Initial Biomechanical Response to Different Attachment Configurations and Class II Elastics During Clear Aligner–Based Canine Distalization Following Premolar Extraction: A Three-Dimensional Finite Element Analysis
Abstract
Abstract Objectives To compare the initial biomechanical responses generated by different attachment configurations and button-cut Class II intermaxillary elastic mechanics during a single 0.25-mm programmed activation for maxillary canine distalization with clear aligners following first premolar extraction. Methods A patient-specific three-dimensional finite element model comprising the maxillary dentition, periodontal ligament (PDL), alveolar bone, clear aligner, attachments, and orthodontic button was constructed from cone-beam computed tomography data. Six attachment configurations were analyzed, including one incorporating button-cut Class II intermaxillary elastic mechanics. A single 0.25-mm programmed distalization step was simulated through geometric mismatch between the activated aligner and pretreatment dentition, generating the initial force system through aligner deformation and elastic recovery. Initial three-dimensional crown and root displacements and principal and equivalent (von Mises) stress distributions within the aligner and PDL were evaluated. Results Attachment configuration influenced initial stress distribution, force transmission, and canine displacement patterns. The attachment-free model demonstrated the greatest overall initial canine displacement, extrusive component, and PDL stress. The optimized attachment produced a more balanced initial crown–root displacement pattern with a smaller extrusive component, although the initial response…
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