Complications Encountered in Temporary Orthodontic Anchorage Device Therapy

Although absolute anchorage with the use of fixed skeletal implants is not a recent concept in orthodontic mechanotherapy, its popularity in recent years has increased exponentially as a result of the advent and widespread manufacture of temporary anchorage devices (TADs). TADs are an invaluable asset to contemporary orthodontics, facilitating tooth movement that might otherwise require (1) surgical repositioning of the jaws, (2) extraction of permanent teeth, and/or (3) extended use of extraoral anchorage. As more orthodontists incorporate TADs into their therapeutic regimens, the clinician should be cognizant of the variety of iatrogenic sequelae that may occur with the employment of such adjuncts. Complications include, but are not limited to, encroachment upon adjacent anatomical structures, mucosal perforations or tears, peri-implantitis, and unintended tooth movement. A review of some common problems with clinical examples, as well as protocols for prevention is presented.