Skeletally-anchored miniscrews – the “game changer” for orthodontic treatment including space closure in patients with missing teeth | Prof. Dr. Dr. Bernd Lapatki | Tampere (22424)

Tavoite

• demonstrates how skeletally-anchored mini screws (TADs) facilitate orthodontic treatment of various tooth malpositions and malocclusions, and how TADs may increase the acceptance of adult patients for orthodontic treatment by using minimized fixed appliances alone or in combination with aligners.


• suggests decision paths for interdisciplinary treatment planning (i.e., orthodontic or prosthetic space closure, preservation of deciduous teeth or tooth transplantation) of missing lower second premolars or upper lateral incisors, and introduces basic rules for solving the problem of oligodontia. 

Sisältö

Introduction of skeletally-anchored mini screws – so-called temporary anchorage devices (TADs) – has tremendously expanded the possibilities of orthodontic treatment solutions. In the maxilla, TADs are mainly inserted into the palatal “T-zone” comprising the anterior palate and the region of the palatal suture. In the mandible, treatment of orthodontic problems is mainly assisted by interradicular TADs, while most approaches for orthopedic class III correction require so-called “bone anchors” attached in more basal locations of the maxilla and mandible. The paradigm shift in orthodontics linked to the application of skeletally-anchored appliances becomes particularly obvious in the treatment of patients with tooth aplasia. Studies report a prevalence of congenital agenesis of permanent teeth between 3.4% - 10.1% which means that orthodontists are relatively often concerned with this problem.

This one-day course covers a wide spectrum of problems confronting us orthodontists in daily clinical life, such as (isolated) distalisation and mesialisation of the buccal segments, palatal expansion, vertical correction of the occlusal plane, and movement of single teeth or small tooth segments without collateral movement of other teeth. The applied treatment mechanics comprise full labial or lingual multibracket appliances with supplementary skeletally-anchored components, or so-called “mini fixed appliances” consisting only of a few attachments and one or two TADs with connecting elements to the teeth.

A special focus of this course is directed on diagnostic and therapeutic aspects of tooth agenesis. Not only patient examples with TAD-supported orthodontic space closure are discussed and presented, but also the other possible treatment modalities – prosthodontic replacement, tooth transplantation or long-term preservation of corresponding deciduous teeth – are exemplified. For the most frequently missing teeth, lower second premolars and upper lateral incisors, decision paths are introduced and their application is illustrated by numerous patient examples to provide the clinician with clear and concrete recommendations for orthodontic and interdisciplinary treatment planning. Basic rules for the treatment strategy are also discussed for oligodontia cases.

The main goal of this one-day course is to demonstrate how the use of skeletal anchorage considerably facilitates (previously) more severe orthodontic problems and how easy it is to minimize the orthodontic intervention. This implies that TADs make orthodontic treatment easier to manage and control, shorten treatment duration and lead to a greater degree of acceptance for orthodontic treatment particularly among adult patients.