Temporary anchorage device with interchangeable superstructure for mandibular tooth movement

The aim of this report is to introduce our new temporary anchorage device (TAD) for the mandible, the superstructure of which is removable and enables mesiodistal movement, intrusion and extrusion, as well as expansion and constriction, employing the palatal implant with the same system as we reported previously. The TAD has a removable superstructure on a plate fixed on two screws. It is positioned on the external oblique ridge, and the superstructure shape can be changed into various forms. Case 1 was a 19-year old woman with an anterior open bite; her mandible was shifted to the left. The molar relationship was Class III on the right and Class II on the left, and inclination of the occlusal plane was observed. Intrusion of the maxillary right molars and distalization of the left molars were performed using the palatal implant. Distalization of the mandibular right molars was achieved using the TAD. Case 2 was a 38-year old man with an anterior cross bite and deviation of the mandible to the left. Distalization of the mandibular right molars and movement of the midline to the right were achieved using the TAD. The TAD system can handle all force systems, move teeth effectively, and save treatment time.