IVAN GILL, orthodontic specialty registrar at Barts and the London/ Southend University Hospital, gives an insight into the Infinitas TAD course, presented by Richard Cousley and DB Orthodontics.
Ivan Gill graduated from Barts and the London School of Medicine & Dentistry in 2014. He underwent dental foundation training in N.E. London and subsequently obtained posts in oral and maxillofacial surgery, and pediatric dentistry. Ivan has obtained the MFDS and a Postgraduate Certificate in Dental Education. He is currently an orthodontic specialty registrar at Barts and the London/Southend University Hospital.
A rise in TADs
The use of TADs has dramatically risen over recent years and this has allowed orthodontists to broaden the scope of orthodontic treatment. There is increasing evidence to show that TADs provide a more effective source of anchorage reinforcement compared to conventional forms such as headgear, as they do not rely so heavily on patient compliance. Furthermore, the evidence suggests that TADs are better tolerated by patients. Therefore, I decided to attend the Infinitas TAD course to gain a further insight into this rapidly advancing field of orthodontics.
The course lasted for a day, and there were approximately 14 delegates in attendance, ranging from registrars through to experienced specialist practitioners. It was well structured with a good balance of lectures and practical sessions in the morning and afternoon. The lectures provided an overview on the clinical applications of TADs, and covered the following topics:
- Maximizing TAD success
- Planning and insertion: “Infinitas insertion protocol”
- Incisor retraction
- Molar protraction
- Molar intrusion (Anterior open bite therapy)
- Molar distalization and palatal appliances including RME techniques
The sessions were very interactive and engaging with Dr Cousley encouraging us to treatment plan various clinical cases with TADs.
In my opinion, the practical sessions throughout the day were the most valuable.
We initially placed TADs in bone blocks resembling the maxilla and mandible, to gain an appreciation of the tactile sensation of the procedure. Each delegate had a TAD kit provided by DB Orthodontics, and we all found the instruments incredibly easy to set-up and use.
The next practical session involved placing TADs in the typodont models. We were encouraged to insert TADs both free handed and with ready-made stents. It quickly became apparent that the insertion of TADs is a very technique-sensitive procedure, with little margin for error, particularly in the confines of an oral cavity. The stents were extremely useful, particularly when placing TADs in difficult anatomical locations to access, such as the palate.
One to one support
Dr Cousley was able to spend time with each of us during the sessions to reflect on our TAD placements and suggest improvements in our technique. Whilst we were simulating biomechanics on the models, another striking feature of the Infinitas TAD was its versatility and the ease at which various attachments could be placed on the TAD e.g. NiTi springs and power chain.
At the end of the course, we were given a hardcopy of 'The orthodontic mini-implant clinical handbook' written by Dr Richard Cousley, and DB orthodontics kindly allowed us to take our typodont models home, which can serve as a great visual aid of TADs for our patients.
"I would certainly recommend this course to any clinician looking to enhance their experience in placing TADs and give a special thanks to Dr Cousley and DB Orthodontics for hosting this course."
I would certainly recommend this course to any clinician looking to enhance their experience in placing TADs and give a special thanks to Dr Cousley and DB Orthodontics for hosting this course. Dr Cousley has opened my imagination to the versatility of TADs with its use in a range of clinical situations. With increasingly high-quality evidence illustrating its effectiveness, it is clear that the use of TADs will continue to rise, and therefore is an option that should be discussed with patients. I feel much more confident in planning such cases and I am looking forward to placing TADs in the near future!
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