Biomechanical Effects of Different Auxiliary-Aligner Designs for the Extrusion of an Upper Central Incisor: A Finite...

To evaluate the biomechanical effects of four different auxiliary-aligner combinations for the extrusion of a maxillary central incisor and to define the most effective design through finite element analysis (FEA).

A full maxillary arch (14 teeth) was modelled by combining two different imaging techniques: cone beam computed tomography and surface-structured light scan. The appliance and auxiliary element geometries were created by exploiting computer-aided design (CAD) procedures. The reconstructed digital models were imported within the finite element solver (Ansys® 17). For the extrusion movement, the authors compared the aligner without an attachment with three auxiliary-aligner designs: a rectangular palatal attachment, a rectangular buccal attachment, and an ellipsoid buccal attachment. The resulting force-moment (MF) system delivered by the aligner to the target tooth and the tooth displacement were calculated for each scenario.

The maximum tooth displacement along the z-axis (0.07 mm) was obtained with the rectangular palatal attachment, while the minimum (0.02 mm) was obtained without any attachments. With the ellipsoid attachment, the highest undesired moments M and M were found. The rectangular palatal attachment showed the highest F (2.0 N) with the lowest undesired forces (F  = 0.4 N; F  = -0.2 N).

FEA demonstrated that the rectangular palatal attachment can improve the effectiveness of the appliance for the extrusion of an upper central incisor.