Temporary Anchorage Devices (TADs) Can Be a Solution For Complex Misalignments

TADs are concealed and work wonders behind the scenes

If you are reading this article, it is probably because someone told you you need a palatal bar, a lingual arch, a nance button, or a quad helix.

TADs in orthodontics are very important and fulfill many functions. For example, the most common one is to maintain space when there is a premature loss of a tooth in a child.

On other occasions, Albany orthodontists use them as auxiliary appliances during orthodontic treatment. In most cases, when an orthodontist performs an extraction because she needs to make room or work on the symmetry of a smile.

The orthodontist also uses these appliances, which sometimes look like mini-screws, as an anchor to pull and close spaces between teeth. Also, the application of TADs is temporary, and only through time, they fulfill their function, which sometimes refers to putting some teeth in position in a specific stage of the orthodontic plan.

The orthodontist uses TADs (palatal bar, lingual arch, nance button, and quad helix) to support orthodontic treatment with traditional braces or fixed orthodontics to provide additional support.

With temporary anchorage devices, spaces produced by dental extractions for orthodontics can be closed as anchorage in the extraction of retained canines and cases of class 2 and 3 malocclusions as an alternative to headgear.1

In this article, we will talk about TAD orthodontic temporary anchorage devices and the common questions about TADs that our patients have regarding these devices.

What Are Temporary Anchorage Devices?

TADs are functional appliances or accessories used for a specific time within an orthodontic treatment. Some TADs adhere to the bone by a mechanical lock. That is, it does not have a function of permanent integration with the bone.

Classification of TADs

We classify TADs from the construction and structure perspective:

Self-drilling and Self-tapping

They have a tip design that allows the same screw to pierce the cortical bone.


They require the elaboration of a guide hole or pilot hole. The orthodontist makes a small hole in the cortex with a bur to help the screw penetrate properly.

The tip of this device cannot penetrate the cortex on its own. The reamer used to perforate the cortex should have a diameter of 60% to 70% of the total diameter of the screw.

When using a 2mm diameter TAD, the orthodontist must make the guide hole with a drill ranging from 1.2mm to 1.4mm.

Types of Orthodontic TADs

Currently, with temporary anchorage devices, there are almost no limits to solving the different types of malocclusion, helping get quicker tooth movement, jaw displacements, and widening to eliminate the need to extract teeth in some cases. Here are some examples:


With TADs, an orthodontist can solve transversely (widthwise) when the patient has narrow dental arches.

Tooth Extractions in Dental Crowding

In an anteroposterior direction (front to back), the orthodontists use a TAD to nullify the option of extractions in patients.

Support in Overbite

The orthodontist uses the TADs to make a total displacement of the maxilla in patients with class 2 malocclusion.

Support In Underbite

TADs allow the orthodontist to achieve lower arch displacement in patients with class 3 malocclusion.

Additional Cases Solved With TADs

The orthodontist can also solve vertical direction malocclusion problems by correcting increased or decreased vertical overbites or open bites.

How Do We Place a Temporary Anchorage Device?

The placement of inter radicular anchorage devices requires a millimeter digital periapical radiograph. The orthodontists apply gentle pressure to insert mini-implants with titanium anchors that have a screw tip in the cortical bone tissue.

Patients will feel slight pressure and mild discomfort for three days, then the discomfort recedes.

A clinical study shows that the minimum distance a patient should have from side to side of the mini-screws surface can range from 0.5 to 0.7 mm.1

This means that if the patient has a temporary anchorage device with a diameter of 1.5mm and a distance of 2.5mm from the structure of the orthodontic mini-screws. To the diameter of the screw location, add 0.5mm for each side. The orthodontist can increase the distance to 0.7 mm from side to side.

How to Clean Temporary Anchorage Devices?

To begin with, not all patients are suitable for TAD placement. There are contraindications for certain patients. Some factors are inherent to the patient.

For example, one of the most affecting factors is inadequate hygiene. The colonization of bacteria and bacterial plaque is one reason a TAD fails. Bacteria seep into the screw placement area.

Sometimes the specialist detects in the tomographic exams that the patient does not have adequate bone quality. Similarly, when the cortical bone thickness is low, it makes a patient unsuitable for TAD placement.

You can clean your TAD as you practice oral hygiene with braces. This means that it is necessary to brush your teeth at least twice a day and floss. It is crucial that dental cleaning includes interdental floss and mouthwash.

The Cost of Orthodontics with TADs

There are many factors affecting orthodontic treatment costs. In fact, the American Association of Orthodontists (AAO) doesn’t have a specific number. Notwithstanding, patients should consider various factors that could affect the price:

  • The severity of the problem;
  • Anticipated length of treatment;
  • Orthodontic office location (in a city or rural area) and;
  • The complexity of the orthodontic device and appliance type.

In 2016, the American Dental Association performed a survey of dental fees. The study findings are as follows:

  • Teenager Comprehensive Treatment from $4,978 to $6,900
  • Adult Comprehensive Treatment from $5,100 to $7,045.

At Estes Orthodontics, We Strive to Deliver Exceptional Orthodontic Results

When it comes to results, at Estes Orthodontics, we make a treatment plan that includes the most suitable and effective combination of appliances to reduce the chance of teeth extractions and has accelerated results.

Dr. Laurie Estes and her team provide patients with a warm environment and the confidence they need to get a beautiful smile. Contact or visit Estes Orthodontics and make an appointment.