Science

Implants - To date, the majority of the scientific data on osseointegrated implants has been published in journals related to implant dentistry. It follows, therefore, that a discussion of the basic biology must also begin with the original dental implant research.

Healing Duration - Originally, all implants were thought to need a 4-6 month healing period prior to functional loading. However, recent data for both dental implants and OrthoTADs, suggest they can be loaded earlier than previously thought as long as micromotion is minimized.

Loading Type - Does the type of load, i.e., dynamic versus static, affect implant stability? Statically loaded implants have been shown to have more dense cortical lamellar bone and higher bone:implant contact on the loaded surface than dynamically loaded or unloaded control implants. How are OrthoTADs loaded?

Bony Integration - Original implants were designed to fuse or osseointegrate with the bone. This, however, is not necessary for orthodontic purposes. The biologic rationale for integrated and nonintegrated TADs is outlined and described.

Implant Surface - The implant material as well as its surface properties determines to a large extent whether or not it osseointegrates. In addition, various implant surface treatments are available that also affect osseointegration. These are explained in detail.

Force Levels - Orthodontic forces are generally in the range from 10-300 grams, with lower forces being shown to be more effective and biologically efficient for tooth movement. Will OrthoTADs withstand orthodontic forces?

Screw Types - The nomenclature for screw types and designs are very confusing. Terms are often used that do not accurately describe the screw or the technique by which it is placed. The following terms are defined, described, and illustrated: non-self-tapping, self-tapping, self-drilling (drill-free), auto-advancing, etc.

TAD Dimensions - What constitutes a Temporary Anchorage Device? This is primarily determined by it's indented use and dimensions. Certain dimensions are too large for use as TADs, particularly in inter- and intra-radicular areas. Therefore, the TAD size requirements are outlined and illustrated.

Placement Orientation - Several authors suggest that OrthoTADs should be placed at an angle relative to the surface of the bone in order to obtain a tent-peg biomechanical effect. Recent data suggests this is not accurate. However, there are valid reasons to place OrthoTADs both perpendicular and angular relative to the bone surface.

Bone Remodeling - What happens to the bone around an implant? Does it become weaker or stronger, more or less compliant? This section succinctly covers local bony remodeling around an implant, both osseointegrated and non-osseointegrated types.

Long Term Stability - Recent reports document the ability to treatment skeletal openbites via dental intrusion using OrthoTADs. However, does this treatment result remain as stable over the long term as traditional orthodontic tooth movement?

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