Temporary anchorage devices in orthodontics

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For technical assistance: email expertconsult.help@elsevier.com call 1-800-401-9962 (inside the US) call +1-314-447-8200 (outside the US) Use of the current edition of the electronic version of this book (eBook) is subject to the terms of the nontransferable, limited license granted on expertconsult.inkling.com Access to the eBook is limited to the first individual who redeems the PIN, located on the inside cover of this book, at expertconsult.inkling.com and may not be transferred to another party by resale, lending, or other means 2015v1.0 Temporary Anchorage Devices in Orthodontics This page intentionally left blank       Temporary Anchorage Devices in Orthodontics SECOND EDITION Ravindra Nanda, BDS, MDS, PhD Professor Emeritus Division of Orthodontics Department of Craniofacial Sciences School of Dental Medicine University of Connecticut Farmington, Connecticut, USA Flavio Uribe, DDS, MDentSc Burstone Professor of Orthodontics Graduate Program Director Division of Orthodontics Department of Craniofacial Sciences School of Dental Medicine University of Connecticut Farmington, Connecticut, USA Sumit Yadav, DDS, MDS, PhD Associate Professor Division of Orthodontics Department of Craniofacial Sciences School of Dental Medicine University of Connecticut Farmington, Connecticut, USA © 2021, Elsevier All rights reserved First edition 2009 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations, such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein) Notices Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein Because of rapid advances in the medical sciences, in ­particular, independent verification of diagnoses and drug dosages should be made To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein ISBN: 978-0-323-60933-3 Content Strategist: Alexandra Mortimer Content Development Specialist: Kim Benson Project Manager: Beula Christopher Design: Patrick Ferguson Marketing Manager: Allison Kieffer Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 Contents Preface, vii Part IV:  Skeletal Plates Contributors, ix 8 Nonextraction Treatment of Bimaxillary Anterior Crowding With Bioefficient Skeletal Anchorage, 89 Acknowledgements, xiii Dedication, xv Part I: Biology and Biomechanics of Skeletal Anchorage 1 Biomechanics Principles in Mini-Implant Driven Orthodontics, Madhur Upadhyay and Ravindra Nanda Part II:  Diagnosis and Treatment Planning 2 Three-Dimensional Evaluation of Bone Sites for Mini-Implant Placement, 23 Aditya Tadinada and Sumit Yadav 3 Success Rates and Risk Factors Associated With Skeletal Anchorage, 29 Sumit Yadav and Ravindra Nanda Junji Sugawara, Satoshi Yamada, So Yokota and Hiroshi Nagasaka 9 Managing Complex Orthodontic Problems With Skeletal Anchorage, 109 Mithran Goonewardene, Brent Allan and Bradley Shepherd Part V:  Zygomatic Implants 10 Zygomatic Miniplate-Supported Openbite Treatment: An Alternative Method to Orthognathic Surgery, 149 Nejat Erverdi and Çağla Şar 11 Zygomatic Miniplate-Supported Molar Distalization, 165 Nejat Erverdi and Nor Shahab Part III:  Palatal Implants Part VI: Buccal TADs and Extra-Alveolar TADs 4 Space Closure for Missing Upper Lateral ­Incisors, 35 12 Managing Complex Orthodontic Tooth Movement With C-Tube Miniplates, 183 Bjöern Ludwig and Bettina Glasl 5 Predictable Management of Molar ThreeDimensional Control with i-station, 43 Yasuhiro Itsuki 6 MAPA: The Three-Dimensional Mini-Implants-­ Assisted Palatal Appliances and One-Visit ­Protocol, 61 B Giuliano Maino, Luca Lombardo, Giovanna Maino, Emanuele Paoletto and Giuseppe Siciliani 7 Asymmetric Noncompliance Upper Molar ­Distalization in Aligner Treatment Using ­Palatal TADs and the Beneslider, 71 Benedict Wilmes and Sivabalan Vasudavan Seong-Hun Kim, Kyu-Rhim Chung and Gerald Nelson 13 Application of Buccal TADs for Distalization of Teeth, 195 Toru Deguchi and Keiichiro Watanabe 14 Application of Extra-Alveolar Mini-Implants to Manage Various Complex Tooth Movements, 209 Marcio Rodrigues de Almeida Part VII: Management of Multidisciplinary and Complex Problems 15 Management of Skeletal Openbites With TADs, 223 Flavio Uribe and Ravindra Nanda v vi Contents 16 Orthognathic Camouflage With TADs for Improving Facial Profile in Class III Malocclusion, 243 Eric JW Liou 17 Management of Multidisciplinary Patients With TADs, 263 Flavio Uribe and Ravindra Nanda 18 Second Molar Protraction and Third Molar Uprighting, 283 Un-Bong Baik 19 Class II Nonextraction Treatment With MGBM System and Dual Distal System, 295 B Giuliano Maino, Giovanna Maino, Luca Lombardo, John Bednar and Giuseppe Siciliani 20 Anchorage of TADs Using Aligner Orthodontics Treatment for Lower Molars Distalization, 305 Kenji Ojima, Junji Sugawara and Ravindra Nanda Index, 321 Preface The new millennium brought about a new era in orthodontics with the advent of temporary anchorage devices (TADs) The realm of possibilities to correct malocclusions that in the past were only treatable by means of orthognathic surgery was made available in a cost-effective manner through the insertion of small screws and miniplates during orthodontic treatment Clinicians quickly became interested in adopting this new approach in their patients, and precise indications for the use of skeletal anchorage started to shape up The first edition of Temporary Anchorage Devices in Orthodontics, which was compiled in the early days of skeletal anchorage, was a very timely book that introduced many aspects of this new approach The chapters of this first book described the use of miniplates and screws with emphasis on the multiple locations of placement in the maxilla and mandible and a myriad of screw systems and appliances The biomechanics involved with new skeletal anchorage orthodontic adjuncts was described in detail, with many case reports illustrating the expanded possibilities to correct complex malocclusions and enhance smile esthetics Approximately a decade has transpired since the first edition, and significant refinements to the techniques and appliances have been developed In this second edition, we wanted to highlight these advances described by multiple authors that had been at the forefront of skeletal anchorage era since the early days The first chapters in this edition review the biology and interaction of the titanium hardware and bone and the basic biomechanic principles that apply when using skeletal anchorage The application of space closure, distalization, and overall molar control form palatal appliances is described in depth with different approaches Later in the book, the versatility of miniplates and infrazygomatic mini-implants is presented by multiple authors managing cases of significant complexity Finally, the management with skeletal anchorage of anteroposterior and vertical problems, such as the management of the Class III malocclusion, second molar protraction, anterior openbite correction, and the mechanical advantages of TADs in multidisciplinary patients, are described A very interesting development in skeletal anchorage presented in this new edition is the integration of threedimensional (3D) technologies for the placement of miniimplants and the fabrication of TAD-supported appliances With the advent of 3D-printing, precise palatal appliances are now available as described in this book with the MAPA appliance Overall, this new approach sets a trend where the application of 3D-printing facilitates the insertion of miniimplants and the delivery of appliances in a single visit in a very precise and predictable manner Another novel and interesting approach is the combination of clear aligner therapy with skeletal anchorage Clear aligners are increasingly becoming the elected orthodontic appliance by adults, and a tightly coupled synergy with TADs for the treatment of more complex malocclusions in patients demanding nonvisible appliances is described in this book We want to thank all the contributors who have invested time and effort to advance our knowledge regarding skeletal anchorage We also appreciate the contributions of numerous individuals who are not part of this book but who have influenced all of us with their scientific publications We hope you will enjoy reading it, and various methods of skeletal anchorage usage shown will help in efficient treatment of patients Ravindra Nanda Flavio Uribe Sumit Yadav Farmington, Connecticut, USA vii This page intentionally left blank       Index Distalization of dentition using loop mechanics, 44, 48f and intrusion using loop mechanics, 56f of mandibular molars, in skeletal III, angle class III case, 200–202 diagnosis of, 200–201, 200f, 201t retention of, 202, 203f superimposition of, 202, 203f treatment plan of, 201 treatment progress of, 201, 202f treatment results of, 201, 202f of maxillary and mandibular molars in skeletal II, angle class II bimaxillary case, 203–207 diagnosis of, 203, 204f, 204t retention of, 206, 206f superimposition of, 206–207, 206f treatment plan of, 205 treatment progress of, 205, 205f treatment results of, 205–206, 205f of maxillary molars in skeletal II, angle class II case, 197–200 diagnosis of, 197, 197f, 198t retention of, 199, 199f superimposition of, 199–200, 200f treatment plan of, 197–199, 198f treatment progress of, 197 treatment results of, 197–199, 199f in mini-implant assisted retraction, 16–17, 17f retention of of mandibular molars, 202, 203f of maxillary molars, 197–200, 199f using i-stations, 57f Distalizing molars biomechanics in, with buccal TADs, 195–196, 196f methods of, 195 by TADs, 195 stability of, 196–197 treatment outcome of, 196 Dual distal system, 301–302, 302f–303f Dynamics, E Eccentric force, Edentulous span, 270–273 Edge to edge anterior occlusion, 184, 187f–189f Efficient force systems, 43–44, 46f–48f Elastomeric chain, 112, 120 Endosseous dental implants, for missing posterior teeth, temporary anchorage devices in, 265, 268f–270f Equilibrium, in orthodontics, 8, 8f Equivalent force systems, 8–9, 9f Extraalveolar anchorage, with i-station device, 43–44, 44f–45f light and efficient force systems, 43–44, 46f–48f Extraalveolar implants, 209–220 benefits of, 215 in buccal shelf area, 210f characteristics of, 211–213, 214f–218f in extraalveolar site, 209f–210f final considerations for, 215 indications for, 210–211, 211f–213f infrazygomatic crest (IZC) area, 210f magnitude of the force applied, 215 placement techniques for, 213 buccal shelf, 213–214 buccal shelf region, 209f, 215 infrazygomatic crest, 208f, 213 precautions of, 215 Extraalveolar mini-implants, 30 Extraalveolar sites, for implants, 209f–210f Extraoral photographs, of mandibular deviation, 45, 49f, 52f postretention, 46–47, 53f posttreatment, 58f pretreatment, 47, 54f Extrusion, 38 bimaxillary and single-dentition extrusion, 257–260 without TADs, 243–245, 244f–249f single-dentition, with TADs in mandible, 250–254, 250f–255f in maxilla, 254, 256f–259f F Fabrication, of openbite appliance, 152–153 Facial profile improvement, in class III malocclusion, orthognathic camouflage with temporary anchorage devices for, 243–262 bimaxillary extrusion and single-dentition extrusion, 257–260 without TADs, 243–245, 244f–249f maxillary vertical development, 254–256 orthodontic extrusion stability, 260 single-dentition extrusion with TADs in mandible, 250–254, 250f–255f in maxilla, 254, 256f–259f Failed growth modification/camouflage in skeletal class II, reversing effects of, 110–112, 113f–115f considerations of, 112 problem list, 110 treatment goals, 112 treatment of, 112 323 324 Index FHP see Frankfort horizontal plane Fixed lingual retainers, 154 Force, 3, 4f directional effects of, 4–6, 5f effects on system, 4, 5f Force arm, Force diagrams, 4–6 Force system through time, 14, 16f Force vectors, 4–6, 4f Frankfort horizontal plane (FHP), 4–5 Free vector, G Gingivectomy, 38 H Hawley type retainers, 120 Horizontally impacted third molars, 286–287, 287f–293f Hybrid model, with mini-implant anchorage, 17–19, 18f–19f I Idiopathic condylar resorption (ICR), 132 Impacted third molars, horizontally, 286–287, 287f–293f Implants extraalveolar, 209–220 benefits of, 215 in buccal shelf area, 210f characteristics of, 211–213, 214f–218f in extraalveolar site, 209f–210f final considerations for, 215 indications for, 210–211, 211f–213f infrazygomatic crest (IZC) area, 210f magnitude of the force applied, 215 placement techniques for, 213 buccal shelf, 213–214 buccal shelf region, 209f, 215 infrazygomatic crest, 208f, 213 precautions of, 215 multipurpose, 150–151, 150f–151f possible complications of, 151 removal of, 151 surgical method for, 150–151, 151f IMTEC Ortho mini-implants, 263, 264f–265f, 275 Incisors mechanics to apply labial crown torque, 45–51, 49f retraction mechanical factors, 17–19, 17t, 18f in MGBM system, for class II nonextraction, 297– 301, 298f–302f Inflammation, multipurpose implant and, 151 Infrazygomatic crest, mini-implants in, placement of, 208f, 213 Infrazygomatic (IZ) Lomas mini-implant, 265, 266f–267f Infrazygomatic temporary anchorage device, for anchorage, 274f–275f Interdisciplinary plan, 120 Interradicular mini-implants, 29–30 Intraoral photographs, of mandibular deviation, 45, 49f, 52f postretention, 46–47, 53f posttreatment, 58f pretreatment, 47, 54f Intrusion, 38 I-station, predictable management with, 43–60 extraalveolar anchorage through, 43–44, 44f–45f light and efficient force systems, 43–44 mechanics to apply labial crown torques, 45–51, 49f L Lateral incisors, upper, missing, space closure for, 33–42 interdisciplinary aspects of, 38 canine, 38 first premolar, 38 orthodontic space closure for, 35, 37f palatal screw selection and insertion for, 35–38 prosthetic-implantologic solution for, 35, 36f therapy options to replace, 35, 36f Lateral openbite, with anterior crowding, lower molars distalization for, 305–309, 306f treatment alternatives for, 305 treatment goals for, 305 treatment progression for, 305–309, 307f–309f treatment results for, 309, 310f Left dentition, masticating problem with, 184–186, 189f–192f Light force systems, 43–44, 46f–48f Line of action, Lomas mini-implant, 273–274, 278 Lomas Quattro mini-implant, 269 Loop mechanics comparison of sliding mechanics and, 44, 47f distalization of dentition, 44, 48f maxillary bilateral molar distalization, 56f range of movement, 44, 48f Lower arch crowding, 166 diagnosis and case summary of, 166–168 extraoral analysis for, 166, 167f final result of, 170, 171f–172f functional analysis for, 166 intraoral analysis for, 166 Index Lower arch crowding (Continued) problem list of, 168 smile analysis for, 166, 167f treatment objectives of, 168 treatment options of, 168 treatment sequence and biomechanical plan for, 168f–170f, 169 treatment sequence of, 170 Lower fixed appliances, 112 Lower molars distalization, anchorage of TADs for, 305–320 anterior openbite, 309–311, 313f–314f treatment progression for, 311, 314f–315f treatment results for, 311, 316f–317f lateral openbite, with anterior crowding, 305–309, 306f treatment alternatives for, 305 treatment goals for, 305 treatment progression for, 305–309, 307f–309f treatment results for, 309, 310f–312f patient, discussion in, 309–311 M Macroglossia, diagnostic criteria of, 149 Malocclusion class II, 71, 265, 266f–267f decompensation of a retreatment case presenting with, 113–120, 118f considerations of, 117 division type, 110, 111f, 121f problem list, 116–117 treatment goals of, 117 treatment of, 117–120, 119f, 122f–123f class III, orthognathic camouflage with temporary anchorage devices for, 243–262 bimaxillary extrusion and single-dentition extrusion, 257–260 without TADs, 243–245, 244f–249f maxillary vertical development, 254–256 orthodontic extrusion stability, 260 single-dentition extrusion with TADs in mandible, 250–254, 250f–255f in maxilla, 254, 256f–259f Mandible i-station in, 43, 44f single-dentition extrusion with TADs in, 250–254, 250f–255f bite raisers and extrusion of upper anterior teeth, 254 extrusion of posterior teeth, 254 insertion of TADs, 250 Mandibular anterior crowding, 183–184, 186f Mandibular buccal shelf screw, 29 Mandibular dentition intrusion, 57f Mandibular left second molar protraction, 293f Mandibular midline correction, 290f Mandibular molars distalization of, 200–202 diagnosis of, 200–201, 200f, 201t retention of, 202, 203f superimposition of, 202, 203f treatment plan of, 201 treatment progress of, 201, 202f treatment results of, 201, 202f intrusion, in openbite, 236f–237f, 237 MAPA see Mini-implants assisted palatal appliances Maxilla i-station in, 43, 44f narrow, 65–67, 67f–68f single-dentition extrusion with TADs in, 254, 256f–259f vertical development, in class III malocclusion, 254–256 Maxillary bilateral molar distalization, 46, 50f, 56f Maxillary incisors, compromised, temporary anchorage devices in, 274–275, 274f–275f Maxillary i-station, 46, 51f Maxillary molars, distalization of, 197–200 diagnosis of, 197, 197f, 198t retention of, 199, 199f superimposition of, 199–200, 200f treatment plan of, 197–199, 198f treatment progress of, 197 treatment results of, 197–199, 199f Maxillary posterior area, TAD sites in, 25, 25f Mechanics, defined, Mesial sliding appliance, 37–38, 37f–38f MGBM system, for class II nonextraction, 295–304 dual distal system and, 301–302, 302f–303f incisor retraction in, 297–301, 298f–302f upper molar distalization in, 295–296, 296f upper premolars and canines, retraction of, 296–297, 297f Midline deviations, 183 Mini-implant assisted retraction, distalization effect of, 16–17, 17f Mini-implant diameter, 31 Mini-implants anchorage, hybrid model with, 17–19, 18f–19f benefits of, 215 in buccal shelf area, 210f characteristics of, 211–213, 214f–218f in extraalveolar site, 209f–210f final considerations for, 215 indications for, 210–211, 211f–213f 325 326 Index Mini-implants (Continued) infrazygomatic crest (IZC) area, 210f magnitude of the force applied, 215 optimal insertion sites for, 71–72 placement techniques for, 213 bone sites for, 21–28 buccal shelf, 213–214 buccal shelf region, 209f, 215 infrazygomatic crest, 208f, 213 three-dimensional evaluation of, 21–28 precautions of, 215 space closure mechanics with, 12, 13f Miniplates, 109, 110f Mini-implant-driven orthodontics, biomechanics principles in, 1–20 approaches for studying tooth movement in, basic mechanical concepts in, 3–8 concept of equilibrium as, couple as, 7–8, 7f–8f force as, 3, 4f force diagrams and vectors as, 4–6, 4f moment (torque) as, 6–7, 7f basic model for space closure in, 12–17, 13f–15f center of rotation in, 9, 10f equilibrium in orthodontics in, estimating the center of rotation in, 10–12 mechanical factors affecting incisor retraction in, 17–19, 17t, 18f principle of equivalent force systems in, 8–9, 9f space closure mechanics with mini-implants, 12, 13f Mini-implants application of, 62, 64f ridge, for orthodontic anchorage, 267–274, 271f–273f in vertical alveolar ridge development, 278, 280f–281f Mini-implants assisted palatal appliances (MAPA), 61–70 appliance fabrication of, 62, 64f–65f clinical cases of, 62–67 asymmetrical cases, 67, 68f class II patient, 63–65, 66f class III growing patients, 62–63, 65f narrow maxilla, 65–67, 67f–68f mini-implant application of, 62, 64f surgical guide fabrication in, 61–62, 61f–63f Mini-implant-supported zygomatic miniplates, use of, 165–166, 165f Molars distalization, lower, anchorage of TADs for, 305–320 anterior openbite, 309–311, 313f–314f treatment progression for, 311, 314f–315f treatment results for, 311, 316f–317f lateral openbite, with anterior crowding, 305–309, 306f Molars distalization, lower, anchorage of TADs for (Continued) treatment alternatives for, 305 treatment goals for, 305 treatment progression for, 305–309, 307f–309f treatment results for, 309, 310f–312f patient, discussion in, 309–311 Moment of the couple (MC), Moment of the force (MF), 6–7 Moment (torque), 6–7, 7f Moment-to-force (M/F) ratios, 11–12 altering, 11–12, 12f point of force application, 11, 11f Multidisciplinary patients, with temporary anchorage devices, management of, 263–282 in compromised maxillary incisors, 274–275, 274f–275f endosseous dental implants, for missing posterior teeth, 265, 268f–270f mini-implants in vertical alveolar ridge development, 278, 280f–281f for preprosthetic space appropriation, 265, 266f–267f ridge mini-implants for orthodontic anchorage, 267– 274, 271f–273f skeletal anchorage in orthognathic surgery, 275, 276f–279f for space development for implant in congenitally missing lateral incisor, 263, 264f–265f Multipurpose implant (MPI), 150–151, 150f–151f possible complications of, 151 removal of, 151 surgical method for, 150–151, 151f Muscle exercises, openbite treatment and, 154 N Nance button, 71 Nickel-titanium (NiTi) springs, 73–74 Nonextraction, 197 O O-caps, 275 Occlusion, after space closure, 38, 39f Openbites, 149 anterior, 149, 156, 159f classification of, 149 problem list of, 160 treatment objectives of, 160 treatment plan of, 160 treatment results of, 160, 161f–162f treatment sequence of, 160 class II, progressive condylar resorption case, 132–142, 135f–139f considerations of, 138–139 Index Openbites (Continued) problem list, 138 treatment goals, 138 treatment of, 139–142, 140f–144f skeletal, 221–242 biomechanics of molar intrusion in, 223–227, 224f–227f case report on, 227, 228f–231f mandibular molar intrusion in, 236f–237f, 237 through incisor extrusion with TADs, 237–241 case report on, 238–241, 238f–241f vertical control with palatal TADs, 232–237 case report on, 232–237, 232f–237f treatment, retention of, 154 Openbite appliance (OBA), new generation, 152–160 clinical application of, 153–154, 153f–154f clinical experience of, 154 fabrication of, 152–153 acrylic cap, 152–153 wire bending, 152, 152f retention of, 154 Openbite malocclusion, treatment and, 149–150 Orthodontic anchorage, ridge mini-implants for, 267–274, 271f–273f Orthodontic extrusion stability, 260 Orthodontic space closure, 35, 37f Orthognathic camouflage, with temporary anchorage devices, for class III malocclusion, 243–262 bimaxillary extrusion and single-dentition extrusion, 257–260 without TADs, 243–245, 244f–249f maxillary vertical development, 254–256 orthodontic extrusion stability, 260 single-dentition extrusion with TADs in mandible, 250–254, 250f–255f in maxilla, 254, 256f–259f Orthognathic surgery, skeletal anchorage in, temporary anchorage devices in, 275, 276f–279f Overbite, correction of, 265 Overjet, correction of, 265 P Pain, multipurpose implant and, 151 Palatal acrylic pad, 71 Palatal mini-implants, 30–31 extraalveolar mini-implants and, 30 risk factors for, 30–31, 30t Palatal screw insertion of, 35–38 selection of, 35–38 Palatal temporary anchorage devices, 196 aligner treatment using, 71–86 with Beneslider, strategies and clinical tips for, 72–73, 74f clinical considerations of, 80–83 clinical procedure and rationale of, 72–80 during distalization, 74–80, 76t, 78f–83f, 80t distalization and, simultaneous start of, 73–74, 75f–77f site of, 25, 25f Panoramic photographs, of mandibular deviation, 45, 49f, 52f, 55f posttreatment, 58f Partial anterior crossbite, 89 case summary of, 89, 91f diagnosis of, 89 extraoral analysis of, 89t intraoral analysis and functional analysis of, 90t problem list for, 90t smile analysis of, 90t treatment objectives of, 92t treatment options of, 89, 93f–98f treatment sequence and biomechanical plan, 92t Peclab screw kit, 207f, 212 Positron emission tomography (PET)-G bite, 61–62 Posterior teeth in bimaxillary extrusion without TADs, 245 missing, endosseous dental implants for, temporary anchorage devices in, 265, 268f–270f single-dentition extrusion with TADs in mandible, 254 Postsurgical swelling, multipurpose implant and, 151 Power arm–based space closure, 15f Preprosthetic space appropriation, temporary anchorage devices for, 265, 266f–267f Progressive condylar resorption case, class II openbite development, 132–142, 135f–139f considerations of, 138–139 problem list, 138 treatment goals, 138 treatment of, 139–142, 140f–144f Prosthetic-implantologic solution, 35, 36f Protruded upper teeth, 170, 197 diagnosis and case summary of, 173, 174f extraoral analysis for, 172, 174f final results of, 175, 178f–179f functional analysis for, 173 intraoral analysis for, 173 problem list of, 173 smile analysis for, 172–173 treatment objectives of, 173 treatment options of, 175 327 328 Index Protruded upper teeth (Continued) treatment sequence and biomechanical plan for, 175, 176f treatment sequence of, 175, 177f Push-type mechanics, for edge to edge anterior occlusion, 184 Q Qualitative approach, for studying tooth movement, Quantitative approach, for studying tooth movement, Quasi-static system, 8, 8f R Rapid palatal expansion (RPE), 62–63 Restorative treatment, previous, complex interdisciplinary challenge compromised by, 120–123, 123f, 125f considerations of, 120 problem list, 120 treatment goals, 120 treatment of, 120–123, 126f–130f Resultant, Retrognathic mandible, 154, 155f problem list of, 155 treatment objectives of, 156 treatment plan of, 156 treatment results of, 156, 158f treatment sequence of, 156, 156f–157f Ricketts’ Chart for Calculation of Force Magnitude, 153–154, 153f Ridge mini-implants for orthodontic anchorage, 267–274, 271f–273f placement techniques, 269 Rugae, T-Zone palatal posterior from, 72f S Sagittal split osteotomy, simultaneous mandibular advancement with, 113, 116f Second molar protraction, 283–294 Self-drilling screws, 211 Self-tapping screws, 211 Sequential plastic aligners, 72 Simple tipping, 10–11 Simultaneous mandibular advancement, 123 Simultaneous Upper Molar Distalizing System (SUMODIS) component, 295–296, 296f Single-dentition extrusion bimaxillary extrusion and, 257–260 with TADs in mandible, 250–254, 250f–255f bite raisers and extrusion of upper anterior teeth, 254 extrusion of posterior teeth, 254 insertion of TADs, 250 in maxilla, 254, 256f–259f Skeletal Anchor System (SAS) plates, 109 Skeletal anchorage complex orthodontic problems managing with, 109–146 bimaxillary dental protrusion, decompensation of treatment case, 113–120, 118f considerations of, 117 final facial outcome of, 120, 124f problem list, 116–117 treatment goals of, 117 treatment of, 117–120, 119f, 122f–123f previous restorative treatment, 120–123, 123f, 125f considerations of, 120 problem list, 120 treatment goals, 120 treatment of, 120–123, 126f–130f progressive condylar resorption case class II openbite development, 132–142, 135f–139f considerations of, 138–139 problem list, 138 treatment goals, 138 treatment of, 139–142, 140f–144f reversing effects of failed growth modification/ camouflage in skeletal class II, 110–112, 113f–115f considerations of, 112 problem list, 110 treatment goals, 112 treatment of, 112 tooth surface loss, dental asymmetry and crowding, 126–129, 131f considerations of, 129 problem list, 129 treatment goals of, 129, 132f treatment of, 129, 133f–134f group A, mechanics, maximum, 110f in orthognathic surgery, temporary anchorage devices in, 275, 276f–279f palatal mini-implants and, 30–31 protocol of, 175 risk factors associated with, 29–32 site of placement, 29–30 buccal alveolar mini-implants/interradicular miniimplants, 29–30 success rates with, 29–32 Skeletal anterior openbite, 149 Skeletal mandibular retrognathism, magnitude of, 112 Skeletal openbites, 221–242 biomechanics of molar intrusion in, 223–227, 224f–227f case report on, 227, 228f–231f mandibular molar intrusion in, 236f–237f, 237 Index Skeletal openbites (Continued) through incisor extrusion with TADs, 237–241 case report on, 238–241, 238f–241f vertical control with palatal TADs, 232–237 case report on, 232–237, 232f–237f Sliding mechanics, and loop mechanics, 44, 47f Space closure basic model for, 12–17, 13f–15f mechanics with mini-implants, 12, 13f Space development, for implant in congenitally missing lateral incisor, temporary anchorage devices for, 263, 264f–265f Spontaneous vertical eruption, of impacted third molar, 284–285, 285f Statics, SUMODIS component see Simultaneous Upper Molar Distalizing System (SUMODIS) component Superimposition, 51, 52f, 58f, 291f of distalization of mandibular molars, 202, 203f of maxillary molars, 199–200, 200f Surgical guide fabrication, 61–62, 61f–63f Surgically assisted rapid palatal expansion (SARPE), 65 T TADs see Temporary anchorage devices Temporary anchorage devices (TADs), 23, 150, 283 application of, 109 in compromised maxillary incisors, 274–275, 274f–275f endosseous dental implants, for missing posterior teeth, 265, 268f–270f management of multidisciplinary patients with, 263–282 mini-implants in vertical alveolar ridge development, 278, 280f–281f orthognathic camouflage with, for class III malocclusion, 243–262 bimaxillary extrusion and single-dentition extrusion, 257–260 without TADs, 243–245, 244f–249f maxillary vertical development, 254–256 orthodontic extrusion stability, 260 single-dentition extrusion with TADs in mandible, 250–254, 250f–255f in maxilla, 254, 256f–259f in orthognathic surgery, 275, 276f–279f preoperative treatment planning of, 24–26 in buccal shelf area, 25–26, 26f in maxillary posterior area, 25, 25f in palate, 25, 25f for preprosthetic space appropriation, 265, 266f–267f ridge mini-implants for orthodontic anchorage, 267– 274, 271f–273f Temporary anchorage devices (TADs) (Continued) root damage of, 23, 24f “safe zones” for, 23, 24f sites, 23, 24f for skeletal openbites, 221–242 biomechanics of molar intrusion in, 223–227, 224f–227f case report on, 227, 228f–231f mandibular molar intrusion in, 236f–237f, 237 through incisor extrusion with, 237–241 case report on, 238–241, 238f–241f vertical control with palatal, 232–237 case report on, 232–237, 232f–237f for space development for implant in congenitally missing lateral incisor, 263, 264f–265f Temporary Skeletal Anchorage Devices (TSAD), 183 Temporo-mandibular joint radiographs, 55f Third molar angulation, 285–286, 285f changes with second molar protraction, 284–286, 285f–286f horizontally impacted, 286–287, 287f–293f spontaneous mesioangular tipping of, 285–286, 286f uprighting, 283–294, 285f–286f Tipping controlled, 11 simple, 10–11 uncontrolled, 10–11 β-Titanium alloy, 120, 129 Tongue thrust swallowing, 149 Tooth movement approaches for studying, managing of, with C-tube microplates, 181–194 clinical report of, 183–186, 186f–192f methods of, 183, 184f–185f types of, 10–11, 10f Transmissibility, principle of, Transpalatal bar, in upper molar distalization, 295, 296f TSAD see Temporary Skeletal Anchorage Devices U Uncontrolled tipping, 10–11 Unilateral premolar extraction, for asymmetrical malocclusion, 170 Unresponsive mandibular third molar, 285, 285f Upper anterior teeth, extrusion of, placement of bite raisers and, 254 Upper arch crowding, 166 diagnosis and case summary of, 166–168 extraoral analysis for, 166, 167f final result of, 170, 171f–172f functional analysis for, 166 329 330 Index Upper arch crowding (Continued) intraoral analysis for, 166 problem list of, 168 smile analysis for, 166, 167f treatment objectives of, 168 treatment options of, 168 treatment sequence and biomechanical plan for, 168f–170f, 169 treatment sequence of, 170 Upper central incisor crowns, 123 Upper fixed appliances, 112, 117f Upper lateral incisors, missing, space closure for, 33–42 interdisciplinary aspects of, 38 canine, 38 first premolar, 38 orthodontic space closure for, 35, 37f palatal screw selection and insertion for, 35–38 prosthetic-implantologic solution for, 35, 36f therapy options to replace, 35, 36f Upper molar distalization, 295–296 asymmetric noncompliance, 71–86 in aligner treatment, 71 clinical considerations of, 80–83 clinical procedure and rationale of, 72–80 aligner start during distalization, 74–80, 76t, 78f–83f, 80t combine Beneslider and aligners, strategies and clinical tips, 72–73, 74f simultaneous start of aligner and distalization, 73–74, 75f–77f Upper teeth, protruded, 170 diagnosis and case summary of, 173, 174f extraoral analysis for, 172, 174f final results of, 175, 178f–179f Upper teeth, protruded (Continued) functional analysis for, 173 intraoral analysis for, 173 problem list of, 173 smile analysis for, 172–173 treatment objectives of, 173 treatment options of, 175 treatment sequence and biomechanical plan for, 175, 176f treatment sequence of, 175, 177f V Vector addition, 4, 5f Vector composition, Vector resolution, 4–6, 5f Vertical alveolar ridge development, mini-implants in, 278, 280f–281f Vertical eruption patterns, of impacted third molar, 284–285 W Wire bending, 152, 152f Z Zygomatic anchorage, 150–151 Zygomatic buttress, 150 Zygomatic miniplate supported molar distalization, 165–180 method description of, 165–166, 165f–166f supported openbite treatment, 147–164 multipurpose implant, 150–151, 150f–151f new generation openbite appliance, 152–160 openbite malocclusion and, 149–150 This page intentionally left blank       This page intentionally left blank       This page intentionally left blank       This page intentionally left blank       This page intentionally left blank       This page intentionally left blank       Conf idence is ClinicalKey Evidence-based answers, continually updated A subscription to ClinicalKey draws content from countless procedural videos, peer-reviewed journals, patient education materials, and books authored by the most respected names in medicine Your patients trust you You can trust ClinicalKey Equip yourself with trusted, current content that provides you with the clinical knowledge to improve patient outcomes Get to know ClinicalKey at store.clinicalkey.com 2019v1.0 ... resale, lending, or other means 2015v1.0 Temporary Anchorage Devices in Orthodontics This page intentionally left blank       Temporary Anchorage Devices in Orthodontics SECOND EDITION Ravindra Nanda,... 3D-printing facilitates the insertion of miniimplants and the delivery of appliances in a single visit in a very precise and predictable manner Another novel and interesting approach is the combination... Skeletal Anchorage Biomechanics Principles in Mini-Implant Driven Orthodontics Madhur Upadhyay and Ravindra Nanda 1 This page intentionally left blank       Biomechanics Principles in Mini-Implant