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Updated: Sep 22, 2025

Author Spotlight: 3D Movement Assessment of Maxillary Posterior Teeth in Clear Aligner Treatment
Published on: February 23, 2024
A retrospective study of factors contributing to anchorage loss in upper premolar extraction cases
1First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100034; National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing, China.
Background:
Anchorage control is one of the components in the treatment of extraction cases. However, what determines more or less anchorage loss is still an unanswered question. Aim: The purpose of this study was to investigate the most important factors contributing to the anchorage loss of maxillary first molars in premolar extraction cases.
Materials And Methods:
The study included 726 upper premolar extraction cases, including 214 male patients and 512 female patients, and the mean age was 14.4 ± 4.5 years old (range: 9-45). Factors including physiological characteristics, treatment mechanics, and cephalometric variables were collected and their influences on the angulation changes of maxillary first molars were analyzed.
Results:
The mean angulation change of maxillary first molar after treatment was 2.81°(mesial tipping). The change of UM/PP showed a statistically significant difference in different sex (male 3.84° ± 5.26° vs female 2.38° ± 5.10°), age (adult -0.05° ± 4.73° vs teenager 3.46° ± 5.07°), and molar relationship (Class II 3.28° ± 5.15° vs Class I 2.36° ± 5.19°). There are six variables accounted in the regression analysis (R = 0.608, R2 = 37.0%). Among them, the pre-treatment molar tipping (Standardized Coefficients: -0.65) and the pre-treatment incisor/molar height ratio (Standardized Coefficients: -0.27) were the most important factors influencing anchorage loss during treatment.
Conclusion:
Compared with treatment-related factors, the patient's physiological characteristics play a more important role in anchorage loss. The pre-treatment angulation of the maxillary first molar is the most influential factor in changes to maxillary molar angulation, which are often predisposing anchorage loss.

