Risk factors and indications of orthodontic temporary anchorage devices: a literature review.

Abstract

AIMS: The aims of this review are twofold, firstly, to give an overview of the general and local risk factors when using temporary anchorage devices (TADs) and the prerequisites for placement and, secondly, to illustrate the orthodontic indications of various TADs. METHODS: The PubMed database was searched for original articles on: 'orthodontics and miniscrews/mini-implants/ miniplates/temporary anchorage devices/titanium screws/skeletal anchorage', 'miniscrews/mini-implants/miniplates and risk factors/biomechanics/placement procedure'. Only articles published between 2001 and December 2007 were used. In addition, each article was hand searched for references that may have been missed by the PubMed search. RESULTS: General risk factors are factors concerning general health. Bone quality and oral hygiene are local risk factors. Aspects of the placement procedure discussed were: primary stability, loading protocols, pre-drilling diameter and whether or not to make an intra-oral incision. A selection of published case reports is given to illustrate some orthodontic indications of TADs. CONCLUSIONS: Temporary anchorage devices have a place in modern orthodontics. Careful treatment planning involving radiographic examination is essential. Consultation with an oral surgeon is advisable if a soft tissue flap is required. Excellent patient compliance, particularly avoidance of inflammation around the implant, is an important consideration for successful use of TADs.