Effects of time and clear aligner removal frequency on the force delivered by different polyethylene terephthalate glycol-modified materials determined with thin-film pressure sensors.

Abstract

Many factors influence the force changes of clear aligners. The purpose of this study was to identify the various factors that influence the force changes generated by polyethylene terephthalate glycol-modified (PET-G) materials. Therefore, a force measurement system based on a flexible thin-film pressure sensor was established. A series of clear aligners with 2 material properties and different activations at the maxillary central incisor, maxillary second premolar, and maxillary permanent first molar was designed and fabricated. The first material was conventional PET-G; the second material was modified PET-G with a higher modulus of elasticity and greater abrasion resistance. Several models, including teeth and aligners, were produced. Then, a force change detection device, including a thin-film pressure sensor, a signal acquisition circuit board, and a computer, was applied to measure changes in the forces delivered by the conventional and modified PET-G materials with increased frequencies of appliance removal. Finally, the forces were repeatedly measured to detect the force changes over 48hours. The forces of both materials decreased similarly over time. These forces also decreased when the aligner removal frequency increased, but the forces decreased differently. The modified PET-G, with a higher modulus of elasticity and greater abrasion resistance, showed a more stable and lower force change than did the conventional PET-G. The forces delivered by both materials were within the orthodontic force range. Force changes were apparent when the appliance removal frequency increased. Compared with the conventional material, the modified PET-G material showed better stability. Therefore, the modified PET-G is a promising and applicable material with advantages for both orthodontists and patients.