Skeletal Orthodontic Anchorage

How does conventional Orthodontics work?

picture of TADs

When an orthodontist puts braces on a patient’s teeth, they are usually bonding tooth colored or metal attachments on each tooth (termed “brackets”), then tying the brackets together with thin wires of various sizes and strengths. Gentle slow pushing, pulling, or rotational forces are then applied to teeth to move them in a desired direction in a slow controlled fashion. Typically, this is done by tying groups of teeth together to form a firm stable base (termed “anchorage.”) The tooth that is to be moved is then slowly pushed, pulled, or rotated against that stable base until the desired movement of the tooth occurs. This is all done within the context of an individual’s specific anatomy, bone density, and biology.

Why use Skeletal Orthodontic Anchorage?


There are some Orthodontic tooth movements that are more difficult to accomplish than others. Sometimes patients may have missing teeth that would otherwise be used for stable anchorage during treatment. Occasionally a patient’s bone may be less dense in one area than in another. In adults, periodontal bone loss can affect the stability of a tooth needed for anchorage. These and other situations can create circumstances where there is less than ideal anchorage present for the type of tooth movement planned. In these cases, your orthodontist may recommend you see us for the placement of small Skeletal Orthodontic Anchorage attachments to help in the efficient orthodontic movement of your teeth.

What is Skeletal Orthodontic Anchorage?


Skeletal Orthodontic Anchorage involves the placement of small attachments in the jawbone around the teeth. These attachments are then used by the orthodontist to put a pushing or pulling force on the teeth to be moved, not by applying the force against groups of teeth tied together with braces, but against the rigid bone in the area(s). This form of anchorage is stronger and can be more efficient in moving a tooth in the desired way.

How are Skeletal Orthodontic Anchorage attachments placed?


There are basically 2 types of Skeletal Orthodontic Anchorage attachments. The simplest is termed a Temporary Anchorage Device (TAD.) A TAD is essentially a mini screw with a head that has different types of orthodontic attachments to be used by the orthodontist to place small elastics or wires to direct the appropriate tooth movement in the area. TAD’s can be placed in many different areas including between the roots of teeth. The second type of Skeletal Orthodontic Anchorage attachment is a mini bone plate with similar orthodontic attachment modifications. These plates are usually attached to firm bone above or below the teeth, buried under the gum tissue, and have a thin “arm” that extends through the tissue to place the orthodontic attachment into the appropriate area for the orthodontist to use.

picture of TADs1b
picture of AnchoragePlates2
picture of TADs1
picture of AnchoragePlates


What can I expect after surgery?


Both TAD’s and bone plates can be placed in our office, under local anesthesia. If you are very anxious about the procedure, IV Sedation can be used, but it is usually not necessary. TAD placement is minimally invasive and usually requires no incision(s). Bone plate placement requires a small incision above the teeth with a few dissolvable stiches. Bone plate placement takes a little more time than TAD’s. Both procedures are minimally traumatic and result in little pain and swelling.

What happens after my orthodontic treatment is finished?


When your orthodontist feels that there is no longer any need for the Skeletal Orthodontic Anchorage attachments to be in place, they can be quickly and easily removed in our office under local anesthesia with very little trauma, pain, and swelling.

Schedule Your Appointment


If you would like to learn more about our surgical procedures, call (914) 768-8220, and schedule your appointment today!