Loose mini screws are not adequate to serve as anchorage; they need to be replaced. Loosening of mini screw in the initial placement could be because of the inadequate cortical bone thickness. 8 Delayed mobility, which occurs after a period of time, may occur due to excessive force applied to the device. 9 There are other reasons for the loosening of the TAD; for example, infection, osteomyelitis or inhibited vascularization. Root trauma, due to the TAD penetrating the root surface, can occur if proper care is not taken during the site selection. This can lead to ankylosis or loss of tooth vitality. Soft tissue irritation is another possible complication. Minor apthous ulcers can occur. Many times, loose tissue surrounding the TAD gets irritated and overgrowth of the tissue covers the tip of the TAD. Sometimes allergic reaction to the TAD in patients with metal sensitivity is a possible complication. If the TAD is placed in close proximity to a nerve, it may cause nerve injury. In the same way sinus perfo-ration is also a possible complication if proper site selection is not done in the beginning. In orthodontics, proper use of TADs improves treatment outcomes. TADs appropriately help improve anchorage. Patients benefit as a result of improved treatment methods. REFERENCES 1. Fritz U, Ehmer A, Diedrich P. Clinical suitability of titanium microscrews for orthodontic anchorage-preliminary experiences. J Orofac Orthop 2004;65(5):410-8. 2. Gainsforth BL. A study of orthodontic anchorage possibilities in basal bone, Am J Orthod oral surgery, 1945;31:406-417 3. Straumann USA. 510(k) summary. Available at: “www.fda.gov/cdrh/pdf4/k040469.pdf”. Accessed on January 29, 2011 4. Miyawaki S, Koyama I, Inoue M, Mishima K, Sugahara T, TakanoYamamoto T. Factors associated with the stability of tita-nium screws placed in the posterior region for orthodontic anchorage. Am J Orthod Dentofacial Orthop 2003;124(4):373-8. 5. Persson M, Thilander, B. Palatal suture closure in man from 15 to 35 years of age. Am J Orthod 1977;72:42-52. 6. Straumann USA. 510(k) summary. Available at: “www.fda.gov/cdrh/pdf4/k040469.pdf”. Accessed January 29 2011 7. Melsen B. Mini-implants: where are we? J Clin Orthod 2005;39(9):539-47. 8. Graham J, Cope J. Miniscrew troubleshooting. Orthod Products 2006;4-5:26-32. 9. Jaffar A, Hamadah H. An analysis of the position of the greater palatine foramen. J Basic Med Sci 2003;3:24-32 16 September/October 2011 JAOS
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