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      Effect of clear aligner type on maxillary full-arch intrusion: 3D analysis using finite element method

      research-article
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      BMC Oral Health
      BioMed Central
      Clear aligners, Tooth intrusion, Finite element analysis

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          Abstract

          Background

          Vertical maxillary excess (VME) is one of the most common reasons for seeking orthodontic treatment. Total intrusion with aligners is a promising alternative to surgery in some cases. Considering the elastic deformation of aligners, this study aimed to evaluate the possible desirable and undesirable teeth displacements during full maxillary arch intrusion using clear aligners and temporary anchorage devices (TADs).

          Methods

          The maxillary arch and clear aligners were modeled in SolidWorks. Four aligner brands including Leon, Duran, Duran Plus, and Essix Plus were selected based on their material properties. Anterior and posterior intrusion forces of 80 and 300 g were applied from attachments between the canines and first premolars and between the first and second molars, respectively. Vertical and anteroposterior tooth displacements were determined.

          Results

          The greatest intrusion was recorded at the buccal of the second molar, followed by the first molar. The lowest value was measured at the palatal of the molars with all aligners except Duran, which indicated minimal intrusion in the central incisor. All teeth were mesially displaced at the incisal/occlusal except incisors that moved distally. All apices showed distal movement.

          Conclusions

          Total intrusion using clear aligners may be accompanied by other tooth movements, including buccal tipping and mesial-in rotation of the molars, retrusion of incisors, and mesial movement of other teeth.

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          Most cited references54

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          Clear aligners in orthodontic treatment

          T. Weir (2017)
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            Initial force systems during bodily tooth movement with plastic aligners and composite attachments: A three-dimensional finite element analysis

            To describe, using a three-dimensional finite element (FE) model, the initial force system generated during bodily movement of upper canines with plastic aligners with and without composite attachments. A CAD model of an upper right canine, its alveolar bone and periodontal ligament, thermoformed plastic aligner, and two light-cured composite attachments were constructed. A FE model was used to analyze the effects of imposing a distal movement condition of 0.15 mm on the aligner (simulating the mechanics used to produce a distal bodily movement) with and without composite attachments. In terms of tension and compression stress distribution, without composite attachments a compression area in the cervical third of the distal root surface and a tension area in the apical third of the mesial surface were observed. With composite attachments, uniform compression areas in the distal root surface and uniform tension area in the mesial root surface were observed. Compression areas in the active surfaces of the composite attachments were also observed. In terms of movement patterns, an uncontrolled distal inclination, with rotation axis between the middle and cervical root thirds, was observed without composite attachment. Distal bodily movement (translation) was observed with composite attachment. In a three-dimensional FE analysis of a plastic aligner system biomechanically supplementary composite attachments generate the force system required to produce bodily tooth movement; the absence of biomechanically supplementary composite attachments favors the undesired inclination of the tooth during the translation movements.
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              A comparison of treatment effectiveness between clear aligner and fixed appliance therapies

              Background Align technology has developed greatly over past few years. Patients tended to prefer clear aligners over conventional brackets because of the superior comfort and esthetics, while the effectiveness of clear aligners was still controversial. The aim of this systematic review was to verify whether the treatment effectiveness of clear aligners was similar to the conventional fixed appliances. Methods A comprehensive search of the Pubmed, Web of Science, Embase, Scopus, and Cochrane Central Register of Controlled Clinical Trials Register databases for studies published through to August 20, 2018 was conducted. Comparative clinical studies assessing the effectiveness of clear aligners compared with braces were included. Results Eight papers were included in this study. Two of the included papers were randomized controlled trials and six were cohort studies. Clear aligners might not be as effective as braces in producing adequate occlusal contacts, controlling teeth torque, increasing transverse width and retention. While no statistically significant difference was found between two groups in Objective Grading System score (WMD = 8.38, 95% CI [− 0.17, 16.93]; P = 0.05). On the other hand, patients treated with clear aligners had a statistically significant shorter treatment duration than with braces (WMD = − 6.31, 95% CI [− 8.37, − 4.24]; P < 0.001). Conclusion Both clear aligners and braces were effective in treating malocclusion. Clear aligners had advantage in segmented movement of teeth and shortened treatment duration, but were not as effective as braces in producing adequate occlusal contacts, controlling teeth torque, and retention.
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                Author and article information

                Contributors
                safarii_fatemeh@yahoo.com
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                13 February 2024
                13 February 2024
                2024
                : 24
                : 231
                Affiliations
                Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, ( https://ror.org/01c4pz451) Tehran, Iran
                Article
                3984
                10.1186/s12903-024-03984-6
                10865575
                38350943
                13eeebea-ecc7-420a-b6b2-d7ef86a5885f
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 26 September 2023
                : 5 February 2024
                Categories
                Research
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                © BioMed Central Ltd., part of Springer Nature 2024

                Dentistry
                clear aligners,tooth intrusion,finite element analysis
                Dentistry
                clear aligners, tooth intrusion, finite element analysis

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