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Severe bimaxillary dento-alveolar proclination with hyperdivergent jaw bases treated with temporary anchorage devices: a case report Narayan H Gandedkar Ameet V Revankar Dental Update 2024 6:3, 707-709.
Authors
Narayan HGandedkar
BDS, MDS
Clinical and Research Fellow, Department of Craniofacial Dentistry and Orthodontics, Chang Gung Memorial Hospital, Tun Hwa North Road, Taipei, Taiwan and Assistant Professor, Department of Orthodontics and Dentofacial Orthopaedics, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India
The article describes the orthodontic treatment of a 19-year-old female with severe bimaxillary dento-alveolar proclination and severely hyperdivergent jaw bases. Clinical and cephalometric analyses denoted it to be a critical anchorage case. Accordingly, with the aim of providing absolute anchorage, temporary anchorage devices (TADs) were placed in all four quadrants in the inter-radicular area of the second premolar and first molar, following extraction of all first premolars. Facial aesthetics improved considerably, fullness of the upper and lower lip reduced and incompetency of the lips was eliminated. The application of TADs not only reduced the antero-posterior discrepancy, but also addressed the vertical problem.
Clinical Relevance: The treatment of critical anchorage, hyperdivergent cases with conventional orthodontics has always remained a challenge, with a greater chance of an unsatisfactory treatment outcome. The use of TADs has changed the scenario with the concept of absolute anchorage coming closer to reality.
Article
Conservation of anchorage is a decisive constituent of en masse retraction.1 Utmost importance is placed on Newton's third law – the law of action and reaction. Orthodontists are sentient of the fact that, for any force applied on the teeth, there will be an equal and opposite reaction.2,3,4 Poor patient compliance can only skew the ‘vector equation’ towards greater anchorage loss and hence unsatisfactory treatment results; these factors have led to the greater exercise of intra-osseous anchorage.5 Use of implants have become more practical as far as conservation of anchorage is concerned.6,7,8,9,10,11,12,13 The mechanics of force application can be simple or complicated, depending on the level of anchorage control necessary. The use of TADs reduces the number of teeth requiring bands or brackets, especially second molars, hence reducing the risk of damage to the periodontium or enamel surfaces.14
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