Rapid Palatal Expander and TAD Anchors

Since the beginning of the Wireworks in 1996 we have treated many of our patients with a palatal expansion procedure as an initial step to orthodontic therapy. The orthodontic advantage is that it has allowed us to create space to align teeth where we were frequently challenged with inadequate space. Not all of our patients and dental colleagues initially appreciated this, but fortunately over the decades this has become more mainstream.

Lately, there have also been research findings linking palatal expansion orthodontic treatment contributing to improved nasal airway flow and resultant reduction in sleep apnea for some people. This has contributed to more focus on and support for palatal expansion treatment.

Since about 2021 we have been performing more combined therapy using rapid palatal expansion appliances (RPE) and TAD bone anchors. This is frequently referred to as a MARPE appliance. This has been facilitated through our in-house lab, as we can make these appliances ourselves. We have been encouraged by the excellent results we have seen in our practice. Unfortunately, this is not very common yet, as many clinicians do not feel comfortable placing the TAD anchors, and the appliances can also be expensive when sourced through commercial labs.

Temporary Anchorage Device (TAD) Implants

This is a technology to use temporary bone screws as adjuncts to facilitate challenging orthodontic tooth movements. This technology was introduced into orthodontics in the late 1990s, with significant research focus and clinical case reports from the early 2000s onwards. We started using TADs as of 2005 and have had great clinical success with this technology. We have learned that to incorporate this treatment modality we had to place the anchors at our office, as referring this out to other clinicians just took too much time and resulted in increased expense for our patients. Since 2005 we have placed close to 3000 TAD anchors at The Wireworks with very few complications. The primary complication is that about 10% of anchors do come loose and fall out. Fortunately, the sites heal very quickly, once the anchor falls out, or is removed. The anchors are removed at the end of treatment. Frequently, when an anchor fails, we just replace it once the site has healed, sometimes with a slightly longer anchor. TADs look a bit like a piercing. Fortunately, we can do very challenging clinical treatments using TAD anchors, and we have shown a clinical case below that we have treated at our office for illustration purposes. You can find more information about TADs on our colleague’s website skeletalanchorage.com.