Temporary Anchorage Devices Research Articles

Development and invitro testing of an orthodontic miniscrew for use in the mandible.

Temporary anchorage devices (TADs) have been successfully used in the maxilla. However, in the mandible, lower success rates present achallenge in everyday clinical practice. Anew TAD design will be presented that is intended to demonstrate optimization of the coupling structure as well as in the thread area for use in the mandible. Three TADs were examined: (A)Aarhus® system (68.99.33 A, Medicon, Tuttlingen, Germany), (B)BENEfit® orthodontic screw (ST-33-54209; PSM Medical, Gunningen, Germany) and(C) anew design with atwo-part screw thread. The TADs were inserted into artificial bone blocks after predrilling to test primary stability. To test the fracture stability, the TADs were embedded in Technovit® 4004 (Heraeus Kulzer, Wehrheim, Germany) and torsional loaded at an angle of 90° until fracture. The threshold torque values occurring were recorded digitally. The statistical evaluation was carried out using the Kruskal-Wallis test with aposthoc test according to Bonferroni (p < 0.05). The following values were measured for the insertion torque: A: 33.7 ± 3.3 Ncm; B: 57.1 ± 8.4 Ncm; C: 34.2 ± 1.4 Ncm. There were significant differences between A-B andB-C. The measured values for the fracture strength were as follows: A: 46.7 ± 3.5 Ncm; B: 64.2 ± 5.1 Ncm; C: 55.4 ± 5.1 Ncm. Significant differences were found between all groups. The adapted screw design has no negative influence on primary and fracture stability. Whether the design has apositive effect on the success rates in the mandible must be clarified in further clinical studies.

TADs smart easy bending (T.S.E.B.) protocol for impacted canines treatment supported by temporary anchorage devices and aligners

TADs smart easy bending (T.S.E.B.) protocol for impacted canines treatment supported by temporary anchorage devices and aligners

Lingual Orthodontic Retreatment of an Adult Patient with Protruded Lips and a Missing Lower Incisor: A Case Report

AbstractOrthodontic retreatment in adult patients presents unique challenges and considerations. Previous dental intervention or even missing teeth may influence treatment planning and pose challenges for bracket bonding.A 23-year-old female patient sought orthodontic retreatment to address her chief complaint of upper lip protrusion. She had previously completed fixed labial orthodontic treatment involving the extraction of a lower central incisor.The diagnosis was a skeletal maxillary protrusion and mandibular dentoalveolar protrusion on dental class I and skeletal class II relationships.A nonsurgical camouflage treatment option was chosen, which involved the removal of the upper first premolars and lower right first premolar. The lower left canine, lateral, and central incisor were substituted with the lower left first premolar, canine, and lateral incisor, respectively. Lingual self-ligating brackets, straight archwires, and temporary anchorage devices were utilized. The treatment was completed after 32 months with an improved facial profile and a stable occlusion.This case report demonstrates the successful retreatment of an adult patient with lip protrusion and relapse of lower arch crowding using straight-wire lingual appliances and premolar extractions. This approach achieved optimal aesthetics and a stable occlusion, highlighting the effectiveness of lingual appliances in complex adult retreatment cases.

A comparative evaluation of the displacement and stress distribution of Kilroy spring, ballista spring and temporary anchorage devices during traction of palatally impacted canine using a 3 dimensional finite element analysis

The above study comprises a comparative evaluation of the displacement and stress distribution of Kilroy spring, Ballista spring and Temporary anchorage devices during traction of palatally impacted canine using a 3 dimensional finite element analysis. Palatally impacted canine is a common phenomenon occuring in around 8% of individuals. The Finite Element Analysis/Finite Element method (FEA/FEM) is the most intricate and dependable study that significantly revolutionized the world of dentistry and biomechanical research. Stresses and displacements can be precisely located using this type of numerical analysis. The orthodontist can better comprehend the physiological reactions that take place within the dentoalveolar complex because of the quantitative information it gives them. A Cone Beam Computed Tomography (CBCT)scan of the maxilla was obtained from a patient who reported to the Department of Orthodontics and Dentofacial Orthopaedics after he satisfied the inclusion and exclusion criterion. Finite element 3-D models of Kilroy spring, Ballista spring, Cantilever spring, miniscrew, lingual button, 0.022-inch-slot brackets, 0.019x0.025-inch SS archwire, stainless steel bands with molar tubes were constructed using a three-dimensional computer-aided design program (SolidWorks 2017; Solid Works K.K., Tokyo, Japan). All these components were imported and individually assembled in the ANSYS Software (Version 2021 R2, ANSYS, Canonsburg, Pa) and stress analysis was carried out. On the basis of this study following conclusion were drawn: The maximum amount of impacted canine displacement, with initial simulation, wasobserved with Kilroy spring followed by Ballista spring and miniscrew assisted Cantilever spring and the maximum amount of displacement of adjacent teeth i.e. lateral incisor and 1st premolar is observed with Ballista spring followed by kilroy spring and miniscrew assisted Cantilever spring. Furthurmore stress concentration on the canine is highest in case of ballista spring followed by Kilroy spring and miniscrew assisted Cantilever spring. Over all, miniscrew assisted Cantilever spring can be an efficient treatment option for traction of a palatally impacted canine.

Evaluation of Two Mini-implant Lengths in the Infrazygomatic Crest Region: A Randomized Clinical Trial.

Temporary anchorage devices (TADs) have revolutionized fixed orthodontic appliance treatment through anchorage controlling in the clinic and play an essential role in resolving many complex cases. Due to the limited space, there is a risk of injury to the roots while using interradicular microimplants. Therefore, the infrazygomatic crest (IZC) area can be an alternative mini-implant insertion site in the maxillary arch. The aim of the study was to evaluate the primary stability, pain perception, sinus penetration, late stability, and failure rate with two mini-implant lengths in the IZC area. Forty-eight mini-implants (Tusk Dental Co., Ltd., Canada) with two different lengths (length/diameter: 12/2 and 14/2 mm) were grouped by length (24 per group) and inserted bilaterally into the IZC area of 24 patients. The data were statistically analyzed, considering a significance level of p < 0.05. Sinus penetration prevalence did not differ significantly between 12-mm (54.2%) and 14-mm (62.5%) mini-implants (p > 0.05). Primary stability was significantly higher with the 14-mm mini-implants (p < 0.05). The failure rate did not differ significantly between the 12-mm (20.8%) and 14-mm (16.7%) mini-implants (p > 0.05). While the failure rate was similar between 12- and 14-mm mini-implants, the 14-mm mini-implants were more likely to damage adjacent structures. Therefore, shorter mini-implants should be preferred over longer mini-implants for most cases requiring IZC TADs. ClinicalTrials.gov identifier: NCT06293872.

Treatment of adult class II division 2 with deep bite using Forsus appliance and intrusion with TADs

This case report details the treatment of a 23-year-old female patient with Class II division 2 malocclusion with a Class II skeletal base due to a retrognathic mandible. The condition was further complicated by a complete overbite, absence of tooth #36, and a gummy smile. The Forsus appliance has shown to be effective in correcting Class II malocclusion in adult patients, with significant improvements in bite and facial esthetics. The use of temporary anchorage devices for intrusion resulted in lower overbite and increased actual intrusion compared with alternative methods for intruding upper incisors.

Intrusion and retraction with an innovative crane spring

Today, one of the most common lines of treatment for gummy smiles is the use of temporary anchorage devices (TADs). One of the major issues with the TADs is the unpredictability of stability during treatment. Additional to the loosening of TAD, gingival tissue overgrowth, especially when placed above the attached gingiva, is a persistent issue. During the process of intrusion and retraction, the point of force attachment in relation to the center of resistance is of prime importance to achieve the correct and required vector of force. This, at most times, is not achievable with TADs due to the interference of the roots of teeth. Thus, an alternative to TADs with the convenience of placing the point of force attachment anywhere in the buccal vestibule is discussed here in. This article describes the design and action of an innovative spring (Crane spring) wherein the point of force attachment can be varied to suit the biomechanics apart from delivering light and continuous forces using looped mechanics. The spring is of a simple design and can be easily constructed. It is highly efficient with intrusion and retraction.

Safe sites in the mandibular buccal shelf for orthodontic mini-screws: Tomographic study in different facial types

Objectives: The objective of this study was to verify safe sites on the mandibular buccal shelf (MBS) for extra-alveolar mini-screw insertion according to facial type. Material and Methods: In this retrospective study, 84 cone-beam computed tomography scans were equally divided into three groups according to the patient’s facial type: Group 1, hyperdivergent; Group 2, neutral; and Group 3, hypodivergent. The total buccal alveolar bone thickness was measured in five zones between the mesial root of the first molar and the distal root of the second molar, 3, 6, and 9 mm apical to the cementoenamel junction (CEJ). Results: MBS areas with adequate thickness for temporary anchorage device (TAD) insertion were as follows: Group 1, second molar distal root 9 mm from the CEJ; Group 2, second molar distal root 6 and 9 mm from the CEJ; and Group 3, second molar mesial root 9 mm from the CEJ and second molar distal root 6 and 9 mm from the CEJ. Conclusion: The safe zones on the MBS for TAD insertion were located on the distal root of the second molar, 9 mm from the CEJ, for all facial types. For neutral and hypodivergent patients, the site located on the second molar distal root, 6 mm from CEJ, was included; for hypodivergent patients, the site located on the second molar mesial root, 9 mm from the CEJ, was included.

Making a palatal temporary anchorage device distalizer more comfortable

Making a palatal temporary anchorage device distalizer more comfortable

Mandibular molar protraction: A comparison between fixed functional appliances and temporary anchorage devices.

This study aimed to compare the efficiency of temporary anchorage devices (TADs) and fixed functional appliances (FFAs) for mandibular molar protraction. Orthodontic records of 1050 consecutively treated patients with molar protraction were screened. Thirty-six records (22 females and 14 males; mean age, 17.4 years) were divided into two groups: TAD (21 subjects with 25 edentulous spaces) and FFA (15 subjects with 24 edentulous spaces). The primary outcome measure was the efficiency of protraction [magnitude and time required for protraction (rate) and anchor loss (AL)]. The secondary outcomes involved measuring the type of tooth movement (TOTM), external apical root resorption (EARR), alveolar bone height change (ABHC), alveolar bone width change (ABWC) and appliance failure. The rate of tooth movement was significantly higher for FFAs (0.83 ± 0.35 mm/month) versus TADs (0.49 ± 0.2 mm/month) (P = .005). Total treatment duration was less for FFAs (34.78 ± 8.1 months) versus TADs (47.72 ± 13.94 months) (P = .002). TOTM was similar for both (P = .909). EARR was 1.42 ± 1.38 mm for TAD and 1.25 ± 0.88 mm for FFA (P = .81). ABHC increased in the FFA group (1.01 ± 3.62 mm) and decreased for the TAD group (0.68 ± 1.66 mm). ABWC increased for both TAD (1.81 ± 1.73 mm) and FFA (1.75 ± 1.35 mm). The failure rate was 50% for FFAs and 33% for TADs. Both systems provided translation of lower molars with comparable anchorage control. However, FFAs were more efficient than TADs for lower molar protraction.

Nonsurgical correction of occlusal canting using temporary anchorage devices: A systematic review

ObjectiveThe recent development of temporary anchorage devices (TADs) allows orthodontic canting correction by selective intrusion of the molars. The purpose of this study was to review the treatment strategy and outcomes after orthodontic correction of occlusal canting using the TADs based on published literature including the case reports. Materials and methodsA systematic review of published English-language human clinical studies was conducted by electronic search of PubMed, Embase & Medline, and Scopus reviews up to Dec 2023. For inclusion, reports required documentation of subject demographic characteristics; location or type of TADs; diagnosis; presence of maxillary occlusal canting (MOC); and treatment outcomes (MOC correction). Studies were excluded if they involved orthognathic surgery to correct MOC. Critical appraisal for all included studies were conducted with the case reports/case series appraisal checklist of the Joanna Briggs Institute (JBI). The current study was registered in PROSPERO (CRD42021226432). ResultsThe search identified 260 reports and a total of 33 case reports met inclusion criteria with 46 individual patient cases. The results reported that occlusal canting could be resolved by unilateral intrusion of maxillary posterior teeth using TADs. The reported the amount of maxillary molar intrusion ranged from 1 mm to 4.8 mm. However, there were fundamental limitations in study subjects, paucity of data regarding the long-term stability, lack of standardization in intrusion mechanics, and variations in TAD devices. ConclusionsAlthough the previous reports mentioned that orthodontic canting correction with TADs could avoid maxillary surgery or orthognathic surgery itself, it cannot be concluded that non-surgical correction of occlusal canting can be comparable to surgical treatment. Further comparative investigation between surgical and nonsurgical canting correction is needed to clarify whether orthodontic intrusion can be an alternative to surgical canting correction in terms of efficacy and stability.

Evaluation of Treatment Effects of en Masse Mandibular Arch Distalization Using Skeletal Temporary Anchorage Devices: A Systematic Review.

Mandibular arch distalization using temporary anchorage devices (TADs) is effective in correcting borderline Class lll cases without surgery. This review analysed the existing literature evaluating the dental, skeletal, and soft tissue changes after en masse mandibular arch distalization using TADs. We followed PRISMA guidelines and registered this review in PROSPERO database CRD42023450524. PubMed, Google Scholar, Cochrane, Web of Science, and SCOPUS databases were searched. Orthodontic patients requiring en masse mandibular distalization using TADs were compared with different modalities of distalization. Dental changes were evaluated along with skeletal and soft tissue changes and treatment duration. Randomized controlled trials (RCTs), cohort studies, longitudinal studies, and retrospective studies were eligible to be included. The risk of bias was assessed using ROBINS-I tool ("Risk Of Bias In Non-randomized Studies-of Interventions"). Of 1764 identified records, seven studies (one non-RCT, one prospective clinical trial, and five retrospective cohort studies) were included. One study had a low risk of bias, three had moderate bias, two had serious bias, and one had critical bias. All studies showed molar distalization and distal tipping with significant retraction of the lower lip. Miniplates showed greater distalization compared to miniscrews. Interradicular miniscrews exhibited the least distal tipping. Changes in SNB, ANB, occlusal plane angle, and mandibular plane angle were reported. Retromolar screws and ramal plates reported reduced treatment duration. TADs are effective in en masse distalization of mandibular dentition with intrusive or extrusive effects.

Simulator practice of temporary anchorage device (TAD) insertion on inter-radicular sites improves learning and confidence in dental residency.

This exploratory study elicited the procedural considerations and inter-radicular site placement techniques of experts and investigated how the use of a simulator, with and without feedback, influenced novice learners' procedural considerations, placement techniques, and confidence. Three orthodontic/oral maxillofacial surgery expert clinicians participated in a temporary anchorage device (TAD) insertion assessment accompanied by a think-aloud protocol. Expert transcripts were coded according to a coding scheme to analyze clinicians' (N=18) procedural considerations and placement techniques. Residents were randomly allocated to control and intervention groups. Two placement sessions were conducted at two inter-radicular sites with audio recordings. The intervention group received real-time feedback on root contact from the simulator's sensor and postoperative radiographs for self-assessed feedback. Residents' confidence levels were compared before and after placements, and subjective feedback about the simulator was obtained. This study utilized the think-aloud protocol to capture experts' procedural considerations and placement techniques during TAD insertion and revealed a disparity between residents' and experts' thought processes. Only four out of 15 expert themes were mentioned by more than 50% of the residents. The use of the TAD insertion simulator in combination with feedback broadened residents' procedural considerations after one round of placement. Residents' confidence increased significantly in both groups (p<0.05), but there was no significant difference between them (p>0.482). When used in conjunction with feedback, simulator practice of TAD insertion broadened residents' procedural considerations after one round of placement. It improved residents' confidence level and was well received as a learning tool.

Mandibular Advancement and Skeletal Anchorage in Class II Malocclusion Patients: A Systematic Review with Meta-Analysis

(1) Objectives: The purpose of this review was to compare the effects of combining skeletal anchorage and Class II devices, both from an overall perspective and individually for each type of appliance, considering as main outcomes the vertical dimensions and the inclination of the mandibular and maxillary incisors. (2) Materials and Methods: A search without time restrictions was performed up to February 2024 in PubMed, PubMed Central, Scopus, and Medline for randomized controlled trials, as well as prospective and retrospective cohort studies, considering Class II patients treated with and without skeletal anchorage. The effect measure used for the meta-analytic evaluation was the standardized mean difference (SMD). The SMD calculation was obtained by subtracting the mean values of T1–T0 for each individual treatment and then calculating the SMD between the treatments involved. The meta-analysis was performed using the standardized mean difference of the mean difference of the T1–T0 change in the outcome between the different treatments evaluated as the effect size. (3) Results: A total of 1217 documents were initially retrieved. According to the PRISMA protocol, 18 studies comparing different skeletal anchorage protocols (upper/lower miniscrews and miniplates), combined with four appliances (Herbst, Forsus, Carriere Motion, and elastics), were included in the analysis. No significant difference in skeletal divergence was found between groups from an overall point of view (SMD: 0.19 (−0.48 to 0.83) according to the random-effects model). A statistically significant reduction in IMPA° was found in patients treated with temporary anchorage devices (TADs) (SMD of 5.58 (3.40 to 7.75)), except for the elastics group (SMD: 3.76 (−0.91 to 8.43)). The effect on the upper incisors’ inclination appeared to be strictly dependent on the type of anchorage (TADs in one or both of the arches). Some limitations must be considered when interpreting the results: the small number of studies included and the heterogeneity among them are among the limitations, and the temporal disparity among some studies; the ages of the patients were not always comparable; and, finally, the clinical relevance of the effects of TADs is sometimes questionable. (4) Conclusions: The vertical dimension seems not to be significantly affected by skeletal anchorage; instead, the proclination of mandibular incisors is generally reduced when TADs are used. Skeletal anchorage might be useful if lingual tipping of the upper incisors is required; however, it is influenced by the anchorage protocol.

Taming the vertical growth of mandible in a growing patient with skeletal open bite: A case report

Skeletal open bite poses a significant challenge due to its association with downward and backward mandibular rotation and vertical maxillary overgrowth. Early intervention is critical, especially in patients with a hyperdivergent skeletal phenotype, as facial growth patterns are established early in development. This case report details the treatment of a 9-year-old male with a severe anterior open bite of 6 mm, vertical growth pattern, and class I skeletal relationship. Initial treatment included high-pull headgear with an intraoral transpalatal arch and tongue cribs to control the molar eruption and tongue posture. Over nine months, this approach reduced the open bite by restricting maxillary molar movement and promoting mandibular autorotation. In the second phase of treatment, temporary anchorage devices (TADs) were placed in the parasagittal region along with a transpalatal arch to achieve active molar intrusion and improve incisor exposure. The combination of orthopedic appliances and TADs successfully eliminated the open bite and corrected overjet, while improving incisor alignment, facial profile, and smile esthetics. Cephalometric analysis revealed a reduction in the mandibular plane angle, lower anterior facial height, and improved incisor extrusion. This case highlights the efficacy of early skeletal open bite correction using non-surgical methods, with TADs providing effective molar intrusion and stable long-term results. The integration of headgear and skeletal anchorage offers an effective treatment modality for young patients with severe open bites, potentially eliminating the need for more invasive surgical procedures in the future.

Evaluating the efficiency of mandibular molar protraction using Herbst appliances versus temporary anchorage devices: a retrospective case-controlled study

BackgroundMandibular second premolar agenesis is a common problem in orthodontics and is often treated in conjunction with maxillary counterbalancing extractions. However, in cases without maxillary crowding or dental protrusion, space closure may pose challenges leading to compromised occlusal results or patient profile. Multiple techniques have been described to treat these patients; nevertheless, there is a paucity of data comparing effectiveness of space closure utilizing various anchorage techniques. The goal of this study is to assess the effectiveness of the Herbst device during mandibular molar protraction and compare it to the use of temporary anchorage device (TADs) in patients with mandibular second premolar agenesis.Materials and methodsThis retrospective study included 33 patients with mandibular premolar agenesis treated without maxillary extractions. Of these patients, 21 were treated with protraction Herbst devices and 12 with TADs. Changes in molar and incisor positions, skeletal base positions and occlusal plane angulations were assessed on pretreatment (T0) and post-treatment (T1) lateral cephalograms. Scans/photographs at T0 and T1 were used to evaluate canine relationship changes representing anchorage control. Space closure and breakage/failure rates were also compared. Data was analyzed with paired and unpaired t-tests at the significance level of 0.05.ResultsWithin the Herbst group, changes in mandibular central incisor uprighting and mandibular molar crown angulations were statistically significant. However, no significant differences were noted between the Herbst and TAD groups. Protraction rates as well as overall treatment times were comparable (0.77 mm/month vs. 0.55 mm/month and 3.02 years vs. 2.67 years, respectively). Canine relationships were maintained or improved toward a class I in 82.85% of the Herbst sample, compared to in 66.7% of the TAD sample. Emergency visits occurred in 80.1% of the Herbst group, with cementation failures or appliance breakages as the most common reasons.ConclusionThe Herbst device could be a viable modality in cases with missing mandibular premolars where maximum anterior anchorage is desired, or if patients/parents are resistant to TADs. Furthermore, they could be beneficial in skeletal class II patients with mandibular deficiency who also need molar protraction. However, the increased incidence of emergency visits must be considered when treatment is planned.

Vertical Maxillary Excess Simplified: A Non-surgical Management with Mini-Implants

Abstract Vertical maxillary excess (VME) refers to an excessive growth of the maxilla and related dentoalveolar structures in an inferior direction, which can affect the entire maxilla. This clinical condition can result in a long face, an excessive display of gums when smiling, and occasionally an open bite. In non-growing patients, this may often require a surgical intervention. This article describes the orthodontic treatment of a 20-year-old female patient who presented with proclination of incisors and excess visibility of teeth during smile. Clinical and radiographic examination revealed a convex facial profile, Angle’s Class I malocclusion and VME. A comprehensive orthodontic treatment plan with the help of temporary anchorage devices was executed which resulted in achieving all the treatment objectives. Hence, these simple biomechanics contributed to the effective intrusion of upper teeth correcting the gummy smile which is found to be non-inferior to the surgical counterpart.

Surface Analysis of Orthodontic Mini-Implants after Their Clinical Use.

Temporary anchorage devices (TADs) are orthodontic mini-implants with remarkable characteristics that, once inserted, present mechanical retention (primary stability) without the process of bone osseointegration. However, interaction with the biological environment may cause changes in the morphology of the external surface of dental TADs. In this study, we used 17 TADs made of aluminum-vanadium titanium alloy, produced by two companies, which were analyzed through optical microscopy after being removed from the patients during orthodontic treatment. We evaluated the changes that appeared on the TADs' surfaces after their use in the biological environment, depending on the morphological area in which they were inserted. In our study, we found changes in the morphology of the implant surface, and especially deposits of biological material in all study groups. On all samples examined after clinical use, regardless of the period of use, corrosion surfaces in different locations were observed. Our obtained results support the idea that the biological environment is aggressive for mini-implant structures, always producing changes to their surface during their clinical use.

Revolutionizing orthodontics: Effective management of Class III skeletal malocclusion using innovative buccal shelf bone screws

The advent of the temporary anchorage devices has revised the envelope of discrepancy in modern orthodontic practice. Orthodontic camouflage is opted in situations where the patient is reluctant to have an invasive orthognathic surgical procedure and the associated risks or where, by the use of temporary anchorage devices, the orthodontic envelope can be expanded, and optimal orthodontic result can be obtained non surgically. In such cases, TAD’s can be used to obtain an acceptable orthodontic result with a cusp to fossa posterior relation, an optimal aesthetic outcome, and a functional occlusion. This case report showcases a camouflage treatment of a Class III non-growing patient treated by use of TAD’s, to cause clockwise rotation of maxillo- mandibular occlusal complex for achieving optimum molar relation, facial esthetics, and function.A case of skeletal and Angle’s Class III malocclusion is presented where orthodontic camouflage was carried out to deliver optimal orthodontic results. This was achieved effectively by in toto distalization of the lower arch. This was brought about with the use of two extra alveolar TAD’s placed in the buccal shelf region of the lower arch. Two 2 x 12 mm bone screws were used, after space creation by extraction of lower third molars bilaterally, and elastic chains was the chosen force delivery system. Here in toto distalization of the lower arch was achieved to end in an Angle’s class I molar and canine relationship with normal overjet and overbite. Total treatment duration was of 17 months.Challenging skeletal malocclusions can be treated non surgically by effective use of TAD’s and correct and efficient use of biomechanics.

Accuracy of Orthodontic Anchor Screw Placement Using a 3D-Printed Surgical Guide.

Background Although radiographs and computed tomography (CT) images are reviewed before temporary anchorage device (TAD) implantation, implantation of TADs exactly as planned is difficult. This study aimed to evaluate the accuracy of TAD implantation using an original surgical guide fabricated using cone-beam CT data and computer-aided design software. Methodology The studyparticipants included six experienced orthodontists who had implanted ≥20 TADs, and six inexperienced orthodontists who had never implanted a TAD. Maxillary dental typodont models with radiopaque tooth crowns and roots were used. A total of four TADs were implanted on the buccal sides: between the second bicuspid and first molars and between the first and second molars bilaterally. The accuracy of TAD implantation was examined in two groups: in 12 dental typodont models, TAD implantation was performed using a surgical guide (guide group), and in 12 dental typodont models, TAD implantation was performed without a surgical guide (freehand group). All dental typodont models implanted a total of 96 TADs.The TAD position was evaluated using the CT coordinate system and 3D image measurement software. Using the long axis of the TAD as a reference, the distance between the coronal and apical ends of the implanted TAD and those of the planned TAD, i.e., the ideal implantation position, was measured in both groups along the x, y, and z axes. The medians of the values were compared between the groups. Additionally, the presence of root contact was compared between the experienced and inexperienced orthodontists. Results On the x-axis, the linear deviations (median) of the coronal and apical ends of the TAD in the freehand group were 1.06 mm and 1.36 mm, respectively. In contrast, in the guide group, the deviations were 0.65 mm and 0.90 mm, respectively, and the difference was statistically significant (p = 0.002 and p = 0.005, respectively). On the y-axis, the deviations in the freehand group were 1.13 mm and 1.08 mm, respectively. In contrast, the deviations in the guide group were 0.71 mm and 0.79 mm, respectively, and only the coronal deviations were significantly different between the groups (p = 0.006). On the z-axis, the deviations in the freehand group were 1.44 mm and 1.86 mm, respectively. In contrast, the deviations in the guide group were 0.75 mm and 1.16 mm, respectively, and the difference was statistically significant (p = 0.006 and p = 0.002, respectively). Conclusions The use of a surgical guide allowed for more accurate TAD implantation. Additionally, TAD implantation using a guide prevented root damage.