Force direction using miniscrews in sliding mechanics differentially affected maxillary central incisor retraction: Finite element simulation and typodont model

BACKGROUND/PURPOSE: En masse retraction was still controversy in orthodontics. The aim of this study was to investigate the effect of force directions created by different miniscrew positions and lever arm heights on maxillary central incisor movement using Finite Element (FE) simulation and a Typodont model. MATERIALS AND METHODS: A typodont model and 3-dimensional FE were used to simulate en masse anterior teeth retraction in sliding mechanics. The lever arm and the miniscrew positions were varied to change the force direction. The maxillary central incisor displacement was recorded and analyzed. RESULTS: The typodont results revealed that miniscrew vertical position and lever arm height affected the type of tooth movement. The best control in the vertical plane was achieved by a 7 mm lever arm height and miniscrew 9 mm from the archwire. When the lever arm height and miniscrew were 7 mm from the archwire, the tooth extruded. When the lever arm height was 9 mm and the miniscrew was 7 or 9 mm from the archwire, the tooth intruded. The FE stimulation determined that near bodily movement of the maxillary central incisor was achieved when the lever arm height and miniscrew was 9 mm from the archwire. The highest strain distribution in the periodontal ligament was observed at the apical third of the lateral incisor. CONCLUSION: In en masse retraction, the appropriate direction of force or the height of the miniscrew and the lever arm may enable orthodontists to maintain better control of the anterior teeth in sliding mechanics.