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The use of Temporary Anchorage Devices (TADs) has become a cornerstone of modern orthodontics, but their application requires careful consideration of patient age. In adolescent patients, bone density and healing capacity are generally favorable, often allowing for easier TAD placement and stability. However, growth-related changes must be accounted for—TADs may need repositioning as jaws develop, and their use in mixed dentition requires careful planning to avoid interference with erupting teeth. In contrast, adult patients present unique challenges, such as denser cortical bone and reduced vascularity, which can affect TAD stability. Additionally, adults are more likely to have periodontal concerns or missing teeth, requiring customized anchorage strategies to optimize outcomes.
Biomechanical approaches also differ between age groups. Adolescents often benefit from TADs in growth modification protocols, such as molar distalization or maxillary expansion, where skeletal changes can still be influenced. For adults, TADs are more frequently used for tooth-driven movements, such as intrusion of overerupted molars or uprighting tipped teeth in pre-prosthetic cases. Since adult bone is less adaptable, lighter and more controlled forces are typically needed to prevent TAD failure. Furthermore, adults may have higher aesthetic demands, necessitating discreet TAD placement (e.g., in the palate or buccal shelf) to avoid visible hardware during treatment.
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