Newsletter - December 2021

ALIGNED 

DB ORTHODONTICS INTERNATIONAL UPDATE 

December 2021

It’s not just the fields that 

are green in Yorkshire 

Caring for the future is embedded in our DNA. As a family business it’s our mission 

to provide the same opportunities and quality of life that we enjoy now, for future 

generations. 

We are always looking for new ways to improve every aspect of our business; 

from packaging materials, to travel, and energy supplies - even down to the last 

lightbulb. 

Over the past few years, we have worked hard to reduce the amount of 

non-eco-friendly items here at DB HQ. Our packaging tape is being phased 

out and replaced with water activated packing tape. Bubble wrap is to be replaced 

with a paper version, and document enclosed wallets will be biodegradable. 

Our Evolve bracket packaging will be made from card instead of plastic, and 

wire boxes will no longer be glued. Grip seal bags will also be replaced with 

biodegradable versions. We are looking at other ways to improve our carbon 

footprint in addition to these changes, and are weighing up options for the 

coming months. 

Our Warehouse team member Sonia is 

using our new paper packing dispenser. 

The honeycomb packing is a greener 

alternative to traditional bubble wrap. 

E: sales@dbortho.com www.dbortho.com

Evolve packaging will be moving to a more 

environmentally friendly and recyclable 

paper solution. 

Water activated packing tape now 

replaces plastic tape packing. 

As you would imagine, we hold vast amounts of stock, and these improvements 

can already be seen across the range in parts. It will however take time for all 

these changes to be fully rolled out; Rome wasn’t built in a day after all! 

We also enjoy working together to raise money for worthy causes in our 

communities. Throughout September and October, we raised £3,000 for 

the Healthcare Workers Foundation through sales of our Colour Boutique 

ranges of ligatures. 

We will continue to focus on responsible working practices and we do 

hope we can inspire you to do the same. Together we can make a 

difference for our future generations. 

Electric car charging stations are now 

available for team members and visitors 

with electric cars. 


What do our customers 

say about our products? 

“Whenever an adjustment kit is opened and there’s an Ixion distal end cutter on it, 

the nurses will comment “you’ve got a good one there!” When using the Ixion 

distal end cutters in particular, I can confidently use them without the risk of 

de-bonding the molar tubes.” 

Sarah Hosni - Consultant Orthodontist 

“I trailed a few different ceramic brackets and chose to stay with SPA. 

I have been using them for several years and absolutely love them.” 

Aisling Byrne - Consultant Orthodontist 

“The consistency (of Autograph Whitening) is pretty thick, which is great as you don’t 

get any leakage outside the trays. Anybody that has ever over loaded a tray knows 

how sore it can make your gums, so this product definitely helps reduce the chance 

of that happening. Their built-in anti-sensitivity agent is a really nice addition.” 

Anna Symmonds - Southend Orthodontics 

“We use DB Orthodontics wire because after trying other brands, we realised that 

the quality of DB wires is far superior. With DB wires in particular, we see far less 

distortion of the wires when patients are attending their 6-week adjustment.” 

Fiona Lyon - Lead Nurse 

“We have used DB archwires for a number of years and have always been happy 

with the quality and performance” 

Fern Stewart - Specialist Orthodontist 

“I find Bond-It to be amongst the best cement available. 

The handling characteristics are great, both for loading and flash removal, 

and the bond strength is reliable.” 

Henry Wong - Orthodontist 



Temporary anchorage devices: 

a paradigm shift 

SARA HOSNI 

Sara is an associate specialist orthodontist at Northenden House Orthodontics and a consultant at Salford 

Royal NHS Foundation Trust and Glan Clwyd Hospital. She qualified at the University of Newcastle and 

following a variety of hospital posts, Sara undertook her orthodontic specialist training at the University of 

Liverpool. In 2015, Sara gained her doctorate of dental sciences degree at Liverpool University. 

Although temporary anchorage devices (TADs) have 

been available for clinical use for at least a couple of 

decades now, it’s fair to say that they are not yet 

being utilised to their full potential. We are well 

versed in the theoretical workings of TADs or, more 

specifically, miniscrews, but how often are we using 

them as realistic alternatives in otherwise complex 

cases? 

Every now and then, a case comes along 

that challenges our well-rehearsed rhythm of the 

usual treatment mechanics and acts as a paradigm 

shift in how we practise clinical orthodontics. So, 

what exactly are TADs, and why are more and more 

people raving about them? 

Temporary Anchorage Devices 

TADs are used for skeletal anchorage and are 

inserted into the bone to enhance orthodontic 

anchorage (Chen et al, 2006), either by supporting 

the anchor teeth (indirect anchorage) or by acting 

as anchor units in their own right (direct anchorage), 

eliminating the need for supporting teeth (Mizrahi 

and Mizrahi, 2007). They are removed once their 

function has been completed. They have many 

advantages, which have been summarised in Table 

1. The risks associated with TADs are well documented 

(Table 2); however, with appropriate training 

and diligence in case planning, most of these can be 

avoided. 

There are several indications and 

contraindications for the use of TADs, which are 

summarised in Table 3, as good case selection is 

key to achieving the intended outcome in a 

predictable manner. Impressive success rates for 

TADs, ranging from 76% to 96%, have been reported 

in the literature (Bearn and Alharbi, 2015; Son 

et al, 2014). It has been shown that success rates 

are directly correlated with various factors, including 

age, site of placement and miniscrew diameter (Lee 

et al, 2010). 

Case Study 

Figures 1 to 11 demonstrate a case where Infinitas 

TADs were used to provide both direct and indirect 

anchorage for the treatment of an anterior open bite 

and class 2 malocclusion. 

The alternative treatment option was a 

combination of orthodontics and orthognathic 

surgery, which the patient was not keen on. The 

plan was for the TADs to be placed palatally and 

‘locked’ to the transpalatal arch in order to provide 

indirect anchorage for correction of the buccal 

segment relationship after extraction of the upper 

first premolars. They would then be used for direct 

anchorage for the intrusion of the upper buccal 

segments, thereby correcting the anterior open bite. 

The patient was compliant, the TADs 

survived the treatment duration, and in the end, we 

had one delighted patient who didn’t need 

orthognathic surgery. So, should we be offering this 

to all anterior open bite patients? Case selection is 

fundamental to achieving a successful outcome, so 

undoubtedly, there will always be cases that will still 

require a surgical approach. However, for a 

number of patients, the use of TADs can mean 

avoiding orthognathic surgery and the risks that 

come with it. 

Being critical of the finish, despite 

undertaking lower arch extractions,the patient still 

had some gingival recession of the lower left central 

incisor. A gingival graft was discussed to address 

the recession of the lower left central incisor. 

Summary 

In summary, TADs provide an alternative to 

conventional mechanics for anchorage control, and 

there is increasing interest in their use. Outcomes 

that would otherwise require orthognathic surgery or 

would not be possible may be achieved using TADs 

in combination with orthodontics. 


Advantages of TADs 

• Simple to place and remove 

• Can be undertaken by the treating 

orthodontist 

• Avoids the need for methods dependent on 

patient compliance (eg, headgear) 

• Can avoid the need for surgery or reduce the 

complexity of surgery 

• Relatively inexpensive 

Risk associated with TADs 

• Can be loaded immediately 

• Well tolerated by patients 

• Trauma of root, nerve or vessel 

• Infection/peri-implantitis 

• Soft tissue impingement 

• Screw fracture 

• Failure 

• Patient discomfort 

TABLE 1: TABLE 2: 

Advantages of temporary anchorage devices Risks associated temporary anchorage devices 

Indications 

• Provision of anchorage 

- En masse retraction 

- Canine retraction 

• Bimaxillary protrusion 

- Molar distalisation 

- Intrusion of anterior teeth 

- Intrusion of posterior teeth 

- Unilateral intrusion to correct occlusal cant 

• Skeletal orthopaedic correction of CIII 

• Miscellaneous 

- Provide attachment for artificial teeth in 

hypodontia cases 

- To provide IMF during orthognathic surgery 

Contraindications 

Absolute 

• Bleeding disorders 

• Bone metabolism disorders (bisphosphonate use) 

• Immunocompromised 

• Diabetes 

• Anti-coagulant drugs 

• Pregnancy 

• Xerostomia 

• Titanium allergy 

Relative 

• Poor OH 

• Smoking 

• Local bone pathology 

• Inadequate bone depth and quality 

• Local factors: infection/amount of bone 

TABLE 1: Indications and contradictions for the use of temporary anchorage devices 

Interested in more articles about DB Orthodontics products? 

Email Maria.brophy@dbortho.com for more information on product reviews, case studies and more. 


This Autograph video is available for marketing 

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Email maria.brophy@dbortho.com for more information on how we can support you with videos 

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Damian 

Meet Damian and Denise 

in the quality team 

With twenty years in the dental industry for laboratories, Damian is now 

excited to join us as a Quality Specialist. Since starting in October, Damian is 

responsible for overseeing customer complaints and enquiries, nonconformances, 

audits, and quarantined goods, among many other tasks. He 

loves history and is a keen follower of Football, NFL and Major League Baseball. 

He also likes walking, cinema and meals out with his wife and two kids. 

Denise 

Quality Assistant Denise joined us in August. After a wealth of 43 years’ 

experience in financial services, Denise has now made the switch to the world 

of Orthodontics and is loving the challenge – dealing with customer complaints 

and enquiries. She loves her dog, and enjoys going on walking holidays with 

her partner, their friends and dogs. She also loves sunny 

holidays, music and dancing! 

Christmas opening and international 

shipping deadlines: 

Please send us your order by 3pm GMT on Wednesday 15th 

December 2021 if you require shipping before Christmas. 

We will be closing our office on Thursday 23rd December 12:30 

and re-opening on Tuesday 4th January 2022.

Newsletter - December 2021

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