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TAD-based anterior intrusion applianceresearched

Quick facts

FieldValue
IDOA-0098
Typeanchorage
Categoryanchorage
Fixed/removablefixed (TAD-anchored)
Primary functionanterior dental intrusion; deep overbite correction
Malocclusion targetdeep overbite
Uses TADsyes — 2–4 buccal TADs
Periodmodern
Statuscurrent

Overview

Deep overbite correction traditionally requires either posterior extrusion (bite plate, brackets) or genuine anterior intrusion. TAD-based anterior intrusion achieves true incisor intrusion by anchoring directly to the bone, bypassing the dental arch as the reaction unit. Two TADs placed between the roots of the upper canine-first premolar or lower canine-first premolar provide direct intrusion anchorage. A sectional wire or NiTi coil spring delivers ~60 g of intrusive force per side to the anterior teeth. This produces genuine incisor intrusion with no extrusion of the posterior teeth — superior to bite plate mechanics where posterior eruption is the primary mode.

Clinical & technical

Mechanism of action

Buccal TADs are placed in the attached gingiva between canine and first premolar roots. An intrusion auxiliary (sectional 0.016 × 0.022 SS or TMA, or NiTi coil spring) is attached from the TAD to the anterior tooth bracket. This delivers a continuous ~60 g intrusive force. The TAD provides absolute anchorage — no posterior extrusion occurs. The anterior segment intrudes by 2–5 mm depending on the treatment plan. Indirect anchorage can be established by ligating the posterior brackets to the TADs passively to prevent mesial drift.

Indications & case selection

Deep overbite (≥4 mm); cases where posterior extrusion is not desired (Class II hyperdivergent with deep bite); anterior open bite with excessive incisor extrusion (intrude to close); cases with gummy smile requiring genuine incisor intrusion; combination with comprehensive fixed appliances.

Contraindications & limitations

Adequate root divergence between canine and first premolar required for safe TAD placement; adjacent root proximity on CBCT must be confirmed; intrusion of multiple teeth simultaneously requires careful force distribution; not appropriate if deep bite is due to mandibular skeletal deficiency (requires orthognathic surgery).

Design & fabrication

Components & materials

Lab fabrication notes

The intrusion auxiliary may be prefabricated (NiTi coil spring) or fabricated chairside from TMA wire. No specialized lab component is required — the TAD and spring are entirely clinician-placed.

Common variants & modifications

for open bite correction

intrusion using TADs

design

Common variants & modifications

molar level delivering intrusive force to anterior segment

anchorage for pure intrusion without posterior extrusion

segment acts independently on anteriors

controlled, low-friction anterior intrusion

anterior brackets — most common clinical approach

Also known as

Sources

PMC](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046359/)

Dentistry](https://decisionsindentistry.com/article/clinical-uses-temporary-anchorage-devices/)

Wiley](https://onlinelibrary.wiley.com/doi/10.1155/2020/5213936)

Research log

deep overbite, force calibration.