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Overcoming difficulties in class 2 correction with TADs in tuberosity and aligners. Susana Palma. Episode 81. June 2nd 2021

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Hosted by
Farooq Ahmed

Overcoming difficulties in class 2 correction with TADs in tuberosity and aligners. Susana Palma

 

Join me for Susana Palma’s lecture looking at an innovative way of using TADs

 

3 different ways of using TADs

  • Interradicular
    • Await until 6 achieves final position, if not the TAD can become mobile and proximity to roots
  • Outside the roots (Infrazygomatic)
    • Does not require awaiting for tooth root movement
    • Around 5mm from the roots
  • Tuberosity
    • 3 types of movement, intrusion, expansion, distalisation
    • Inserted into the space of the 8s
      • Extraction 3-6 months prior to placement

 

Indications of aligners and TADs

  • Class 2 molars in adults
  • Proclined lower incisors
  • Class 2 division 2 incisors: to facilitate torque upper incisors

 

Clinical tip

  • Change aligner rate depending on tooth movement
    • Molar distalisation : 1 week change
    • En mass / premolar distalisation – 10 day changes

 

Intrusion

  • Tuberosity TAD 12mm = above position of posterior teeth
    • Intrusive vector
    • Anticlockwise movement of mandible

Distalisation for 2 div 2 case

  • Distalisation – TAD behind posterior teeth 12 mm
    • 4-7 distalisation
      • Anterior bite turbo for disocclusion 2-2 or U3s
      • Palatal attachments upper 2-2 for anterior anchorage during posterior movement
      • Reciprocal anterior proclination – create overjet
    • After distalisation: Retract anterior teeth
      • Remove anterior bite turbos
      • Palatal root torque upper incisors
      • Class 2 elastics 22 hrs
      • 10 day change
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