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
- 4-7 distalisation
