Evidence map›Paper›PMID 42842071›Full record

ArticleProgress in orthodontics2026

Torque expression in directly printed and thermoformed clear aligners: a controlled in vitro biomechanical comparison of power ridge effects.

Aliaa A Khadre, Mohamed Elkorashie, Mostafa Magdy Elzahar, Christoph Bourauel, Ahmed Mahmoud Fouda

Abstract readComparative Study
In one paragraph

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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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Aliaa A KhadreDepartment of Orthodontics, Suez Canal University, Ismailia, Egypt.ORCID http://orcid.org/0000-0002-7877-9275
Mohamed ElkorashieDepartment of Orthodontics, Suez Canal University, Ismailia, Egypt. mo.elkorashie@dent.suez.edu.eg.ORCID http://orcid.org/0000-0003-3707-3388
Mostafa Magdy ElzaharDepartment of Orthodontics, Universitätsmedizin Greifswald, Greifswald, Germany.
Christoph BourauelDepartment of Oral Technology, University Hospital Bonn, Bonn, Germany.ORCID http://orcid.org/0000-0002-2195-1011
Ahmed Mahmoud FoudaDepartment of Oral Technology, University Hospital Bonn, Bonn, Germany.ORCID http://orcid.org/0000-0002-5139-0956

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTorque control of anterior teeth remains a major challenge in clear aligner therapy. Power ridges have been introduced to improve buccolingual root control; however, their biomechanical performance in directly printed aligners remains insufficiently investigated. The aim of this study was to compare the torque efficiency of power ridges in thermoformed and directly printed aligners. METHODOLOGY: A controlled in-vitro study was conducted using a standardised maxillary model requiring incisor torque correction. Four aligner groups were evaluated: Zendura Flex thermoformed aligners (Bay Materials LLC, USA) with (ZF-PR) and without (ZF-C) power ridges, and two directly printed aligners with power ridges fabricated from TA-28 (Graphy Inc., Seoul, South Korea) and DCA (LuxCreo Inc., Bellevue, WA, USA) resin materials. Power ridges were digitally positioned on the labial gingival third of the maxillary central incisors. Biomechanical testing was performed using the Orthodontic Measurement and Simulation System (OMSS) to assess torque expression, root displacement, and force-moment systems under controlled temperatures (25 °C and 37 °C).

resultsTorque expression demonstrated a clear material-dependent pattern. ZF-C, used as the baseline, showed moderate and consistent torque expression (38-39% of the programmed torque) across temperatures, with no significant temperature-dependent differences. DCA exhibited the highest torque expression, reaching 62% at 25 °C and 47% at 37 °C. ZF-PR showed intermediate performance (32-42%) with moderate temperature-related variation. TA-28 demonstrated the lowest torque expression (10-17%) with no significant temperature effect. Secondary outcomes supported these findings, with moment generation and displacement patterns correlating with torque expression, whereas force magnitude did not.

conclusionsTorque expression in clear aligner systems is primarily governed by material properties and thermomechanical behaviour. Design features alone cannot fully compensate for limitations in material performance. Effective torque delivery depends on the generation and transmission of an appropriate force-moment system rather than on force magnitude alone.

Indexed as

Orthodontic Appliance DesignOrthodontic Appliances, RemovableTooth Movement TechniquesTorqueBiomechanical PhenomenaHumansIncisorIn Vitro TechniquesMaxillaModels, DentalClear alignersDirect-printed alignersOrthodontic biomechanicsPower ridgesTorque control

Identifiers

PMID42842071
PMCPMC13646225

What OpenQuestion holds

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Registered trials

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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.