Temporary anchorage devices (TADs for short) are small titanium-alloy mini-screw or mini-implants (ranging from 1.2-2mm in diameter and 6-12 mm in length) that are inserted into the bone in different areas of the mouth to enhance orthodontic anchorage. Their placement is minimally invasive and non-painful. These versatile mini anchors allow orthodontists to predictably perform difficult tooth movements in ways that were not possible in the past with conventional appliances (such as headgears and holding arches). They are smaller and more discreet and require significantly less work for the patient, therefore, efficiency and effectiveness of treatment is enhanced. TADs can even successfully treat cases that were once treated with only corrective jaw surgery. They can stay in for a few months to a year and then removed once required tooth movement is completed.
Functional appliance systems help correct bite problems and move the jaws into alignment. They come in many designs, removable or fixed. Here are a few that are used in our office.
MARA – The Mandibular Anterior Repositioning Appliance is a simple, esthetic and unobtrusive appliance used to encourage forward growth of the lower jaw to help correct an overbite. It is attached to the patient’s first molars via steel crowns and since it is fixed, it can often be an alternative to wearing a headgear. It can also be combined with other types of appliances such as expanders and provides access to placing brackets while simultaneously advancing the mandible.
The Forsus appliance – is a durable (not indestructible) 3-piece telescopic compression spring assembly that delivers continuous orthopedic force independent of patient compliance. It is a hybrid fixed appliance that can be used with any bracket system and wires. It works by posturing the patients lower jaw in a forward position, and over time helps to eliminate excessive overbites, improving the fit of teeth and possibly preventing the need for jaw surgery. Most patients report an easy transition into the appliance and are pleased with the dental and facial changes that they experience. The major advantage of this system over headgear or elastics/rubber bands is that its effectiveness does not rely on patient cooperation (it functions like a permanent fixed headgear). Most patients will wear Forsus appliance for 4 to 6 months.
HERBST – fixed appliance that encourages the lower jaw to catch up in growth and help correct moderate overbites, for patients that do not wish to consider jaw surgery. It is typically used during peak growth spurts, in combination with fixed braces and worn for about 12 months. The device is attached to the back molars on the upper and lower jaws with bands that are cemented into place. As with all kinds of appliances, patients will need to be careful about what they eat, avoiding chewy, sticky and hard foods that can bend and loosen the Herbst device.
We also offer appliances that can help with obstructive sleep apnea. Obstructive sleep apnea is a common health issue facing more than 18 million Americans and is 85% undiagnosed. It can occur in men, women and children of all ages. It causes gaps in breathing and interrupted sleep due to upper airway obstruction. Obstructive sleep apnea can increase chances of stroke, heart attach, obesity, diabetes and motor vehicle accidents. Signs of sleep apnea can include snoring or snorting during sleep, mouth breathing or pauses in breathing, teeth grinding during sleep and restless sleep.
Orthodontists can help because of their expertise in facial growth and development and can help to identify sleep apnea issues. About half of patients with obstructive sleep apnea have issues or abnormalities in the bone structure. These abnormalities can, in some cases, be corrected with orthodontic treatment. Dr. Radu may also use oral appliance therapy (OAT) to improve breathing in her patients.
If you are at risk for sleep apnea or have poor compliance using Continuous Positive Airway Pressure machines (CPAP), please contact us to see if an orthodontic sleep apnea appliance is a better alternative to help you.