Understanding implant sites for TADs

Buccal alveolar bone is the commonest location for placement of temporary anchorage devices (TADs). To obtain good primary stability, it is preferable to insert TADs between the first and second molars mesiodistally, and the most apically where cortical bone is thick and dense. Palatal alveolar bone is a good site for TAD insertion and can be used effectively in lingual orthodontics and molar intrusion. The midpalatal area usually has a large amount of bone, which can be confirmed with a lateral cephalogram or cone-beam computed tomography. In this area, because bone is firm and abundant, pilot drilling is recommended before TAD placement. In order to avoid failures or complications, clinicians should consider where to place TADs based on the most appropriate anatomical position, the thickness of cortical bone and soft tissue, root proximity, and anatomical limitations.