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Three-Dimensional Displacement Patterns in Maxillary Molar Distalization: A Comparative Finite Element Study.

Roland Kmeid1, Joseph Bouserhal2, Allahyar Geramy3

  • 1Department of Orthodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Rue de Damas, Beirut 1107 2180, Lebanon.

Dentistry Journal
|March 27, 2026
PubMed
Summary
This summary is machine-generated.

The height and direction of force relative to the molar's center of resistance critically influence three-dimensional molar movement. Skeletal anchorage systems, like the Advanced Molar Distalization Appliance (AMDA), offer controlled distalization with minimal tipping.

Keywords:
finite element analysisorthodontic anchorage proceduresorthodontic appliancestooth movement

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Area of Science:

  • Orthodontics
  • Biomechanical Engineering
  • Dental Modeling

Background:

  • Maxillary first molar distalization is crucial in orthodontic treatment.
  • Various appliances exist, but their three-dimensional (3D) biomechanical effects require detailed analysis.
  • Understanding anchorage design and force vector influence is key to optimizing treatment outcomes.

Purpose of the Study:

  • To analyze the 3D displacement of maxillary first molars using finite element analysis.
  • To compare the biomechanical effects of different anchorage systems including headgear, pendulum, miniscrews, miniplates, AMDA, and Beneslider.
  • To clarify how anchorage design and force direction impact molar movement in sagittal, vertical, and transverse planes.

Main Methods:

  • A 3D finite element model of the maxillary dentition was created.
  • Clinical force magnitudes and directions were simulated for each appliance.
  • Tooth displacement was quantified along the sagittal, vertical, and transverse axes relative to the molar's center of resistance (CR).

Main Results:

  • Appliances applying force at or above the molar CR (AMDA, infrazygomatic miniscrews, Bollard miniplates) achieved near bodily distalization with minimal tipping (<0.6°) and slight intrusion.
  • Appliances applying force below the CR (cervical headgear, pendulum) resulted in greater crown tipping and extrusion.
  • The Beneslider showed intermediate displacement with moderate vertical control.

Conclusions:

  • Force vector height and direction relative to the molar CR are critical determinants of 3D molar displacement.
  • Skeletal anchorage and adjustable systems (e.g., AMDA) provide superior control over distalization, minimizing unwanted tipping and extrusion.
  • Conventional tooth-borne appliances induce more tipping and extrusion compared to skeletal anchorage systems.