A novel pressure film approach for determining the force imparted by clear removable thermoplastic appliances

The force imparted by removable thermoplastic appliances (RTA) onto teeth has not been investigated in the past. This investigation was designed to explore a novel methodology to measure the magnitude and identify the pattern of this force. Eight patients with moderate malocclusion were selected. In each patient, the palatally mal-positioned upper first premolar was corrected by wearing a series of four ClearSmile RTA over a duration of 8 weeks. When constructing RTA, the ClearSmile Company was advised that the amount of movement to be programmed into each appliance was 0.5 mm. The Pressurex film was used to measure the pressure generated by ClearSmile RTA against the palatal surface of the upper first premolar for buccal tipping movement. Three measurements were conducted respectively upon the issue and retrieval of each appliance (after 2 weeks of wear), resulting in 24 pressure measurements for each patient. Digital imaging and spectrophotometry analysis were employed to quantify the stain intensity mounted by the pressure on the films. The irrelevant forces were subtracted out to allow an assessment of the force purely acting to buccally repositioning the tooth. The results revealed that (1) the mean force magnitude over 2 weeks of RTA wear was 1.12 N (SE = 0.72 N); (2) the higher force magnitude of 5.12 N (SE = 0.80 N) seen at the issue of the appliance declined drastically to -2.67 N at the time of retrieval. These findings suggest that ClearSmile RTA exerts a high level of force against the tooth to be moved at the initial stage followed by a rapid force diminish.