Korean J Orthod.  2015 Jan;45(1):20-28. 10.4041/kjod.2015.45.1.20.

Distalization pattern of whole maxillary dentition according to force application points

• Sung EH
• Kim SJ
• Chun YS
• Park YC
• Yu HS
• Lee KJ

• KMID: 2074819
• DOI: http://doi.org/10.4041/kjod.2015.45.1.20

Abstract

OBJECTIVE
The purpose of this study was to observe stress distribution and displacement patterns of the entire maxillary arch with regard to distalizing force vectors applied from interdental miniscrews.
METHODS
A standard three-dimensional finite element model was constructed to simulate the maxillary teeth, periodontal ligament, and alveolar process. The displacement of each tooth was calculated on x, y, and z axes, and the von Mises stress distribution was visualized using color-coded scales.
RESULTS
A single distalizing force at the archwire level induced lingual inclination of the anterior segment, and slight intrusive distal tipping of the posterior segment. In contrast, force at the high level of the retraction hook resulted in lingual root movement of the anterior segment, and extrusive distal translation of the posterior segment. As the force application point was located posteriorly along the archwire, the likelihood of extrusive lingual inclination of the anterior segment increased, and the vertical component of the force led to intrusion and buccal tipping of the posterior segment. Rotation of the occlusal plane was dependent on the relationship between the line of force and the possible center of resistance of the entire arch.
CONCLUSIONS
Displacement of the entire arch may be dictated by a direct relationship between the center of resistance of the whole arch and the line of action generated between the miniscrews and force application points at the archwire, which makes the total arch movement highly predictable.

Keyword

Distalization; Entire arch; Finite element; Occlusal plane; Displacement

MeSH Terms

Alveolar Process
Dental Occlusion
Dentition*
Periodontal Ligament
Tooth
Weights and Measures

Figure

• 

  Figure 1 Three-dimensional finite element model. A, Landmarks for the assessment of displacement; B, location of the miniscrew. Dots indicate points for (mesiobuccal) cusp tips/middle incisal edge or mesial root apices. Miniscrew position was simulated at 8 mm above the main archwire, at the contact point portion between the 2nd premolar and 1st molar. C.I., central incisor; L.I., lateral incisor; C, canine; PM1, 1st premolar; PM2, 2nd premolar; M1, 1st molar; M2, 2nd molar.

• 

  Figure 2 Experimental conditions. A, Conditions 1-6: effect of lever arm length (extended between lateral incisor and canine, conditions 1: 0 mm, 2: 2 mm, 3: 4 mm, 4: 6 mm, 5: 8 mm, 6: 10 mm, respectively). B, Conditions 1, and 7-9: effect of force application point (conditions 7: between canine and 1st premolar, 8: between 1st and 2nd premolars, 9: between 2nd premolar and 1st molar).

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  Figure 3 Coordinate system. x-axis: (+) palatal, (-) buccal direction; y-axis: (+) anterior, (-) posterior direction; z-axis: (+) superior, (-) inferior direction.

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  Figure 4 Effect of lever arm length in conditions 1-6 (C1-6). A, Axis change of the central incisor (CI), canine (C), and first molar (M1). B, Distal displacement of CI, C, and M1. C, Vertical displacement of CI, C, and M1. C1-6: conditions 1-6 (for definition, refer to Figure 2).

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  Figure 5 Contour plots. A, Distal displacement (mm). B, Vertical displacement (mm). C, von Mises stress distribution (g/mm2) in conditions 1, 3, 6, and 8.

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  Figure 6 Effect of force application point in conditions 1, and 7-9 (C1, C7-9). A, Axis change of the central incisor (CI), canine (C), and first molar (M1). B, Lateral displacement of the CI, first premolar (PM1), second premolar (PM2), M1, and second molar (M2). C1, 7 and 8: conditions 1, 7 and 8 (for the definition, refer to Figure 2).

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  Figure 7 Rotation of the occlusal plane in conditions 1-9, presented in descending order of the degree of rotation. (+): flattening rotation; (-) steepening rotation. For definition of C1 to C9, refer to Figure 2.

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  Figure 8 Schematic guidelines for the distalization of the entire maxillary arch. M, miniscrew; CR, center of the resistance of the whole maxillary dentition estimated by Jeong et al.23

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