The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
권호 표지
DOI QR코드

DOI QR Code

Biomechanical analysis for different mandibular total distalization methods with clear aligners: A finite element study

  • Sewoong Oh (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Youn-Kyung Choi (Department of Orthodontics, Pusan National University Hospital) ;
  • Sung-Hun Kim (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Ching-Chang Ko (Division of Orthodontics, College of Dentistry, The Ohio State University) ;
  • Ki Beom Kim (Department of Orthodontics, Saint Louis University) ;
  • Yong-Il Kim (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital)
  • Received : 2023.02.14
  • Accepted : 2023.09.14
  • Published : 2023.11.25
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The purpose of this finite element method (FEM) study was to analyze the biomechanical differences and tooth displacement patterns according to the traction direction, methods, and sites for total distalization of the mandibular dentition using clear aligner treatment (CAT). Methods: A finite element analysis was performed on four FEM models using different traction methods (via a precision cut hook or button) and traction sites (mandibular canine or first premolar). A distalization force of 1.5 N was applied to the traction site by changing the direction from -30 to +30° to the occlusal plane. The initial tooth displacement and von Mises stress on the clear aligners were analyzed. Results: All CAT-based total distalization groups showed an overall trend of clockwise or counterclockwise rotation of the occlusal plane as the force direction varied. Mesiodistal tipping of individual teeth was more prominent than that of bodily movements. The initial displacement pattern of the mandibular teeth was more predominant based on the traction site than on the traction method. The elastic deformation of clear aligners is attributed to unintentional lingual tipping or extrusion of the mandibular anterior teeth. Conclusions: The initial tooth displacement can vary according to different distalization strategies for CAT-based total distalization. Discreet application and biomechanical understanding of traction sites and directions are necessary for appropriate mandibular total distalization.

Keywords

Acknowledgement

This research was funded by the National Research Foundation of Korea (NRF) grant funded by the Korean government (2021R1A2C1003240).

References

  1. Proffit W, Fields H, Larson B, Sarver D. Contemporary orthodontics. 6th ed. Maryland Height: Elsevier; 2018. https://shop.elsevier.com/books/contemporary-orthodontics/proffit/978-0-323-54387-3 
  2. Baik H. Limitations in orthopedic and camouflage treatment for Class III malocclusion. Semin Orthod 2007;13:158-74. https://doi.org/10.1053/j.sodo.2007.05.004 
  3. Burns NR, Musich DR, Martin C, Razmus T, Gunel E, Ngan P. Class III camouflage treatment: what are the limits? Am J Orthod Dentofacial Orthop 2010;137:9.e1-9.e13; discussion 9-11. https://doi.org/10.1016/j.ajodo.2009.05.017 
  4. Ngan P, Moon W. Evolution of Class III treatment in orthodontics. Am J Orthod Dentofacial Orthop 2015;148:22-36. https://doi.org/10.1016/j.ajodo.2015.04.012 
  5. Kim YH. Anterior openbite and its treatment with multiloop edgewise archwire. Angle Orthod 1987;57:290-321. https://pubmed.ncbi.nlm.nih.gov/3479033/
  6. Ngan P, Sung JH. Treatment strategies for developing and nondeveloping Class III malocclusions. In: Nanda R, ed. Esthetics and biomechanics in orthodontics. 2nd ed. Philadelphia: WB Saunders; 2015. https://doi.org/10.1016/B978-1-4557-5085-6.00014-X 
  7. Roberts WE, Viecilli RF, Chang C, Katona TR, Paydar NH. Biology of biomechanics: finite element analysis of a statically determinate system to rotate the occlusal plane for correction of a skeletal Class III open-bite malocclusion. Am J Orthod Dentofacial Orthop 2015;148:943-55. https://doi.org/10.1016/j.ajodo.2015.10.002 
  8. Chae JM, Park JH, Kojima Y, Tai K, Kook YA, Kyung HM. Biomechanical analysis for total distalization of the mandibular dentition: a finite element study. Am J Orthod Dentofacial Orthop 2019;155:388-97. https://doi.org/10.1016/j.ajodo.2018.05.014 
  9. Kim TW, Echarri P. Clear aligner: an efficient, esthetic, and comfortable option for an adult patient. World J Orthod 2007;8:13-8. https://pubmed.ncbi.nlm.nih.gov/17373221/
  10. Shalish M, Cooper-Kazaz R, Ivgi I, Canetti L, Tsur B, Bachar E, et al. Adult patients' adjustability to orthodontic appliances. Part I: a comparison between Labial, Lingual, and InvisalignTM. Eur J Orthod 2012;34:724-30. https://doi.org/10.1093/ejo/cjr086 
  11. Yezdani AA. Transparent aligners: an invisible approach to correct mild skeletal class III malocclusion. J Pharm Bioallied Sci 2015;7(Suppl 1):S301-6. https://doi.org/10.4103/0975-7406.155965 
  12. Nanda R, Uribe FA, Yadav S. Temporary anchorage devices in orthodontics. 2nd ed. Maryland Heights: Elsevier; 2020. https://shop.elsevier.com/books/temporary-anchorage-devices-in-orthodontics/nanda/978-0-323-60933-3 
  13. Rota E, Parrini S, Malekian K, Cugliari G, Mampieri G, Deregibus A, et al. Lower molar distalization using clear aligners: bodily movement or uprighting? A preliminary study. Appl Sci 2022;12:7123. https://doi.org/10.3390/app12147123 
  14. Gomez JP, Pena FM, Martinez V, Giraldo DC, Cardona CI. Initial force systems during bodily tooth movement with plastic aligners and composite attachments: a three-dimensional finite element analysis. Angle Orthod 2015;85:454-60. https://doi.org/10.2319/050714-330.1 
  15. Upadhyay M, Arqub SA. Biomechanics of clear aligners: hidden truths & first principles. J World Fed Orthod 2022;11:12-21. https://doi.org/10.1016/j.ejwf.2021.11.002 
  16. Liu L, Zhan Q, Zhou J, Kuang Q, Yan X, Zhang X, et al. Effectiveness of an anterior mini-screw in achieving incisor intrusion and palatal root torque for anterior retraction with clear aligners. Angle Orthod 2021;91:794-803. https://doi.org/10.2319/120420-982.1 
  17. Comba B, Parrini S, Rossini G, Castroflorio T, Deregibus A. A three-dimensional finite element analysis of upper-canine distalization with clear aligners, composite attachments, and Class II elastics. J Clin Orthod 2017;51:24-8. https://pubmed.ncbi.nlm.nih.gov/28253487/
  18. Rossini G, Modica S, Parrini S, Deregibus A, Castroflorio T. Incisors extrusion with clear aligners technique: a finite element analysis study. Appl Sci 2021;11:1167. https://doi.org/10.3390/app11031167 
  19. Cortona A, Rossini G, Parrini S, Deregibus A, Castroflorio T. Clear aligner orthodontic therapy of rotated mandibular round-shaped teeth: a finite element study. Angle Orthod 2020;90:247-54. https://doi.org/10.2319/020719-86.1 
  20. Kawamura J, Tamaya N. A finite element analysis of the effects of archwire size on orthodontic tooth movement in extraction space closure with miniscrew sliding mechanics. Prog Orthod 2019;20:3. https://doi.org/10.1186/s40510-018-0255-8 
  21. Cattaneo PM, Dalstra M, Melsen B. The finite element method: a tool to study orthodontic tooth movement. J Dent Res 2005;84:428-33. https://doi.org/10.1177/154405910508400506 
  22. Tai S. Clear aligner technique. Batavia: Quintessence; 2018. https://www.amazon.com/Clear-Aligner-Technique-Sandra-Tai/dp/0867157771 
  23. Eliades T, Athanasiou AE. Orthodontic aligner treatment. New York: Thieme; 2021. https://shop.thieme.com/Orthodontic-Aligner-Treatment/9783132411487 
  24. Chan E, Darendeliler MA. The Invisalign® appliance today: a thinking person's orthodontic appliance. Semin Orthod 2017;23:12-64. https://doi.org/10.1053/j.sodo.2016.10.003 
  25. Kawamura J, Park JH, Kojima Y, Tamaya N, Kook YA, Kyung HM, et al. Biomechanical analysis for total mesialization of the maxillary dentition: a finite element study. Am J Orthod Dentofacial Orthop 2021;159:790-8. https://doi.org/10.1016/j.ajodo.2020.02.021 
  26. Brezniak N. The clear plastic appliance: a biomechanical point of view. Angle Orthod 2008;78:381-2. https://pubmed.ncbi.nlm.nih.gov/18251593/ https://doi.org/10.2319/0003-3219(2008)078[0381:TCPA]2.0.CO;2
  27. Upadhyay M, Shah R, Peterson D, Asaki T, Yadav S, Agarwal S. Force system generated by elastic archwires with vertical V bends: a three-dimensional analysis. Eur J Orthod 2017;39:202-8. https://doi.org/10.1093/ejo/cjw044