• Recognize the advantages of osseointegrated restorative/prosthodontic implants over other types of implants for orthodontic anchorage