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Nagib R, Farkas AZ, Szuhanek C. Finite element analysis of the mechanical behavior of 3D printed orthodontic attachments used in aligner treatment. Sci Rep 2024; 14:14877. [PMID: 38937650 PMCID: PMC11211347 DOI: 10.1038/s41598-024-65864-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/25/2024] [Indexed: 06/29/2024] Open
Abstract
The composite attachment loss during orthodontic clear aligner therapy is an adverse event that commonly happens in clinical practice and can affect the overall outcome and length of treatment. The aim of our research is to provide a basis for the further study of an innovative digital protocol and application method for orthodontic aligner attachments. Two 3D models were designed, one based on the proposed protocol and the other on the conventional method for aligner attachment application. Four attachment shapes were used to identify the maximum values for the von Mises equivalent stresses, the maximum displacements values and the areas in which these values were recorded through FEM analysis. The results of the mechanical simulation show lower values of von Mises stress recorded in the 3D printed attachments assemblies, independent of their shape, when simulated under the same boundary and load conditions. The trapezoidal prism shaped 3D printed model has a 3.7 times smaller displacement value (0.088 [mm]) compared to the adhesive resin model (0.326 [mm]). In conclusion, the proposed protocol for aligner attachments and the introduction of innovative materials is a promising method of solving conventional attachment problems in current orthodontic treatments.
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Affiliation(s)
- Riham Nagib
- Department of Orthodontics, Orthodontics Research Center 'ORTHO CENTER', "Victor Babeş" University of Medicine and Pharmacy Timişoara, Eftimie Murgu Sq. 2, 300041, Timişoara, Romania
| | - Andrei Zoltan Farkas
- Department of Mechatronics, University Politehnica Timişoara, 1 Mihai Viteazu Ave, 300222, Timişoara, Romania.
| | - Camelia Szuhanek
- Department of Orthodontics, Orthodontics Research Center 'ORTHO CENTER', "Victor Babeş" University of Medicine and Pharmacy Timişoara, Eftimie Murgu Sq. 2, 300041, Timişoara, Romania
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Xia Q, Wang W, Wang C, Feng G, Wang C, Song J, Fan Y. Comparative assessment of orthodontic clear aligner versus fixed appliance for anterior retraction: a finite element study. BMC Oral Health 2024; 24:80. [PMID: 38218801 PMCID: PMC10787995 DOI: 10.1186/s12903-023-03704-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/22/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND The aim of this study is to conduct a comparative evaluation of different designs of clear aligners and examine the disparities between clear aligners and fixed appliances. METHODS 3D digital models were created, consisting of a maxillary dentition without first premolars, maxilla, periodontal ligaments, attachments, micro-implant, 3D printed lingual retractor, brackets, archwire and clear aligner. The study involved the creation of five design models for clear aligner maxillary anterior internal retraction and one design model for fixed appliance maxillary anterior internal retraction, which were subsequently subjected to finite element analysis. These design models included: (1) Model C0 Control, (2) Model C1 Posterior Micro-implant, (3) Model C2 Anterior Micro-implant, (4) Model C3 Palatal Plate, (5) Model C4 Lingual Retractor, and (6) Model F0 Fixed Appliance. RESULTS In the clear aligner models, a consistent pattern of tooth movement was observed. Notably, among all tested models, the modified clear aligner Model C3 exhibited the smallest differences in sagittal displacement of the crown-root of the central incisor, vertical displacement of the central incisor, sagittal displacement of the second premolar and second molar, as well as vertical displacement of posterior teeth. However, distinct variations in tooth movement trends were observed between the clear aligner models and the fixed appliance model. Furthermore, compared to the fixed appliance model, significant increases in tooth displacement were achieved with the use of clear aligner models. CONCLUSIONS In the clear aligner models, the movement trend of the teeth remained consistent, but there were variations in the amount of tooth displacement. Overall, the Model C3 exhibited better torque control and provided greater protection for posterior anchorage teeth compared to the other four clear aligner models. On the other hand, the fixed appliance model provides superior anterior torque control and better protection of the posterior anchorage teeth compared to clear aligner models. The clear aligner approach and the fixed appliance approach still exhibit a disparity; nevertheless, this study offers a developmental direction and establishes a theoretical foundation for future non-invasive, aesthetically pleasing, comfortable, and efficient modalities of clear aligner treatment.
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Affiliation(s)
- Qian Xia
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Weixu Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chunjuan Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Ge Feng
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
- Key Laboratory of Biomechanics and Mechanobiology, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, State Key Laboratory of Virtual Reality Technology and Systems, Ministry of Education, Beihang University, No.37, Xueyuan Road, Beijing, 100083, China.
| | - Jinlin Song
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, State Key Laboratory of Virtual Reality Technology and Systems, Ministry of Education, Beihang University, No.37, Xueyuan Road, Beijing, 100083, China
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Brezniak N, Protter N. Don't forget to overcorrect and much more: The current finite element analysis publications related to clear-aligner treatments. Am J Orthod Dentofacial Orthop 2023; 164:764-765. [PMID: 37777931 DOI: 10.1016/j.ajodo.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 10/02/2023]
Affiliation(s)
| | - Noam Protter
- Orthodontic Section, Soroka Hospital, Beer Sheba, Israel
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Kang F, Wu Y, Cui Y, Yuan J, Hu Z, Zhu X. The displacement of teeth and stress distribution on periodontal ligament under different upper incisors proclination with clear aligner in cases of extraction: a finite element study. Prog Orthod 2023; 24:38. [PMID: 37981597 PMCID: PMC10657915 DOI: 10.1186/s40510-023-00491-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/08/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVES To investigate the displacement of dentition and stress distribution on periodontal ligament (PDL) during retraction and intrusion of anterior teeth under different proclination of incisors using clear aligner (CA) in cases involving extraction of the first premolars. METHODS Models were constructed, consisting of the maxilla, PDLs, CA and maxillary dentition without first premolars. These models were then imported to finite element analysis (FEA) software. The incisor proclination determined the division of the models into three groups: Small torque (ST) with U1-SN = 100°, Middle torque (MT) with U1-SN = 110°, and High torque (HT) with U1-SN = 120°. Following space closure, a 200 g intrusion force was applied at angles of 60°, 70°, 80°, and 90° to the occlusal plane, respectively. RESULTS CA therapy caused lingual tipping and extrusion of incisors, mesial tipping and intrusion of canines, and mesial tipping of posterior teeth in each group. As the proclination of incisors increased, the incisors presented more extrusion and minor retraction, and the teeth from the canine to the second molar displayed an increased tendency of intrusion. The peak Von Mises equivalent stress (VMES) value successively decreased from the central incisor to the canine and from the second premolar to the second molar, and the VMES of the second molar was the lowest among the three groups. When the angle between the intrusion force and occlusal plane got larger, the incisors exhibited greater intrusion but minor retraction. CONCLUSIONS The "roller coaster effect" usually occurred in cases involving premolar extraction with CA, especially in patients with protruded incisors. The force closer to the vertical direction were more effective in achieving incisor intrusion. The stress on PDLs mainly concentrated on the cervix and apex of incisors during the retraction process, indicating a possibility of root resorption.
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Affiliation(s)
- Fujia Kang
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Yumiao Wu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Yuchen Cui
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Jiamin Yuan
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Zhiqiang Hu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Xianchun Zhu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China.
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Wang S, Huang Y, Fan D, Liu H, Yuan C, Yang L, Wang P. Effects of overtreatment with different attachment positions on maxillary anchorage enhancement with clear aligners: a finite element analysis study. BMC Oral Health 2023; 23:693. [PMID: 37749548 PMCID: PMC10521390 DOI: 10.1186/s12903-023-03340-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/22/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The effect of attachment positions on anchorage has not been fully explored. The aim of the present study is to analyze the effect of overtreatment with different anchorage positions on maxillary anchorage enhancement with clear aligners in extraction cases. METHODS Models of the maxilla and maxillary dentition were constructed and imported into SOLIDWORKS software to create periodontal ligament (PDL), clear aligners, and attachments. Attachment positions on second premolars included: without attachment (WOA), buccal attachment (BA), and bucco-palatal attachment (BPA). Overtreatment degrees were divided into five groups (0°, 1°, 2°, 3°, 4°) and added on the second premolars. The calculation and analysis of the displacement trends and stress were performed using ANSYS software. RESULTS Distal tipping and extrusion of the canines, and mesial tipping and intrusion of the posterior teeth occurred during retraction. A strong anchorage was achieved in cases of overtreatment of 2.8° with BA and 2.4° with BPA. Moreover, the BPA showed the best in achieving bodily control of the second premolars. When the overtreatment was performed, the canines and first molars also showed reduced tipping trends with second premolars attachments. And the stress on the PDL and the alveolar bone was significantly relieved and more evenly distributed in the BPA group. CONCLUSIONS Overtreatment is an effective means for anchorage enhancement. However, the biomechanical effect of overtreatment differs across attachment positions. The BPA design performs at its best for stronger overtreatment effects with fewer adverse effects.
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Affiliation(s)
- Shiyu Wang
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China
| | - Yangyang Huang
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China
| | - Dian Fan
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China
| | - Hao Liu
- Department of Orthodontics, Affiliated Stomatological Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Changyong Yuan
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China
- Department of Implantology, Affiliated Stomatological Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Li Yang
- Department of Orthodontics, Affiliated Stomatological Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Penglai Wang
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China.
- Department of Implantology, Affiliated Stomatological Hospital of Xuzhou Medical University, 221000, Xuzhou, China.
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