Aligners, TADs and Digital Workflow

First Day by Dr. Wilmes:

Overcoming aligner limitations by using mini-implant borne sliders and expanders introducing the new BAT philosophy (Benefit for Aligner Therapy)

An increasing number of patients seek orthodontic treatment with aligner therapy. Bodily tooth movement with aligner therapy is challenging when relying on aligners alone. Whilst there are limited reports of successful bodily molar movements of up to 1-2 mm in the literature, a very long treatment time and high level of patient compliance and is expected.

Moreover, the potential side effects of intermaxillary elastics must be considered in terms of shift of the anchorage teeth; this might be a severe problem especially in unilateral elastics applications with the potential for development of a midline shift, arch rotation and a jaw discrepancy, and transverse occlusal canting. To avoid this anchorage loss and the high demand on elastic wear, orthodontic mini-implants may be used. Currently, the alveolar process and the IZC region are still the most preferred insertion sites for mini-implants.

However, due to a failure rate and the risk of root damage, insertion in these areas is far from satisfactory. Additionally, a bodily tooth movement is not granted. On the other hand, the anterior palate provides much better conditions for the insertion and stability of skeletal anchorage devices, as the amount and quality of the available bone is far superior. In this course, the combination of mini-implant-borne appliances and aligners is presented to achieve more predictable and faster results in aligner therapy.

Second Day by Dr. Ludwig

TADs – The Digital Way: From insertion guides to metal 3d printed appliances 

The benefits of using skelettal anchorage got over the last two decades obvious and the use of these small screws is wide spread.Many well working workflows are established and sound biomechanics are identified. Scientifically a lot of evidence in matter of failure rates, insertion sites and risk factors was published.But the evolution of the use of TADs doesn´t stop! Especially the digital era brings new and promising features.

This lecture will present a full digital workflow using TADs. Starting from the intraoral scan, digital X-ray, virtual screw placement, digital appliance design and finally 3D printing.Many clinical examples will be shown – current literature will be discussed and a critical evaluation of these new procedures will finalize the lecture.