ArticleProgress in orthodontics2025
Biomechanical effects of periodontal status on molar sequential distalization with clear aligners: a finite element study.
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 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 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
- In Vivo Assessment of SED: A Novel Biomechanical Indicator for Periodontal Tissue Remodeling in Clear Aligner Therapy.Annals of biomedical engineering · 2026Article
- CBCT assessment of maxillary molar distalization and root length changes during clear aligner therapy.BMC oral health · 2026Article
- Labiolingual Loading Biomechanics on Central Incisor Under Different Periodontal Conditions: A Finite Element Study.International dental journal · 2026Article
- Combined effects and weight analysis of factors affecting initial maxillary central incisor retraction: a three-dimensional finite element study.Frontiers in bioengineering and biotechnology · 2026Article
- Clear Aligner Therapy Assisted by Implant Anchorage and S-Shaped Root Control Attachments for Anterior Open Bite Correction: A 30-Month Treatment Case Report.Case reports in dentistry · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
objectiveMolar sequential distalization with clear aligners was advantageous. However, the effect of periodontal status on it has yet to be investigated. This study aimed to analyze the influence of the different periodontal states on molar distalization to reduce the adverse mechanical stimulation caused by periodontal states by the different stagings of movement and further explore therapeutic recommendations for clinical practice.
methodsTo ascertain the initial displacement of dentition and periodontal ligament (PDL) hydrostatic stress, finite element models (FEMs) were developed. These models included the distalization of the second molars (Step A) and the first molar (Step B) in three distinct periodontal conditions (simulating the periodontal state of mild, moderate, and severe periodontitis) and three distinct distances (0.10 mm, 0.18 mm, 0.25 mm).
resultsPeriodontal status affected the tooth movement during molar distalization. During the molar distalization with 0.25 mm step distance, the initial displacement of the molar was greater in the model with worse periodontal condition. However, it did not increase the efficiency of tooth movement because the initial displacement is accompanied by tipping. Moreover, the second molar relapse to mesialization for a reaction from the first molar distalization affected efficiency. Fortunately, reducing the step distance could control those undesired tooth movements positively associated with alveolar bone resorption. LIMITATIONS: The finite element method cannot simulate complex periodontal conditions in clinical practice.
conclusionTo reduce the undesired tipping and relapse, the personalized staging of movement should be designed according to the periodontal condition. Designing 0.18 mm step distance for patients with 1/3 alveolar bone resorption is recommended, whereas patients with 1/2 alveolar bone resorption need 0.1 mm. These recommendations can guide orthodontists in designing effective treatment plans for patients with varying degrees of periodontal disease.
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