Dr. Joseph S. Petrey

Non-Traditional TADs! Uncommon TAD Techniques in Treating Challenging Cases Part 1 and Part 2.

This two-part lecture will delve into unconventional applications of TADs and TAD mechanics demonstrating treatments that would otherwise be unachievable without surgery or face significant clinical challenges. Both TAD treatments and TAD-supported appliances will be showcased in innovative treatment approaches, and “off-label” uses.

The lecture covers a range of topics, from simple sliding mechanics for both anterior and posterior tooth substitution to full arch substitution using TADS and TAD appliances to more complex mechanics with TADs and impacted teeth and Molar uprighting with retromolar TADs. Topics addressed include complexities such as poor bone locations and the distance of substitution. More challenging substitutions and anchorage requirements will be demonstrated using the AMDA (Advanced Molar Distalizing Appliance) in non-traditional ways to illustrate both posterior and anterior tooth protraction for substitution.

The AMDA mechanics for distalizing teeth in Class II cases and increasing arch length to create space in severely crowded arches will be demonstrated. While the benefits of molar distalization have been recognized in orthodontics for over a century, techniques like headgear have drawbacks for patients, and appliances like distal jets have inherent anchorage challenges. The TAD AMDA appliance offers a unique solution by allowing for distal translation of posterior teeth while maintaining “absolute anchorage.” AMDA cases will be presented, showcasing the resolution of crowding, Class II correction, en masse retraction, and bilateral and unilateral movements.

The lecture also explores the use of TAD mechanics to close Anterior Open Bites. The application of TADs for posterior intrusion in Anterior Open Bite correction will also be demonstrated. The use of TADs alone and in combination with TPAs and non-traditional expanders will be illustrated. The impact of posterior intrusion and vertical change on anterior-posterior relationships will be discussed. Additionally, a TAD-supported retention protocol for Anterior Open Bite corrections will be presented.

A unique skeletal-only MARPE technique will also be demonstrated with multiple case presentations. MARPE has gained popularity in TAD mechanics, with various systems and techniques emerging. This section of the presentation will focus on case selection and protocols for TAD-supported palatal expansion using skeletal-only MARPE design. Cases in adults with expansion that otherwise could only be achieved through surgical intervention will be showcased. The benefits of MARPE, which is not tooth-borne, will be discussed and demonstrated.

Non-traditional techniques of using TADs for pontic teeth as temporary tooth replacements in both congenitally missing and trauma-induced edentulous ridges in growing patients will be presented. The results of the evolution of TADs with pontic teeth over the past 18 years of placements will be presented. Both mechanical and digital techniques for pontic fabrication will be showcased. A digital technique for determining the ideal TAD placement for pontics will also be demonstrated. Additionally, new techniques, including abutment placement to facilitate easy replacement of pontic teeth without TAD removal, will be presented.