Dataset Information

Effects of upper arch expansion using clear aligners on different stride and torque: a three-dimensional finite element analysis.

ABSTRACT:

Background

During maxillary arch expansion with a clear aligner (CA), buccal tipping of the posterior teeth often occurs, resulting in an unsatisfactory arch expansion effect. The aim of this study was to analyze the appropriate maxillary arch expansion stride length and torque compensation angle for maxillary dentition to achieve an ideal moving state when a CA was used for upper arch expansion.

Methods

This study established a three-dimensional (3D) finite element model including a CA, maxilla, periodontal ligament (PDL), and maxillary dentition. The stress distribution, stress situation, expansion efficiency, and movement trends of the maxillary dentition during upper arch expansion of different stride (0.1 mm, 0.2 mm, and 0.3 mm) and torque compensation (0°, 0.5°, 1°, and 1.5°) were measured.

Results

Maxillary arch expansion lead to buccal tilt of the posterior teeth, lingual tilt of the anterior teeth, and extrusion of the incisors. As the angle of compensation increased, the degree of buccal tilt on the posterior teeth decreased, with this reducing the efficiency of upper arch expansion. When the stride length was 0.1 mm, the torque compensation was 1.2°, and when stride length was 0.2 mm and the torque compensation was approximately 2°, there was a tendency for the posterior teeth to move bodily. However, when the stride length was 0.3 mm, the increase in torque compensation could not significantly improve the buccal tilt phenomenon. In addition, the equivalent von-Mises stress values of the maxillary root, PDL, and alveolar bone were in the same order of magnitude.

Conclusions

This study indicated that the posterior teeth cause a degree of buccal tilt when maxillary arch expansion is ensured. The specific torque compensation angle should be determined based on the patient's situation and the desired effect.

SUBMITTER: Zhang Y

PROVIDER: S-EPMC10662809 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature

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Publications

Effects of upper arch expansion using clear aligners on different stride and torque: a three-dimensional finite element analysis.

Zhang Yanqi Y Hui Shuoyi S Gui Linyuan L Jin Fang F

BMC oral health 20231120 1

<h4>Background</h4>During maxillary arch expansion with a clear aligner (CA), buccal tipping of the posterior teeth often occurs, resulting in an unsatisfactory arch expansion effect. The aim of this study was to analyze the appropriate maxillary arch expansion stride length and torque compensation angle for maxillary dentition to achieve an ideal moving state when a CA was used for upper arch expansion.<h4>Methods</h4>This study established a three-dimensional (3D) finite element model includin ...[more]

PMID: 37986060

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Project description:Background/objectivesTo compare the biomechanical characteristics of maxillary molar distalization with clear aligners in conjunction with three types of miniscrew anchorage.Materials/methodsThree-dimensional (3D) finite element models of maxillary molar distalization with clear aligners and three types of miniscrew anchorage were established, including (A) control group, (B) direct buccal miniscrew anchorage group, (C) direct palatal miniscrew anchorage group, and (D) indirect buccal miniscrew anchorage group. The 3D displacement of maxillary teeth and the principal stress (maximum tensile and compressive stress) on the root and periodontal ligament (PDL) during molar distalization were recorded.ResultsThe tooth displacement pattern during maxillary molar distalization in the four groups showed similarities, including labial tipping of anterior teeth, mesial and buccal tipping of premolars, and distal and buccal tipping of molars, but with varying magnitudes. Group C exhibited the greatest molar distalization, with the first molar achieving 0.1334 mm of crown distalization. Group D demonstrated a notable buccal crown movement (0.0682 mm) and intrusion (0.0316 mm) of the first premolar. Compared to Groups A and B, Groups C and D showed less labial crown tipping of the central incisor. Group B showed the greatest amount of maxillary incisor intrusion (central incisor: 0.0145 mm, lateral incisor: 0.0094 mm). Moreover, Groups C and D displayed significantly lower levels of compressive and tensile stress in the roots and PDL of the maxillary central and lateral incisors.LimitationMolar distalization is a dynamic process involving sequential tooth movement stages; however, our research primarily examined the tooth movement patterns in the initial aligner.Conclusions/implicationsThe use of miniscrew anchorage, especially direct palatal miniscrew anchorage, may enhance the treatment efficacy of maxillary molar distalization with clear aligners, leading to increased molar distalization, reduced mesial movement of premolars, and minimized labial tipping of anterior teeth.

Project description:ObjectivesThis study established three-dimensional finite element models to explore the impacts of surface wear of attachments on maxillary canine distalization with clear aligners, thereby guiding the clinical application of attachments and enhancing the efficiency of clear aligner therapy.Materials and methodsFinite element models of maxillary canine distalization, including the maxilla, dentition, periodontal ligament, attachments (in both initial and worn states), and clear aligners, were established. Two groups of attachments (vertical rectangular attachment and optimized root control attachment) and five working conditions representing different degrees of attachment wear (M0, M2, M4, M6, and M8) were designed for canine distalization. Tooth displacement and equivalent stress in the roots and periodontal ligaments were analyzed.ResultsThe canines in both groups exhibited a tipping movement pattern under all working conditions. By M8, the distal displacement of the canine crown, the equivalent stress values in the roots, and the equivalent stress values in the periodontal ligaments in the rectangular attachment group decreased by 12.04%, 30.80%, and 16.48%, respectively, compared to M0. In the optimized root control attachment group, these values decreased by 24.98%, 34.69%, and 19.15%, respectively. However, under all working conditions, the canines in the rectangular attachment group presented greater displacement and stress. The greatest reduction in canine crown distal displacement and stress values was observed between M6 and M8 in the rectangular attachment group, but the efficiency of canine distalization was still 64.30% at M8, with minimal change. In the optimized root control attachment group, the greatest reduction was observed in M4-M6, and the efficiency of canine distalization decreased to less than 60% in response to M6.ConclusionThe canines tended to tip when maxillary canine distalization was performed with clear aligners. Attachment wear led to a reduction in the efficiency of canine distalization. Compared with optimized root control attachments, the impact was less significant for rectangular attachments. Once optimized root control attachments have been in place for more than 4 months and maxillary canine distalization is still required, orthodontists should closely monitor the wear of these attachments. If necessary, timely restoration or rebonding of the attachments is recommended.

Project description:BackgroundClear aligner (CA) treatment has been gaining popularity, but the biomechanical effects of CAs in bimaxillary dentition have not been thoroughly investigated. Direct and indirect strong anchorages are two common anchorage control methods, but the underlying biomechanical mechanism has not yet been elucidated. This study aimed to investigate the different biomechanical effects of CAs in closing the bimaxillary space under different anchorage controls, further instructing the compensation strategies design and strong anchorage choice in clinical practice.MethodsThree-dimensional (3D) bimaxillary models of different anchorage controls were created based on cone-beam computed tomography and intraoral scan data. Four first premolars were extracted using 3D modeling software. Finite element analysis was conducted to simulate the space closure process of the CAs.ResultsIn the two strong anchorage groups, the bimaxillary dentition presented different movement patterns during the space closure process, and the lower dentition was more vulnerable to elastic force. From the vertical view, direct strong anchorage with elastic force had the advantage of flattening the longitudinal occlusal curve and resisting the roller-coaster effects, whereas indirect strong anchorage could lead to a deep longitudinal occlusal curve. From the sagittal view, indirect strong anchorage with metallic ligaments had a greater instantaneous anchorage protection effect, particularly in the lower dentition, which reduced the mesial movement of the posterior teeth by nearly four times that of the direct anchorage group. In addition, indirect strong anchorage presented better anterior teeth torque/tipping control, while direct strong anchorage could aggravate lingual tipping of the upper central incisors. Due to the differences in anterior-posterior anchorage and arch shape, compared with the upper dentition, anchorage preservation and vertical control effects were amplified in the lower dentition.ConclusionsThe biomechanical effects of CAs differed between the two strong anchorage groups. Due to the differences in dentition morphology, anterior-posterior anchorage, and dental arch shape, CAs present different biomechanical effects in bimaxillary space closure. Orthodontists should consider the corresponding mechanical compensation according to specific anchorage control methods and dentitions.

Dataset Information

Effects of upper arch expansion using clear aligners on different stride and torque: a three-dimensional finite element analysis.

Background

Methods

Results

Conclusions

Publications

Effects of upper arch expansion using clear aligners on different stride and torque: a three-dimensional finite element analysis.

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