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Comparative Study
. 2025 Apr;28(2):242-252.
doi: 10.1111/ocr.12865. Epub 2024 Oct 9.

In Vitro Comparison of Direct Attachment Shape and Size on the Orthodontic Forces and Moments Generated by Thermoplastic Aligners During Expansion

Megann Lear  1 , Amin Akbari  2 , Olivia Robertson  3 , Janine Magura  1 , Alexandra Bojrab  1 , George Eckert  4 , Jie Chen  2 , Richard Scott Conley  1 , Hakan Turkkahraman  1
Affiliations
Comparative Study

In Vitro Comparison of Direct Attachment Shape and Size on the Orthodontic Forces and Moments Generated by Thermoplastic Aligners During Expansion

Megann Lear et al. Orthod Craniofac Res. 2025 Apr.

Abstract

Objective: To evaluate the effects of varying direct attachment shape and size on the forces and moments generated by thermoplastic aligners during simulated expansion.

Materials and methods: An in vitro orthodontic force tester (OFT) was used to measure the forces and moments from a typodont where the buccal teeth were translated lingually 0.2 mm to simulate expansion. Hemi-ellipsoid and rectangular attachments with either 0.5 or 1.0 mm thickness were added on upper right first premolar (UR4), second premolar (UR5) and first molar (UR6). Analysis of variance (ANOVA) was used to determine two-way interactions among the factors on the outcomes.

Results: The interactions between group and tooth were significant for all outcomes (p < 0.001). The greatest buccal forces (Fy) were observed with 1 mm rectangular attachment on the UR4 (0.78 ± 0.29 N), with 1 mm hemi-ellipsoid attachment on UR5 (0.28 ± 0.21 N) and with 0.5 mm rectangular attachment on UR6 (1.71 ± 0.18 N). The greatest buccolingual moments (Mx) were obtained with 1 mm rectangular attachment on UR4 (5.61 ± 1.43 Nmm), without any attachments on UR5 (3.33 ± 1.73 Nmm) and with 1 mm hemi-ellipsoid attachment on UR6 (4.18 ± 4.31).

Conclusion: Direct attachment shape and size had a significant effect on the orthodontic forces and moments generated by thermoplastic aligners during simulated expansion. Although loads varied significantly by tooth morphology and its location in the arch, best forces and moments for expansion were obtained with 1 mm rectangular attachments on UR4s, 1 mm hemi-ellipsoid attachments on UR5s and 0.5 mm rectangular attachments on UR6s.

Keywords: biomechanical phenomena; clear aligner appliance; orthodontic appliance design; tooth movement techniques.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
(A) Occlusal view of the Orthodontic Force Tester (OFT). (B) Lateral view of the OFT. (C) Digital setup of the experimental model with the defined local coordinate system for upper right first premolar (UR4), second premolar (UR5) and first molar (UR6).
FIGURE 2
FIGURE 2
Box and whisker plot depicting the distribution of the buccolingual forces (Fy). (A) Combined, (B) On the upper right first premolar (UR4), (C) The upper right first premolar (UR5) and (D) The upper right first molar (UR6).
FIGURE 3
FIGURE 3
Box and whisker plot depicting the distribution of the buccolingual moments (Mx). (A) Combined, (B) On the upper right first premolar (UR4), (C) The upper right first premolar (UR5) and (D) The upper right first molar (UR6).
See this image and copyright information in PMC

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