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Errors, mistakes and failures in orthodontics. Palatal TADs-the digital way

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11-12 November 2022

  • Resident
  • Specialist - +€120.00

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Errors, mistakes and failures in orthodontics.
Palatal TADs-the digital way

Bucharest, Romania

Dr. Björn LUDWIG

Dr. Björn LUDWIG

Dr. Björn Ludwig maintains a private orthodontic practice in Traben-Trarbach, Germany. He is Assistant Professor at the University of Homburg/Saar, Department of Orthodontics. His focus of research work is skeletal anchorage and 3D imaging. He has published more than 200 peer reviewed clinical and scientific articles, and is editor of three books. He is editor in chief of the Quintessenz publication Kieferorthopädie” (Orthodontics). He is also co-editor of the Journal of Clinical Orthodontics. He is active member of the Angle society of Europe and serves in the council of the German board of Orthodontics. He is the current president of the European Begg Society.

Course Outline:

November 11th
Failures and errors in orthodontics - how to say sorry. Errors, Errors, Errors and (n)one solution in sight?!

At the end of advanced orthodontic training, after studying some basics of dentistry and orthodontics, one is often convinced that major diagnostic and treatment-related errors could now be avoided. After working in orthodontics for several years, this idea changes and one comes to believe in, or at least sees, only problems and errors. For instance, there can be an unusually high rate of bracket loss, damaged retainers, or frustrating treatment results - including relapses. The increasing number of difficult cases in orthodontic practices which do not ‘simply’ exhibit gentle crowding during the last years compound this problem. Severe dental and skelettal anomalies, such as multiple aplasia, trans-located teeth, adults with combined orthodontic and maxillofacial surgery treatment needs, as well as pre-prosthetic tasks, are prevalent in our treatment today. In this lecture the most common and most severe orthodontic problems and errors the lecturer encountered in the last 15 years will be presented. These errors are demonstrated using clinical examples and will be discussed with the current literature. Finally the question “how to say sorry” will be ethically reflected. Fundamental diagnostic decision will be discussed: • extraction versus non-extraction
• BSSO surgery versus conservative therapy of skeletal anomalies.
Treatment techniques will be evaluated: • Limitation of aligners
• bracket positioning CAD/CAM or direct Placement
• arch wire selection
• CAD/CAM devices
The question of long-time stability of treat¬ment results, as well as necessary retention devices, must be addressed at the end of the course.

November 12th
From Enthusiasm to frustration or back to the future – TADs in the digital age

TADs were one of the most discussed topics of the last decade. It started in the 90’s and experienced in the last 15 years an extreme hype. Practitioners were enthusiastic about the possibility to counteract Newton’s third law. Now, more than a decade later quite a lot of clinicians are frustrated about high loss rates and non-working biomechanics. Currently, the alveolar process still is the most preferred insertion site. However, due to the varying bone quality and the risk of root contact, the survival rate of implants inserted in the alveolar ridge, especially interradicular, still needs improvement. Other regions, such as the anterior palate for miniscrews and implants or the mental region for miniplates, provide much better conditions for mini-implant insertion, since the amount and quality of the available bone is far superior. Implants with several types of abutments and connectors allow the construction of versatile and cost-efficient appliances for a large variety of orthodontic applications. Utilizing TAD´s in the anterior palate and the mental region eliminates the risk of root injury and takes the implants out of the path of tooth movement. This lecture will show an overview of the up to date literature, current developments of appliance designs, main indications, placement techniques, and risk factors during placement and orthodontic treatment. It will especially focus on the virtual TAD placement from intraoral scanning up to a ONE-VISIT protocol of simultaneous TAD insertion and appliance placement. Many different biomechanics of the connected orthodontic appliance will be presented. The lecture will show scientific and clinical perspectives on how mini-screws can become a safe and reliable standard device. OUTLINE • Insertion sites
• TAD selection
• Insertion techniques – 2D versus 3D – conventional versus digital
• Risk factors
• Survival rates of TADs
• Space closure of missing teeth
• Rapid palatal expansion
• Class III treatment
• Anterior open bite treatment
• Surgical facilitated orthodontics
• Finishing
• Retention and stability