Evidence map›Paper›PMID 42247195›Full record

ArticleProgress in orthodontics2026

Effects of proactive or synchronous anchorage preparation of posterior teeth during anterior en masse retraction with clear aligners: a three-dimensional finite element study.

Ruomei Li, Wenxuan Shi, Yixin Li, Zhiyu Zhu, Ningjuan Ouyang, Yufeng Duan, Peng Mei, Ting Jiang, Xuehui Chen, Luyao Qu and 7 more

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Article in Progress in orthodontics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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17 authors.

Ruomei Li *Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Wenxuan Shi *Case Western Reserve University, Cleveland, USA.
Yixin LiDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Zhiyu ZhuDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Ningjuan OuyangDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Yufeng DuanDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Peng MeiDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Ting JiangDepartment of Pediatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Xuehui ChenDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Luyao QuDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Ziduan DingDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Chengxiao LiuDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Zitong YangDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Yu JinDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Cheng ZhuDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Dian JingDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China. orthodian@foxmail.com.
Lunguo XiaDepartment of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China. xialunguo@hotmail.com.

Funding

China Postdoctoral Science Foundation 2025M771751National Natural Science Foundation of China 32201221National Natural Science Foundation of China 82370988National Natural Science Foundation of China 82401179
6 · The paper itself

Abstract

introductionThe increasing use of clear aligners for anterior retraction following first premolar extraction has highlighted undesirable movements of posterior teeth, impeding efficacy and predictability. Although the anchorage preparation of posterior teeth has been proposed to counteract this effect, the optimal methods and extent remain undefined. Effective anchorage preparation strategies to mitigate undesirable movements of posterior teeth during anterior en masse retraction were investigated in this study. METHODOLOGY: A finite element study based on a maxillary first premolar extraction model was conducted to examine posterior tooth movement with different anchorage preparation methods: (1) without any anchorage preparation (control); (2) proactive anchorage preparation (PAP), where 1°, 2°, and 4° distal tipping of posterior teeth were set prior to anterior tooth retraction; and (3) synchronous anchorage preparation (SAP), where 1°, 2°, or 4° distal tipping of posterior teeth was processed with anterior tooth retraction.

resultsCompared with the control group, the PAP group exhibited a similar tooth displacement pattern (P > 0.1). SAP effectively controlled mesial tipping when applied at 1.245° for U5, 1.386° for U6, and 2.706° for U7, whereas the optimal resistance to mesial movement required 1.258° (U5), 2.148° (U6), and 2.976° (U7) of SAP, respectively. A 1.25° SAP for U6 successfully prevented lingual torque. However, mesial rotation of the posterior teeth, vertical displacement, torque, and transverse displacement of U5 and U7 remained difficult to control despite SAP adjustments.

conclusionCompared with PAP, SAP demonstrated superior effectiveness in controlling mesial tipping and displacement, while PAP showed better performance in managing mesial rotation and transverse movements. For optimal anchorage control during SAP implementation, clinicians should pay particular attention to posterior tooth mesial rotation as well as U7 extrusion and buccal torque development.

Indexed as

Finite Element AnalysisOrthodontic Anchorage ProceduresTooth Movement TechniquesBicuspidHumansImaging, Three-DimensionalModels, DentalTooth ExtractionAnchorage preparationAnterior en masse retractionClear alignersFinite element analysisTooth extraction

Identifiers

PMID42247195
PMCPMC13241375

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