The effects of aligner anchorage preparation on mandibular first molars during premolar-extraction space closure with clear aligners: A finite element study

臼齿 前磨牙 牵引(地质) 口腔正畸科 下颌第一磨牙 牙科 下颌第二磨牙 上颌骨 皮质切开术 下颌骨(节肢动物口器) 医学 材料科学 地质学 植物 地貌学 生物
作者
Yi Yang,Ruicong Yang,Lu Liu,Xiaoqi Zhang,Qingsong Jiang,Qi Fan,Haoxin Zhang,Hu Long,Wenli Lai
出处
期刊:American Journal of Orthodontics and Dentofacial Orthopedics [Elsevier BV]
卷期号:164 (2): 226-238 被引量:24
标识
DOI:10.1016/j.ajodo.2022.12.013
摘要

•Premolar-extraction space closure with clear aligner therapy caused mesial tipping, lingual tipping and intrusion of mandibular molars. •Aligner anchorage preparation effectively prevented mesial and lingual tipping of mandibular molars. •Distal and lingual cutout modes were recommended. •For each aligner stage (0.25 mm), anchorage preparation of 1.7° could be designed to produce bodily protraction of mandibular molars with distal and lingual cutouts, whereas anchorage preparation of 2° could be designed for maximal anchorage patients. Introduction This study aimed to determine the effectiveness of different aligner anchorage preparations on mandibular first molars during premolar-extraction space closure with clear aligners and to assess the effects of different modes of Class II elastics on mandibular first molars. Methods Finite element models were constructed on the basis of cone-beam computed tomography data from an orthodontic patient. The models comprised maxilla, mandible, maxillary and mandibular teeth without first premolars, periodontal ligaments, attachments and aligners. Tooth displacement tendencies were calculated using different aligner anchorage preparations and Class II elastics on the models from the same patient. Three group sets were designed on the basis of the positions of aligner cutouts and buttons (mesiobuccal, distobuccal and lingual). Four groups were established in each of the 3 group sets. Four groups were created: (1) no elastic traction + no anchorage preparation, (2) anchorage preparation only, (3) elastic traction only, and (4) elastic traction + anchorage preparation. Different aligner anchorage preparations (0°, 1°, 2°, 3°) were applied on mandibular second premolars and molars. The Class II traction force was set to 100 g. Results With clear aligners, mandibular first molars were subject to mesial tipping, lingual tipping and intrusion. In the condition of no elastic traction, aligner anchorage preparation resulted in distal tipping, buccal tipping, and extrusion effect on mandibular first molars. Aligner anchorage preparation was more effective in the distal and lingual cutout groups than in the mesial cutout group. In the condition of Class II elastic traction, the bodily movement of mandibular first molars was achieved with a 3° anchorage preparation for the mesial cutout group and a 1.7° anchorage preparation for distal and lingual cutout groups. Absolute maximal anchorage was achieved with a 2° anchorage preparation for distal and lingual cutout groups. Conclusions Clear aligner therapy caused mesial tipping, lingual tipping and intrusion of mandibular first molars during premolar-extraction space closure. Aligner anchorage preparation effectively prevented mesial and lingual tipping of mandibular molars. Distal and lingual cutout modes were more effective than mesial cutout modes in aligner anchorage preparation. For each aligner stage (0.25 mm), 1.7° aligner anchorage preparation and Class II elastics with distal or lingual cutouts led to the bodily movement of mandibular first molars, whereas 2° anchorage preparation reached absolute maximal anchorage.
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