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Updated: Dec 10, 2025
Author Spotlight: 3D Movement Assessment of Maxillary Posterior Teeth in Clear Aligner Treatment
Published on: February 23, 2024
Effect of three different attachment designs in the extrusive forces generated by thermoplastic aligners in the
Rafael Costa1, Fernanda Calabró Calheiros1, Rafael Yagüe Ballester2
1Faculdade de Odontologia, Universidade Ibirapuera, São Paulo, SP, Brazil.
Introduction:
Orthodontic aligners use have increased in dentistry. The resolution of complex movements such as extrusion demands the use of attachments to reach the aimed force, but just a few studies have been developed to evaluate the biomechanical performance of the aligners and their accessories.
Objective:
The objective of this study was to evaluate on the three axes (X, Y and Z) the forces generated by three different attachment designs for the extrusion of the maxillary central incisor using esthetic orthodontic aligners.
Methods:
Three prototypes of maxillary models were developed, each one with a specific attachment inserted in the central incisor. Three aligners were manufactured for each of the three attachment designs, with 0.33-mm activation in the direction of the extrusion. An analytical device was used to evaluate the forces applied to the three axes by each aligner/attachment. The data were assessed by one-way ANOVA and Tukey's test (α = 0.05).
Results:
All of the studied attachment designs could satisfactorily perform the extrusion movement. However, force intensities were different in the three designs (design 1 = 2.5 N; design 2 = 2.2 N, and design 3 = 1.1 N). Furthermore, two of the three attachment designs (designs 1 and 2) eventually exerted significant forces on the X (mesiodistal) and Y (buccopalatal) axes.
Conclusion:
The attachment design 3 presents the best distribution of forces for extrusion movement, generating almost null forces on X and Y axes, and lower intensity of force on the Z axis.
