Implants and Ortho (Bibona)

Question 1

What are some reasons why Temporary Anchorage Devices (TADs) have become popular?

Answer 1

1. Commercial availability
2. Ease of placement
3. Lack of patient cooperation
4. Possibility of achieving better anchorage control during mechanotherapy

Question 2

What is the term for resistance to unwanted tooth movement. With respect to ortho, it is the resistance to reaction forces that is provided by other teeth, by the palate, head or neck, and by anchors screwed to the jaws?

Answer 2

Anchorage

Question 3

Which one of Newton’s Laws does Anchorage seek to minimize?

Answer 3

Newton’s 3rd Law: for every action there is an equal and opposite reaction

Question 4

What is an important aspect of orthodontic treatment with respect to tooth movement?

Answer 4

Maximize desired tooth movement while minimizing undesirable side effects

Question 5

What is central to achieving ideal overjet and overbite correction?

Answer 5

Anchorage control

Question 6

What type of anchorage are Temporary Anchorage Devices (TADs) used for ?

Answer 6

Stationary or absolute anchorage

Question 7

The stationary / absolute anchorage of TADS is synonymous with what?

Answer 7

Skeletal anchorage

Question 8

What is the type of anchorage where the TAD receives reactive forces of a moving tooth / teeth?

Answer 8

Direct anchorage

Question 9

What is the type of anchorage where the TAD is connected via a bar or a wire to a stabilized tooth, which receives the reactive forces of tooth movement?

Answer 9

Indirect anchorage

Question 10

TADs can be used to do what to posterior teeth?

Answer 10

Protraction of posterior teeth

Question 11

TADs can be used to do what to anterior teeth?

Answer 11

Retraction of anterior teeth to distal

Question 12

What is the stability of TADs based on: mechanical retention or osseointegration?

Answer 12

Mechanical retention

Question 13

Do TADs osseointegration?

Answer 13

No

Question 14

What is the max torque a TAD is placed with?

Answer 14

5-10 Ncm torque. Any more than that causes compression necrosis.

Question 15

What are 4 things affecting TAD stability?

Answer 15

1. Thickness of cortical bone
2. Implant design
3. Implant site preparation
4. Insertion torque

Question 16

How much cortical bone is needed for TAD stability?

Answer 16

1-2mm

Question 17

What are 3 considerations for the location of a TAD?

Answer 17

1. Root proximity
2. Cortical bone thickness
3. Gingival type

Question 18

Where do they think the TAD is best placed with respect to the gingiva?

Answer 18

Mucogingival junction

Question 19

What are 3 things to determine with respect to biomechanics considerations before placing TADs?

Answer 19

1. Desired tooth movement
2. Desired force system and its equilibrium
3. Side effects on the teeth and the anchorage system

Question 20

What are 5 indications for TADs (5 tooth movements)?

Answer 20

1. Intrusion of maxillary teeth
2. Distalization of molars and groups of teeth
3. Canine retraction and intrusion retraction mechanics
4. Anterior open bite correction
5. Molar protraction and maximum anchorage

Question 21

What ortho can be done if there is a supererupted maxillary molar decreasing area for mandibular restoration?

Answer 21

Molar intrusion

Question 22

What must be considered when intruding a tooth with respect to bone levels?

Answer 22

Surrounding bone levels. Want it higher with the tooth to avoid causing a perio defect as the tooth intrudes and takes bone with it

Question 23

How many TADs are placed to intrude a tooth?

Answer 23

Two (one on each side). Buccal plate attached to zygomatic buttress and one in the palate.

Question 24

What would happen if only a TAD was placed on the buccal?

Answer 24

Would only tip the molar in that direction

Question 25

With respect to resistance where should the TAD be placed for molar intrusion?

Answer 25

At the center of resistance

Question 26

Will there be some relapse after molar intrusion?

Answer 26

Yes, so sometimes go a little further than needs.

Question 27

If you an have anterior open bite patient with anterior crowding and want to level and align them first with ortho, where is the only way for the teeth to go?

Answer 27

Flare out, therefore the open bite opens a bit more.

Question 28

What is another way to close an anterior open bite?

Answer 28

Place a transpalatal arch and a buccal TAD to intrude the maxillary molars

Question 29

What is the purpose of the TPA when closing an anterior open bit with TADs by intruding the maxillary molars?

Answer 29

Aides the intrusion and stops the buccal tipping

Question 30

How does using a TPA and a Buccal TAD close an anterior open bite?

Answer 30

Intrudes the molars lowering the maxillary occlusal plane, causing the mandible to rotate up, which closes some of the distance to the maxillary anteriors

Question 31

How will an anterior open bite closing be finished after the maxillary molar instrusion via TPA + Buccal TAD?

Answer 31

Some anterior extrusion to close

Question 32

What is the force system in a buccal TAD?

Answer 32

The force is intruding apically. The system is buccal to the center of rotation, so the tooth will roll buccally as it intrudes. That is why you place a palatal TAD or TPA.

Question 33

For every ___ mm of molar intrusion you get a ___ mm of closure in the anterior open bite?

Answer 33

``` 1mm intrusion 2mm closure (or 2mm increase in overbite) ```

Question 34

What is a problem with molar protrusion (bringing molars anterior) especially if it is a unilateral molar protrusion?

Answer 34

Shift of the midline towards side being protracted. Opposite arch problems for the arch that is used as anchorage to protract the opposite molar.

Question 35

What is the TAD for molar protraction a good choice?

Answer 35

It saves the midline

Question 36

Protrusion of molars uses what type of anchorage: direct or indirect?

Answer 36

Direct, the TAD receives all the force to move the molar forward

Question 37

How could indirect anchorage be used to protract a molar?

Answer 37

Attach a group of anterior teeth to the TAD, then use this stabilized group of anterior teeth as the anchorage that protracts the molar (the anteriors are protected from midline shift because their anchorage is the TAD)

Question 38

How can asymmetric space closure be accomplished with TADs?

Answer 38

With simultaneous protraction and retraction.

Question 39

What are 2 things that TADs provide?

Answer 39

1. Maximum anchorage | 2. Ability to do asymmetric mechanics

Question 40

TADs are based on principles of what?

Answer 40

Biomechanics