[Efficiency of clear aligners in extrusion of posterior teeth evaluated by 3-dimensional model superimposition]

To explore the efficiency of posterior teeth extrusion with clear aligners by 3-dimensional model superimposition, which provides a reference for the design of clinical programs.

We selected 24 patients with clear aligners whose posterior teeth were designed to extend more than 0.5 mm, and a total of 126 teeth were included. Digital models were obtained before and after treatment by intraoral scanning with iTero, named as "actual initial" and "achieved" digital models. Initial and final models from the ClinCheck, labeled as "virtual initial" and "predicted" models respectively. Initial, predicted, and achieved digital dental models were exported as stereolithography files and subsequently imported into Geomagic Studio. Extrusive measurements were made from the superimposition of the initial and predicted models (predicted movement) and from the superimposed initial and achieved models (achieved movement). Statistical analysis was performed with SPSS 23.0 and GraphPad Prism 5.0 software package. The extrusion efficiency of the posterior teeth was calculated, at the meanwhile the influencing factors were analyzed.

The mean extrusion efficiency of posterior teeth during clear aligners treatment was 30.2%. The actual extrusion was linearly related to the expected(P<0.05), and the linear regression equation was y=0.305x-0.010. The difference between the actual and the predicted extrusion was positively correlated with the number of appliances(P<0.05), and also positively correlated with the predicted extrusion value(P<0.001). This difference was larger in low-angle patients than in patients with average angle (P<0.05).

The extrusion rate of posterior teeth is relatively low during clear aligners treatment, and the average efficiency is 30.2%. Vertical growth pattern affects the extrusion efficiency. So more overcorrections can be designed for average angle patients.