Evidence map›Paper›PMID 40059251›Full record

ArticleProgress in orthodontics2025

Biomechanical analysis of clear aligners for mandibular anterior teeth intrusion and its clinical application in the design of new aligner attachment.

Shengzhao Xiao, Caiqi Cheng, Haochen Li, Lin Li, Canao Shen, Qiping Feng, Yan Zhao, Yufeng Duan, Lunguo Xia, Fengting Chu and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Progress in orthodontics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Shengzhao XiaoDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Caiqi ChengDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Haochen LiDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Lin LiDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Canao ShenDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Qiping FengDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Yan ZhaoSchool of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China.
Yufeng DuanDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Lunguo XiaDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Fengting ChuDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China. quci2001@163.com.
Bing FangDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, 200011, China. fangbing@sjtu.edu.cn.

Funding

the Interdisciplinary Program of Shanghai Jiao Tong University YG2022QN049The National Key Research and Development Program of China 2022YFC2405900the National Natural Science Foundation of China 11932012the National Natural Science Foundation of China 12202274the National Natural Science Foundation of China 32201221
6 · The paper itself

Abstract

backgroundDuring the process of intruding the mandibular anterior teeth (MAT) with clear aligners (CA), the teeth are susceptible to undesigned buccal and lingual inclinations, leading to complications such as excessive alveolar bone resorption and root exposure that significantly compromise the treatment outcome. Therefore, it is imperative to investigate the underlying causes and develop effective coping strategies.

methodsWe first statistically analyzed the clinical issues, then used FEA to explore their underlying mechanisms to guide the design of attachments in clinical practice. Specifically, CBCT data before and after the intrusion treatment of MAT were collected to analyze the labial-lingual inclination of the MAT and the distance between the root apex and alveolar bone wall. Finite element analysis (FEA) models of MAT undergoing vertical intrusion with standard CA were created with eight incisor mandibular plane angles (IMPA) to assess displacement trends, labial and lingual moments, and crown contact forces. Additionally, six aligner attachments were designed to simulate and analyze their biomechanical mechanisms.

resultsSignificant differences were observed in changes before and after treatment. When the IMPA was 90°, the crown experienced a labial moment. The labial root control ridge (RCR) increased the labial moment of the crown, while the lingual RCR and labial attachment (LA) increased the lingual moment. The lingual fossa excavating holes (LFEH) group also increased the labial moment. The lingual RCR enhanced the lingual movement of the crown, whereas the LFEH promoted labial movement. During the intrusion of MAT, a comprehensive design incorporating labial intrusive attachments, labial RCR, lingual RCR, and LFEH can be employed to ensure true vertical intrusion of the lower anterior teeth.

conclusionThis study revealed the biomechanical changes during intrusion, and innovatively designed the LFEH, thereby promoting the development of novel orthodontic techniques and improving clinical treatment outcomes.

Indexed as

IncisorOrthodontic Appliance DesignOrthodontic Appliances, RemovableTooth Movement TechniquesAlveolar ProcessBiomechanical PhenomenaCone-Beam Computed TomographyDental Stress AnalysisFinite Element AnalysisHumansMandibleAnterior teeth intrusionClear alignerDentistryFinite element analysis

Identifiers

PMID40059251
PMCPMC11891119

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.