The effect of maxillary premolar distalization with different designed clear aligners: a 4D finite element study with...

Area of Science:

• Orthodontics
• Biomechanical Engineering
• Dental Materials

Background:

• Molar distalization using clear aligners (CAs) is a standard orthodontic procedure.
• Mesial movement of molars can compromise distalization efficiency, particularly during premolar distalization stages.
• Investigating different CA designs is crucial for optimizing treatment outcomes.

Purpose of the Study:

• To evaluate tooth movement patterns during premolar distalization with varying clear aligner designs.
• To compare the efficiency of molar distalization across different CA configurations using 4D mechanical simulations.
• To identify optimal CA designs for maximizing distalization effectiveness.

Main Methods:

• A 4D finite element method (FEM) model simulated maxillary dentition, periodontal ligaments, and CAs.
• Three CA designs were tested: conventional (Con), second molar half-wrap (SMHW), and all-molar half-wrap (MHW).
• Simulations replicated 2mm premolar distalization using mini-implants and iterative computational analysis.

Main Results:

• The MHW group showed significantly less mesial movement of first and second molars compared to Con and SMHW groups.
• Premolar distalization efficiency was highest in the MHW group (95.5-96.5%), followed by Con (84.5-85%) and SMHW (75-75.5%).
• The MHW group exhibited the greatest displacement of canines and incisors.

Conclusions:

• Modifying clear aligner design by removing the distal portion covering molars (MHW) effectively minimizes unwanted mesial molar movement.
• This specific CA design enhances the overall efficiency of molar distalization during premolar movement.
• The findings support the use of modified half-wrap aligner designs for improved orthodontic treatment outcomes.