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Abstract
Transparent and removable aligners represent an effective solution to correct various
orthodontic malocclusions through minimally invasive procedures. An aligner-based
treatment requires patients to sequentially wear dentition-mating shells obtained
by thermoforming polymeric disks on reference dental models. An aligner is shaped
introducing a geometrical mismatch with respect to the actual tooth positions to induce
a loading system, which moves the target teeth toward the correct positions. The common
practice is based on selecting the aligner features (material, thickness, and auxiliary
elements) by only considering clinician's subjective assessments. In this article,
a computational design and engineering methodology has been developed to reconstruct
anatomical tissues, to model parametric aligner shapes, to simulate orthodontic movements,
and to enhance the aligner design. The proposed approach integrates computer-aided
technologies, from tomographic imaging to optical scanning, from parametric modeling
to finite element analyses, within a 3-dimensional digital framework. The anatomical
modeling provides anatomies, including teeth (roots and crowns), jaw bones, and periodontal
ligaments, which are the references for the down streaming parametric aligner shaping.
The biomechanical interactions between anatomical models and aligner geometries are
virtually reproduced using a finite element analysis software. The methodology allows
numerical simulations of patient-specific conditions and the comparative analyses
of different aligner configurations. In this article, the digital framework has been
used to study the influence of various auxiliary elements on the loading system delivered
to a maxillary and a mandibular central incisor during an orthodontic tipping movement.
Numerical simulations have shown a high dependency of the orthodontic tooth movement
on the auxiliary element configuration, which should then be accurately selected to
maximize the aligner's effectiveness.