Biomechanical Efficacy and Effectiveness of Orthodontic Treatment with Transparent Aligners in Mild Crowding Dentition—A Finite Element Analysis

Abstract

Orthodontic treatment increasingly involves transparent aligners; however, biomechanical analysis of their treatment effects under clinical conditions is lacking. We compared the biomechanical efficacy and effectiveness of orthodontic treatment with transparent aligners and of fixed appliances in simulated clinical orthodontic treatment conditions using orthodontic finite element (FE) models. In the FE analysis, we used Model Activation/De-Activation analysis to validate our method. Fixed appliances and 0.75-mm and 0.5-mm thick transparent aligners were applied to a tooth-alveolar bone FE model with lingually-inclined and axially-rotated central incisors. Compared to the fixed appliance, the 0.75-mm and 0.5-mm transparent aligners induced 5%, 38%, and 28% and 21%, 62%, and 34% less movement of the central incisors and principal stress of the periodontal ligament and of the alveolar bone, respectively, for lingual inclination correction. For axial-rotation correction, these aligners induced 22%, 37%, and 40% and 28%, 67%, and 48% less tooth movement and principal stress of the periodontal ligament and of the alveolar bone, respectively. In conclusion, transparent aligners induced less tooth movement, it is sufficient for orthodontic treatment, but 0.5-mm aligners should be used for only mild corrections. Additionally, the Model Activation/De-Activation analysis method is suitable for FE analysis of orthodontic treatment reflecting clinical treatment conditions.

External Apical Root Resorption in Clear Aligner Vs. Fixed Orthodontic Appliances: Systematic Review And Meta-Analysis

“…Although the precise mechanism of EARR remains unclear, it is believed that EARR has a direct connection to orthodontic forces and apical movement distance [1,8]. From a mechanical point of view, orthodontic forces delivered to teeth through CAT are intermittent, while in FOAT they are continuous [9].…”

“…Since clear aligner therapy (CAT) has been introduced as a treatment method, an increasing number of patients are opting for this more esthetical and comfortable alternative treatment modality, rather than fixed orthodontic appliances. Theoretically, from the mechanical point of view, clear aligners differ from fixed orthodontic appliances in the number of orthodontic forces applied to teeth [1]. Studies have shown that orthodontic forces have a significant effect on the development of external apical root resorption (EARR) [2].…”

A Hypothesis Testing of Archwire Rounding for the Efficacy of Torque Springs in Orthodontics: A Finite Element Study

“…The finite element method (FEM) is a crucial tool in orthodontics for biomechanical simulations, aiding in the understanding of the behavior of biological structures in various scenarios. Although it yields numerical approximations, FEM is invaluable in clinical research when direct in vivo measurements are challenging [28][29][30][31][32]. These insights from FEM significantly enhance orthodontic treatment planning and outcomes.…”

Application effect of behavioral cognition combined with psychological intervention on orthodontic patients: A prospective, randomized, controlled trial

“…If patients do not pay attention to oral hygiene, it is easy to cause the formation of dental plaque, inducing tooth decay and gingivitis, which can eventually evolve into periodontitis, resulting in alveolar bone damage and ultimately affect the effect of orthodontic treatment, even causing tooth loosening or loss. [ 3 ] Actually, most patients have insufficient cognition of orthodontics, weak self-care awareness, poor health behavior, and orthodontic treatment cannot reach the expected effect. [ 4 , 5 ] In addition, the cycle of orthodontic treatment is as long as 2 years, and the wearing of fixed orthodontics will bring many problems and troubles to patients’ diet, facial appearance and oral hygiene, and easily lead to adverse psychological changes of patients.…”