Esthetic smiles are an increasingly important focus of orthodontic treatment. Factors
related to maxillary incisors, such as smile arc, maxillary gingival exposure, and
maxillary crown torque, are related to esthetic smiles. It is very important to consider
these factors during orthodontic treatment. However, with conventional orthodontic
treatment using traditional anchorage, torque and vertical control of maxillary incisors,
which are closely related to esthetic smile, were significant challenges, but with
the introduction of temporary skeletal anchorage devices (TSADs), control of maxillary
incisors has become easier to accomplish along with premolar extractions. Importantly,
the various clinical applications and biomechanics of TSADs must be understood because
of the variety of sites where the TSADs can be implanted. In general, the torque and
vertical position of the maxillary incisors can be controlled by adjusting the line
of action of force by changing the length of the lever arm and the vertical position
of the TSADs. In this article, we classify TSADs for esthetic control of the maxillary
incisors into anterior labial TSADs, posterior buccal TSADs, and palatal TSADs according
to the implant sites, presenting various cases and discussing the biomechanics associated
with them.
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Published online: October 27, 2022
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