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Certainly! When it comes to selecting the optimal site for placing Temporary Anchorage Devices (TADs), several factors play a crucial role. Let’s dive into the key considerations:
Cortical Bone Thickness:
TADs rely on cortical bone for mechanical stability.
Regions with higher bone density (such as D2 or D3 bone) are ideal for TAD insertion.
Soft Tissue Health:
Thin, attached tissue is preferable for TAD placement.
In the paramedian region, attached tissue has a uniform thickness of 1 mm with minimal submucosal fat.
As we move up the palatal slope, the attached tissue thickens, reaching a combined soft tissue thickness of 3 mm to 5 mm.
Interradicular Bone Stock:
Ideally, TADs should be inserted where there is 4 mm to 5 mm of interradicular bone stock.
The greatest amount of interradicular bone in the posterior dentoalveolus lies between the second premolar and first molar, approximately 5 mm to 11 mm from the alveolar crest.
Root Proximity:
Maintain a recommended distance of 1.5 mm to 2 mm between the root and the body of the TAD.
Under heavy force, a TAD may tip and extrude slightly toward the direction of the pull.
Buccal Posterior Regions:
In areas where the mucogingival junction is shorter (often less than 5 mm), consider diverging roots or placing the TAD in alveolar mucosa to achieve adequate bone stock.
Remember that precise site selection ensures successful TAD placement, allowing for predictable tooth movements during orthodontic treatment.
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