Rethinking Orthodontics: Where Aligners Meet Skeletal Anchorage

Their small size allows mini-implants to be inserted in a variety of sites. Currently, the alveolar process is the most preferred insertion site. However, due to varying bone quality and the risk of root contact, the survival rate of implants inserted in the alveolar ridge still needs improvement. Other regions, such as the anterior palate and the mental region, provide much better conditions for TAD insertion, since the amount and quality of available bone is far superior.

Mini-implants with different types of abutments and connectors allow the construction of versatile and cost-efficient appliances for a large variety of orthopedic and orthodontic applications. Utilizing TADs in the anterior palate and the mental region eliminates the risk of root injury and takes the implants out of the path of tooth movement. The interchangeable abutment system integrates easily into orthodontic practice and allows treatment of cases that were previously difficult or impossible.

Integration of recent advances in digital technology — virtual planning of TAD installation, insertion guides, CAD-CAM design and 3D metal printing of orthodontic appliances — broadens the options significantly.

An increasing number of patients seek treatment with aligner therapy, yet bodily tooth movement is challenging when relying on aligners alone: long treatment times, high compliance demands, and the side effects of intermaxillary elastics such as anchorage-tooth shift, midline shift, arch rotation and transverse occlusal canting. To avoid this anchorage loss and the high demand on elastic wear, orthodontic mini-implants may be used.