Abstract
BackgroundThe aim of the survey was to obtain information on the treatment plan preferences, mechanics and characteristics of temporary anchorage device (TAD) application using a single case presented to orthodontists in Switzerland.MethodsA structured questionnaire to be completed by all study participants with case-specific (treatment plan including mechanics and TAD usage) and general questions (general fixed appliance and TAD usage as well as professional, educational and demographic questions) together with an orthodontic borderline case was utilised. The case was a female adult with dental Class II/2, deep bite and maxillary anterior crowing, who had been treated in childhood with extraction of four premolars and fixed appliance followed by wisdom tooth extraction.ResultsThe response rate was 24.4% (108 out of 443). The majority (96.3%, 104) proposed comprehensive treatment, while 3.7% (4) planned only alignment of maxillary teeth. 8.3% (9) included a surgical approach in their treatment plan. An additional 0.9% (1) combined the surgical approach with Class II mechanics. 75.1% (81) decided on distalization on the maxilla using TADs, 7.4% (8) planned various types of Class II appliances and 3.7% (4) combined distalization using TADs or headgear with Class II appliances and surgery. Palatal implants were the most popular choice (70.6%, 60), followed by mini-screws (22.4%, 19) and mini-plates on the infrazygomatic crests (7.0%, 6). The preferred site of TAD insertion showed more variation in sagittal than in transversal dimension, and the median size of mini-screws used was 10.0-mm long (interquartile range (IQR) 2.3 mm) and 2.0-mm wide (IQR 0.3 mm).ConclusionsDistalization against palatal implants and then distalization against mini-screws were the most popular treatment plans. Preferred site for TAD insertion varied depending on type and size but varied more widely in the sagittal than in the transversal dimension.
Highlights
The aim of the survey was to obtain information on the treatment plan preferences, mechanics and characteristics of temporary anchorage device (TAD) application using a single case presented to orthodontists in Switzerland
Distalization in the upper jaw using TADs to correct Class II cases was chosen by 75.1% (81/108); 70.4% (57/81) used palatal implants, 22.2% (18/81) used miniscrews and 7.4% (6/81) used mini-plates on the infrazygomatic crests
Class II mechanics to correct the sagittal relationship was planned in 7.4% (8/108) with 50.0% (4/8) using Herbst appliance, 37.5% (3/8) using springs and 12.5% (1/8) using elastics
Summary
The aim of the survey was to obtain information on the treatment plan preferences, mechanics and characteristics of temporary anchorage device (TAD) application using a single case presented to orthodontists in Switzerland. Temporary anchorage devices (TADs) have become an established treatment modality in orthodontics and have facilitated successful treatment of more complex orthodontic cases [1] such as borderline adult Class II and asymmetric cases. In growing Class II cases, growth modification or extraction is often the therapy of choice, whereas in adults, orthognathic surgery and orthodontic camouflage treatment, including Herbst appliance treatment [2,3,4], In borderline cases without severe skeletal discrepancies, orthodontic camouflage treatment may be an acceptable choice compared to orthognathic surgery [5,6]. TADs are presently a viable treatment option, to the best of our knowledge, no information about the use of TADs among orthodontists in Switzerland is available
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