ArticleBMC oral health2024
Anchorage loss of the posterior teeth under different extraction patterns in maxillary and mandibular arches using clear aligner: a finite element study.
Article in BMC oral health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- [Advancements in biomechanics and orthodontic strategies for clear aligner therapy].Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology · 2026Pooled it
- Biomechanical analysis of implant anchorage versus class II elastics in maxillary anterior retraction with clear aligners: a three-dimensional iterative finite element study.BMC oral health · 2026Article
- Biomechanical Applications of Finite Element Analysis in Orthodontics: A Scoping Review of Force Distribution, Tooth Movement, and Mechanical Performance.Dentistry journal · 2026Review
- Three-Dimensional Change of Molar Position During Alignment and Leveling With PASS and MBT: A Randomized Controlled Trial.International journal of dentistry · 2026Article
- Review
- An integrated approach to posterior anchorage preparation and incisor torque compensation in premolar extraction cases using clear aligners.BMC oral health · 2025Article
- Retrospective evaluation of clear aligners' adverse effects on open gingival embrasures among orthodontic patients.Bioinformation · 2025Article
- Biomechanically Valid Clear Aligner Therapy for Premolar Extraction Case: A Case Report and Literature Review.Case reports in dentistry · 2025Article
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6 authors.
Funding
Abstract
backgroundExtracting the premolars is an effective strategy for patients with bimaxillary dentoalveolar protrusion. Clear aligners (CAs) close the extraction spaces through shortening the length of aligners. The contraction force generated by the terminal of aligners makes the posterior teeth tip mesially, which is known as the roller coaster effect. This phenomenon is even worse in the 2nd premolar extraction cases. Posterior anchorage preparation is commonly used to protect the angulation of molars, taking the form of presetting distal tipping value. However, the distal tipping design aggravates the anchorage loss of anterior teeth simultaneously. This study aimed to explore the different anchorage loss of the posterior teeth when the 1st or 2nd premolars were extracted using CAs, respectively in maxillary and mandibular arches, further providing guidance for anchorage preparation design in clinical practice.
methodsTwo bimaxillary finite element models with different extraction patterns were established to simulate the anterior en-masse retraction process of the CAs. In Model 1, the maxillary and mandibular 1st premolars were extracted, while in Model 2, the 2nd premolars were extracted. Finite element analysis methods were utilized to analyze the tipping angle of the anterior and posterior teeth.
resultsCompared between two models, the anterior teeth exhibited a greater lingual inclination tendency and the posterior teeth exhibited a slighter mesial tipping tendency in Model 1 regarding individual tooth. The closer to the extraction spaces, the greater the tip, and the distal tipping tendency of the 1st premolars was more evident than the mesial tipping tendency of the 1st molars in Model 2. Compared between the maxillary and mandibular arches, the mesial tipping tendency of individual posterior tooth was more evident in the maxilla. In addition, the highest hydrostatic stress of the periodontal ligaments was concentrated on the cervical and apical parts directly adjacent to the extraction spaces, and it exhibited relatively uniform distribution in Model 1.
conclusionsThe individual posterior tooth showed the same mesial tipping direction but to different degree when the 1st or the 2nd premolars were extracted during clear aligner treatment. Presetting anchorage preparation design for the posterior teeth is essential to alleviate the roller coaster effect, especially in the 2nd premolar extraction cases. Furthermore, larger anchorage preparation value should be proposed for the maxillary posterior teeth.
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