The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Evaluation of different designs of 3D printed clear aligners on mandibular premolar extrusion using force/moment measurement devices and digital image correlation method

  • Jong-Chan Baik (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Youn-Kyung Choi (Department of Orthodontics, Biomedical Research Institute, Pusan National University Hospital) ;
  • Yonghun Cho (School of Computer Science and Engineering, Pusan National University) ;
  • Yunju Baek (School of Computer Science and Engineering, Pusan National University) ;
  • Sung-Hun Kim (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Seong-Sik Kim (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Soo-Byung Park (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Ki Beom Kim (Department of Orthodontics, Saint Louis University) ;
  • Yong-Il Kim (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital)
  • Received : 2024.01.24
  • Accepted : 2024.06.23
  • Published : 2024.11.25
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Abstract

Objective: This study aimed to investigate the effect of three-dimensional (3D) printed clear aligners (CA) with different designs on the extrusion of mandibular premolars using a force/moment measurement system and digital image correlation (DIC). Methods: The forces and moments applied to the mandibular canines, first and second premolars were measured using a multi-axis force/moment transducer when an extrusion of 0.5 mm was planned, assuming the mandibular first premolars were intruded by 1 mm. In addition, displacement and strain changes in the CA were analyzed using the DIC method. CA designs were categorized based on the presence of first premolar attachment and subdivided into equigingival margins, 1-mm extended margins, equi-margins with 1-mm thickness and height, and equi-margins with 1-mm reduced buccolingual width. The CA was printed directly at a thickness of 0.5 mm, and the experiments were conducted at 37℃. Results: The results showed that attachment played an important role in the extrusion of first premolars in both the force/moment measurement system and the DIC method. Intrusion was observed without attachment, even though extrusion was planned. CA designs apply greater force to the cervical region by extending the margin or reducing the buccolingual width, thereby improving extrusion efficiency. Conclusions: Force and moment changes in direct 3D printed CA are complex and difficult to predict; however, modifying aligner designs, such as extending the margin or reducing buccolingual width, and using appropriate attachments could minimize unwanted tooth movement, optimize planned treatment, and increase treatment predictability.

Keywords

Acknowledgement

This study was supported by a Biomedical Research Institute Grant (20240051) from Pusan National University Hospital.

References

  1. Meade MJ, Weir T. A survey of orthodontic clear aligner practices among orthodontists. Am J Orthod Dentofacial Orthop 2022;162:e302-11. https://doi.org/10.1016/j.ajodo.2022.08.018
  2. Galan-Lopez L, Barcia-Gonzalez J, Plasencia E. A systematic review of the accuracy and efficiency of dental movements with Invisalign®. Korean J Orthod 2019;49:140-9. https://doi.org/10.4041/kjod.2019.49.3.140
  3. Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. Angle Orthod 2015;85:881-9. https://doi.org/10.2319/061614-436.1
  4. Haouili N, Kravitz ND, Vaid NR, Ferguson DJ, Makki L. Has Invisalign improved? A prospective follow-up study on the efficacy of tooth movement with Invisalign. Am J Orthod Dentofacial Orthop 2020;158:420-5. https://doi.org/10.1016/.ajodo.2019.12.015
  5. Meng X, Wang C, Xu W, Wang R, Zheng L, Wang C, et al. Effects of different designs of orthodontic clear aligners on the maxillary central incisors in the tooth extraction cases: a biomechanical study. BMC Oral Health 2023;23:416. https://doi.org/10.1186/s12903-023-03106-8
  6. Cheng Y, Liu X, Chen X, Li X, Fang S, Wang W, et al. The three-dimensional displacement tendency of teeth depending on incisor torque compensation with clear aligners of different thicknesses in cases of extraction: a finite element study. BMC Oral Health 2022;22:499. https://doi.org/10.1186/s12903-022-02521-7
  7. Grant J, Foley P, Bankhead B, Miranda G, Adel SM, Kim KB. Forces and moments generated by 3D direct printed clear aligners of varying labial and lingual thicknesses during lingual movement of maxillary central incisor: an in vitro study. Prog Orthod 2023;24:23. https://doi.org/10.1186/s40510-023-00475-2
  8. Jiang T, Wu RY, Wang JK, Wang HH, Tang GH. Clear aligners for maxillary anterior en masse retraction: a 3D finite element study. Sci Rep 2020;10:10156. https://doi.org/10.1038/s41598-020-67273-2
  9. Cai Y, Yang X, He B, Yao J. Finite element method analysis of the periodontal ligament in mandibular canine movement with transparent tooth correction treatment. BMC Oral Health 2015;15:106. https://doi.org/10.1186/s12903-015-0091-x
  10. Yokoi Y, Arai A, Kawamura J, Uozumi T, Usui Y, Okafuji N. Effects of attachment of plastic aligner in closing of diastema of maxillary dentition by finite element method. J Healthc Eng 2019;2019:1075097. https://doi.org/10.1155/2019/1075097
  11. Johal A, Sharma NR, McLaughlin K, Zou LF. The reliability of thermoform retainers: a laboratory-based comparative study. Eur J Orthod 2015;37:503-7. https://doi.org/10.1093/ejo/cju075
  12. Min S, Hwang CJ, Yu HS, Lee SB, Cha JY. The effect of thickness and deflection of orthodontic thermoplastic materials on its mechanical properties. Korean J Orthod 2010;40:16-26. https://doi.org/10.4041/kjod.2010.40.1.16
  13. Ryokawa H, Miyazaki Y, Fujishima A, Miyazaki T, Maki K. The mechanical properties of dental thermoplastic materials in a simulated intraoral environment. Orthod Waves 2006;65:64-72. https://doi.org/10.1016/j.odw.2006.03.003
  14. Lee SY, Kim H, Kim HJ, Chung CJ, Choi YJ, Kim SJ, et al. Thermo-mechanical properties of 3D printed photocurable shape memory resin for clear aligners. Sci Rep 2022;12:6246. https://doi.org/10.1038/s41598-022-09831-4
  15. Tartaglia GM, Mapelli A, Maspero C, Santaniello T, Serafin M, Farronato M, et al. Direct 3D printing of clear orthodontic aligners: current state and future possibilities. Materials (Basel) 2021;14:1799. https://doi.org/10.3390/ma14071799
  16. Savignano R, Valentino R, Razionale AV, Michelotti A, Barone S, D'Anto V. Biomechanical effects of different auxiliary-aligner designs for the extrusion of an upper central incisor: a finite element analysis. J Healthc Eng 2019;2019:9687127. https://doi.org/10.1155/2019/9687127
  17. Kassas W, Al-Jewair T, Preston CB, Tabbaa S. Assessment of Invisalign treatment outcomes using the ABO model grading system. J World Fed of Orthod 2013;2:e61-4. https://doi.org/10.1016/j.ejwf.2013.03.003
  18. Kravitz ND, Kusnoto B, Agran B, Viana G. Influence of attachments and interproximal reduction on the accuracy of canine rotation with Invisalign. A prospective clinical study. Angle Orthod 2008;78:682-7. https://doi.org/10.2319/0003-3219(2008)078[0682:ioaair]2.0.co;2
  19. Rossini G, Modica S, Parrini S, Deregibus A, Castroflorio T. Incisors extrusion with clear aligners technique: a finite element analysis study. Appl Sci 2021;11:1167. https://doi.org/10.3390/app11031167
  20. Karras T, Singh M, Karkazis E, Liu D, Nimeri G, Ahuja B. Efficacy of Invisalign attachments: a retrospective study. Am J Orthod Dentofacial Orthop 2021;160:250-8. https://doi.org/10.1016/j.ajodo.2020.04.028
  21. Kim WH, Hong K, Lim D, Lee JH, Jung YJ, Kim B. Optimal position of attachment for removable thermoplastic aligner on the lower canine using finite element analysis. Materials (Basel) 2020;13:3369. https://doi.org/10.3390/ma13153369
  22. Yao S, Jiang W, Wang C, He Y, Wang C, Huang L. Improvements of tooth movement efficiency and torque control in expanding the arch with clear aligners: a finite element analysis. Front Bioeng Biotechnol 2023;11:1120535. https://doi.org/10.3389/fbioe.2023.1120535
  23. Elkholy F, Panchaphongsaphak T, Kilic F, Schmidt F, Lapatki BG. Forces and moments delivered by PET-G aligners to an upper central incisor for labial and palatal translation. J Orofac Orthop 2015;76:460-75. https://doi.org/10.1007/s00056-015-0307-3
  24. Wheeler TT. Orthodontic clear aligner treatment. Semin Orthod 2017;23:83-9. https://doi.org/10.1053/j.sodo.2016.10.009
  25. Phan X, Ling PH. Clinical limitations of Invisalign. J Can Dent Assoc 2007;73:263-6. https://pubmed.ncbi.nlm.nih.gov/17439714/
  26. Seo JH, Eghan-Acquah E, Kim MS, Lee JH, Jeong YH, Jung TG, et al. Comparative analysis of stress in the periodontal ligament and center of rotation in the tooth after orthodontic treatment depending on clear aligner thickness-finite element analysis study. Materials (Basel) 2021;14:324. https://doi.org/10.3390/ma14020324
  27. McKay A, McCray J, Bankhead B, Lee MM, Miranda G, Adel SM, et al. Forces and moments generated during extrusion of a maxillary central incisor with clear aligners: an in vitro study. BMC Oral Health 2023;23:495. https://doi.org/10.1186/s12903-023-03136-2