Evolution, Biomechanical Considerations, and Clinical Indications of Temporary Anchorage Devices (TADs) in Orthodontics: A Systematic Review

AbstractBackground: The management of anchorage remains a critical determinant of successful orthodontic outcomes. Conventional anchorage protocols, such as intraoraltrans-palatal arches and extraoral headgears, are often limited by unavoidable anchorage loss and heavy reliance on patient compliance.Objectives: To systematically review the historical evolution, biological aspects, design classifications, and clinical indications of Temporary Anchorage Devices (TADs).Methods: Utilizing the PICO (Population, Intervention, Comparison, Outcome) framework, this review evaluates orthodontic patients requiring absolute anchorage(Population), the application of skeletal anchorage systems (Intervention), compared against traditional modalities (Comparison), to assess zero anchorage loss and overall treatment efficacy (Outcome).Conclusion: Skeletal anchorage provides a predictable, compliance-free modality to achieve absolute anchorage, significantly expanding the envelope of non-extractionand complex orthodontic mechanics.