TADs- Keeping it simple while being successful Sebastian. AAO June 2021. Episode 113

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Farooq Ahmed

1 TADs: Keeping it simple while being successful Sebastian Baumgaertel


·      Insertion torque

o   Ideal 5-10Ncm Baumgaertel 2010

o   Ideal thickness cortical bone 0.5-1.5mm

o   Success

§  Avoid areas of very thin area

§  Pre-drill in thick bony area


·      Insertion where site not ideal:

o   Tissue punch – for mobile mucosa

o   Cortical bone perforation 1.5-2.5mm

o   Cortical bone pilot hole 2.5mm+ (pre-drill)



Simplification TAD placement


1.     Target sites – no implant insertion preparation

·      Ideal bone 1.5mm cortical bone

·      Ideal root clearance

·      Maxilla buccal

o   6mm from crestal bone

o   Located at mucogingival junction 1-2 mm apical from junction


1.     Palatal

o   Parasagittal around 4-5 area: Baumgaertel 2009, same site Wilmes 2016 using 3rd palatal rugae

Avoiding roots

2.     Minimal interradicular distance

o   Size of TAD + 2 x SD – (0.5mm Lioni’s study)

o   =1.6mm + 1mm = 2.6mm


Hierarchy sites

1.     Sites lacking roots – buccal shelf / anterior palate

2.     Site naturally diverging roots – Palatal alveolus

3.     Site requiring diverging roots – orthodontic divergence of roots




·      AOB

o   TAD palatal between 6-7 with powerchain from palatal TAD to molars

o   TPA – 5mm clearance from palate

o   Biomechanic effects

§  Centre of rotation of maxilla between 3-4, therefore rotation of maxillary plane = posterior intrusion and anterior clockwise rotation

·      MARPE

o   Sebastian’s own design

·      AOB – failure

o   Palatal TADs between 6-7

o   Thick mucosa, overgrew


·      Intrusion of 1 tooth when over-erupted U6

o   Sectional appliances buccal

o   Palatal TADs x 2 rigid fixation to U7, U5

§  = Intrusion of U6 without buccal rolling of tooth – published AJODO




Temporary Anchorage Devices textbook Jae Hyan Park

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