Abstract
Among orthodontists and scientists, in the last years, upper molar distalization has been a debated topic in the orthodontic aligner field. However, despite that few clinical studies have been published, no insights on aligners’ biomechanics regarding this movement are available. The aim of this study was to assess, through finite element analysis, the force system resulting in the upper arch during second maxillary molar distalization with clear aligners and variable attachments settings. The average tooth distalization was found to be 0.029, with buccal flaring of the upper incisors in all attachment configurations. The mesial deformation of the aligner was registered to be 0.2 mm on average. Different pressure areas on the interface between aligners and upper molars were registered, with the mesial attachment surface to be directly involved when present. Periodontal ligament pressure was reported to range between 67 g/cm2 and 132 g/cm2. Configurations with rectangular attachments from second molar-to-canine and from first molar-to-canine present, in an in silico environment, almost equal efficiency in distalizing the upper second molar. However, attachments from the second molar to the canine are suggested to be adopted in clinical environments due to greater feasibility in everyday practice.
Highlights
The demand for minimally invasive solutions led to the development of appliances that combine effectiveness in correcting dental positions with comfort and aesthetics features [1]
A systematic review by Rossini et al focused on the predictability of orthodontic movements of teeth with aligners and found only 11 studies that met the inclusion criteria [2]
The orthodontic movement is the result of the interactions of metal wires and brackets to the tooth; in the aligners system, the forces and moments are generated by the difference between the shape of aligners and the teeth [10]
Summary
The demand for minimally invasive solutions led to the development of appliances that combine effectiveness in correcting dental positions with comfort and aesthetics features [1]. A systematic review by Rossini et al focused on the predictability of orthodontic movements of teeth with aligners and found only 11 studies that met the inclusion criteria [2]. Among the dental movements analyzed in their study, the most predictable was body distalization. The orthodontic movement is the result of the interactions of metal wires and brackets to the tooth; in the aligners system, the forces and moments are generated by the difference between the shape of aligners and the teeth [10]. The resolution of complex movements such as distalization demands
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