{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:06:09Z","timestamp":1784070369489,"version":"3.55.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":62,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"DOI":"10.1186\/s12903-026-08588-w","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T02:36:46Z","timestamp":1778726206000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomechanical analysis of implant anchorage versus class II elastics in maxillary anterior retraction with clear aligners: a three-dimensional iterative finite element study"],"prefix":"10.1186","volume":"26","author":[{"given":"Haoxian","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinming","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujuan","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caixia","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahui","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"issue":"1","key":"8588_CR1","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s13643-023-02437-5","volume":"13","author":"S Caruso","year":"2024","unstructured":"Caruso S, De Felice ME, Valenti C, Pagano S, Caruso S, Gatto R, Lombardo G. An evaluation of the Invisalign(R) Aligner Technique and consideration of the force system: a systematic review. Syst Rev. 2024;13(1):43.","journal-title":"Syst Rev"},{"issue":"1","key":"8588_CR2","doi-asserted-by":"publisher","first-page":"rbac007","DOI":"10.1093\/rb\/rbac007","volume":"9","author":"X Yu","year":"2022","unstructured":"Yu X, Li G, Zheng Y, Gao J, Fu Y, Wang Q, Huang L, Pan X, Ding J. Invisible\u2019 orthodontics by polymeric \u2018clear\u2019 aligners molded on 3D-printed personalized dental models. Regen Biomater. 2022;9(1):rbac007.","journal-title":"Regen Biomater"},{"issue":"1","key":"8588_CR3","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/s41368-024-00338-4","volume":"17","author":"J Pan","year":"2025","unstructured":"Pan J, Lu Y, Liu A, Wang X, Wang Y, Gong S, Fang B, He H, Bai Y, Wang L, et al. Expert consensus on orthodontic treatment of protrusive facial deformities. Int J Oral Sci. 2025;17(1):5.","journal-title":"Int J Oral Sci"},{"issue":"1","key":"8588_CR4","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1093\/ejo\/cjac035","volume":"45","author":"N Al-Taai","year":"2023","unstructured":"Al-Taai N, Persson M, Ransjo M, Levring Jaghagen E, Westerlund A. Dentoskeletal and soft tissue changes after treatment of crowding with premolar extractions: a 50-year follow-up. Eur J Orthod. 2023;45(1):79\u201387.","journal-title":"Eur J Orthod"},{"issue":"1","key":"8588_CR5","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1186\/s12903-024-04951-x","volume":"24","author":"R Qiang","year":"2024","unstructured":"Qiang R, Gao J, Wang Y, Wang W, Ma Y, Jin Z. Anchorage loss of the posterior teeth under different extraction patterns in maxillary and mandibular arches using clear aligner: a finite element study. BMC Oral Health. 2024;24(1):1204.","journal-title":"BMC Oral Health"},{"issue":"4","key":"8588_CR6","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1111\/jebm.12453","volume":"14","author":"Y Yin","year":"2021","unstructured":"Yin Y, Wang Z, Huang L, Zhao Y, Guan Q, Xu H, Han X. Orthodontic maximum anchorages in malocclusion treatment: A systematic review and network meta-analysis. J Evid Based Med. 2021;14(4):295\u2013302.","journal-title":"J Evid Based Med"},{"issue":"1","key":"8588_CR7","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1186\/s12903-025-05945-z","volume":"25","author":"R Qiang","year":"2025","unstructured":"Qiang R, Wu J, Gao J, Chen H, Xu J, Jin Z, Ma Y. An integrated approach to posterior anchorage preparation and incisor torque compensation in premolar extraction cases using clear aligners. BMC Oral Health. 2025;25(1):558.","journal-title":"BMC Oral Health"},{"issue":"7","key":"8588_CR8","first-page":"670","volume":"58","author":"XY Tang","year":"2023","unstructured":"Tang XY, Xu MY, Hua YJ, Wang YY, Jiang T, Tang GH. [Three-dimensional finite element study on the effects of maxillary anterior two-step retraction and en-masse retraction with clear aligners]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2023;58(7):670\u20136.","journal-title":"Zhonghua Kou Qiang Yi Xue Za Zhi"},{"issue":"5","key":"8588_CR9","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1016\/j.ajodo.2022.02.018","volume":"163","author":"GY Zhu","year":"2023","unstructured":"Zhu GY, Zhang B, Yao K, Lu WX, Peng JJ, Shen Y, Zhao ZH. Finite element analysis of the biomechanical effect of clear aligners in extraction space closure under different anchorage controls. Am J Orthod Dentofac Orthop. 2023;163(5):628\u2013e644611.","journal-title":"Am J Orthod Dentofac Orthop"},{"issue":"7","key":"8588_CR10","doi-asserted-by":"publisher","first-page":"3863","DOI":"10.1007\/s00784-023-05006-1","volume":"27","author":"YY Hong","year":"2023","unstructured":"Hong YY, Zhou MQ, Cai CY, Han J, Ning N, Kang T, Chen XP. Efficacy of upper-incisor torque control with clear aligners: a retrospective study using cone-beam computed tomography. Clin Oral Investig. 2023;27(7):3863\u201373.","journal-title":"Clin Oral Investig"},{"issue":"6","key":"8588_CR11","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1016\/j.ajodo.2022.07.021","volume":"163","author":"JQ Liu","year":"2023","unstructured":"Liu JQ, Zhu GY, Wang YG, Zhang B, Yao K, Zhao ZH. Different biomechanical effects of clear aligners in closing maxillary and mandibular extraction spaces: Finite element analysis. Am J Orthod Dentofac Orthop. 2023;163(6):811\u2013e824812.","journal-title":"Am J Orthod Dentofac Orthop"},{"issue":"5","key":"8588_CR12","doi-asserted-by":"publisher","first-page":"881","DOI":"10.2319\/061614-436.1","volume":"85","author":"G Rossini","year":"2015","unstructured":"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(5):881\u20139.","journal-title":"Angle Orthod"},{"issue":"1","key":"8588_CR13","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1038\/s41368-025-00350-2","volume":"17","author":"Y Wang","year":"2025","unstructured":"Wang Y, Long H, Zhao Z, Bai D, Han X, Wang J, Fang B, Jin Z, He H, Bai Y, et al. Expert consensus on the clinical strategies for orthodontic treatment with clear aligners. Int J Oral Sci. 2025;17(1):19.","journal-title":"Int J Oral Sci"},{"issue":"1","key":"8588_CR14","first-page":"12","volume":"11","author":"M Upadhyay","year":"2022","unstructured":"Upadhyay M, Arqub SA. Biomechanics of clear aligners: hidden truths & first principles. J World Fed Orthod. 2022;11(1):12\u201321.","journal-title":"J World Fed Orthod"},{"key":"8588_CR15","doi-asserted-by":"publisher","first-page":"105348","DOI":"10.1016\/j.jdent.2024.105348","volume":"150","author":"P Lahoud","year":"2024","unstructured":"Lahoud P, Faghihian H, Richert R, Jacobs R, EzEldeen M. Finite element models: A road to in-silico modeling in the age of personalized dentistry. J Dent. 2024;150:105348.","journal-title":"J Dent"},{"issue":"1","key":"8588_CR16","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s40510-024-00546-y","volume":"25","author":"H Gao","year":"2024","unstructured":"Gao H, Luo L, Liu J. Three-dimensional finite element analysis of maxillary molar distalization treated with clear aligners combined with different traction methods. Prog Orthod. 2024;25(1):47.","journal-title":"Prog Orthod"},{"key":"8588_CR17","doi-asserted-by":"publisher","first-page":"105748","DOI":"10.1016\/j.cmpb.2020.105748","volume":"197","author":"P Harikrishnan","year":"2020","unstructured":"Harikrishnan P, Magesh V, Ajayan AM, JebaSingh DK. Finite element analysis of torque induced orthodontic bracket slot deformation in various bracket-archwire contact assembly. Comput Methods Programs Biomed. 2020;197:105748.","journal-title":"Comput Methods Programs Biomed"},{"issue":"1","key":"8588_CR18","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1186\/s12903-024-05274-7","volume":"24","author":"T Nakornnoi","year":"2024","unstructured":"Nakornnoi T, Srirodjanakul W, Chintavalakorn R, Santiwong P, Sipiyaruk K. The biomechanical effects of clear aligner trimline designs and extensions on orthodontic tooth movement: a systematic review. BMC Oral Health. 2024;24(1):1523.","journal-title":"BMC Oral Health"},{"key":"8588_CR19","doi-asserted-by":"crossref","unstructured":"Li J, Yang Y, Tang Z, Fan Q, Ghaleb OM, He X, Lai W, Long H. Biomechanical analysis of the effect of Class II traction configurations and aligner overtreatment on molar distalization: a finite-element study. Eur J Orthod 2024, 46(6).","DOI":"10.21203\/rs.3.rs-4146638\/v1"},{"issue":"5","key":"8588_CR20","first-page":"589","volume":"40","author":"Z Shi","year":"2022","unstructured":"Shi Z, Xia K, Luo L, Zhao Z, Liu J. Three-dimensional finite element analysis of upper anterior teeth retraction and intrusion using clear aligners and mini-implants. Hua Xi Kou Qiang Yi Xue Za Zhi. 2022;40(5):589\u201396.","journal-title":"Hua Xi Kou Qiang Yi Xue Za Zhi"},{"issue":"1","key":"8588_CR21","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1186\/s12903-025-06295-6","volume":"25","author":"H Cao","year":"2025","unstructured":"Cao H, Hua X, Yang L, Aoki K, Shang S, Lin D. A systematic review of biomechanics of clear aligners by finite element analysis. BMC Oral Health. 2025;25(1):1026.","journal-title":"BMC Oral Health"},{"key":"8588_CR22","doi-asserted-by":"publisher","first-page":"1388876","DOI":"10.3389\/fbioe.2024.1388876","volume":"12","author":"Y Zhang","year":"2024","unstructured":"Zhang Y, Wang K, Li M, Liu C, Tang L, Wan C, Fan C, Liu Y. Effects of different intrusion patterns during anterior teeth retraction using clear aligners in extraction cases: an iterative finite element analysis. Front Bioeng Biotechnol. 2024;12:1388876.","journal-title":"Front Bioeng Biotechnol"},{"issue":"1","key":"8588_CR23","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s40510-023-00468-1","volume":"24","author":"B Mao","year":"2023","unstructured":"Mao B, Tian Y, Xiao Y, Li J, Zhou Y. The effect of maxillary molar distalization with clear aligner: a 4D finite-element study with staging simulation. Prog Orthod. 2023;24(1):16.","journal-title":"Prog Orthod"},{"issue":"6","key":"8588_CR24","doi-asserted-by":"publisher","first-page":"487","DOI":"10.4041\/kjod25.155","volume":"55","author":"YK Choi","year":"2025","unstructured":"Choi YK, Baek SE, Kim K, Kim SH, Kim SS, Kim YI. Iterative finite element analysis of clear aligner-induced bodily canine movement under alveolar bone loss conditions. Korean J Orthod. 2025;55(6):487\u201394.","journal-title":"Korean J Orthod"},{"issue":"1","key":"8588_CR25","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s40510-022-00417-4","volume":"23","author":"Q Wang","year":"2022","unstructured":"Wang Q, Dai D, Wang J, Chen Y, Zhang C. Biomechanical analysis of effective mandibular en-masse retraction using Class II elastics with a clear aligner: a finite element study. Prog Orthod. 2022;23(1):23.","journal-title":"Prog Orthod"},{"key":"8588_CR26","doi-asserted-by":"crossref","unstructured":"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.","DOI":"10.1155\/2019\/1075097"},{"issue":"1","key":"8588_CR27","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s40510-023-00462-7","volume":"24","author":"X Lyu","year":"2023","unstructured":"Lyu X, Cao X, Chen L, Liu Y, Li H, Hu C, Tan J. Accumulated biomechanical effects of mandibular molar mesialization using clear aligners with auxiliary devices: an iterative finite element analysis. Prog Orthod. 2023;24(1):13.","journal-title":"Prog Orthod"},{"issue":"1","key":"8588_CR28","doi-asserted-by":"publisher","first-page":"26176","DOI":"10.1038\/s41598-024-77320-x","volume":"14","author":"S Lin","year":"2024","unstructured":"Lin S, Lu T, Zhang H, Wang W, Han L, Mei L, Li H. Effectiveness of palatal anchorage device (PAD) for maxillary anterior retraction with clear aligners using finite element study. Sci Rep. 2024;14(1):26176.","journal-title":"Sci Rep"},{"key":"8588_CR29","doi-asserted-by":"crossref","unstructured":"Antonarakis GS, Zekeridou A, Kiliaridis S, Giannopoulou C. Periodontal considerations during orthodontic intrusion and extrusion in healthy and reduced periodontium. Periodontol 2000 2024.","DOI":"10.1111\/prd.12578"},{"key":"8588_CR30","doi-asserted-by":"crossref","unstructured":"Moga RA, Olteanu CD, Botez M, Buru SM. Assessment of the Maximum Amount of Orthodontic Force for Dental Pulp and Apical Neuro-Vascular Bundle in Intact and Reduced Periodontium on Bicuspids (Part II). Int J Environ Res Public Health 2023, 20(2).","DOI":"10.3390\/ijerph20021179"},{"issue":"4","key":"8588_CR31","doi-asserted-by":"publisher","first-page":"383","DOI":"10.2319\/110723-743.1","volume":"94","author":"F Liu","year":"2024","unstructured":"Liu F, Liu J, Guo M, Li Z, Shu G, Dai F. Miniscrew anchorage versus Class II elastics for maxillary arch distalization using clear aligners. Angle Orthod. 2024;94(4):383\u201391.","journal-title":"Angle Orthod"},{"issue":"1","key":"8588_CR32","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s40510-022-00435-2","volume":"23","author":"JQ Liu","year":"2022","unstructured":"Liu JQ, Zhu GY, Wang YG, Zhang B, Wang SC, Yao K, Zhao ZH. Different biomechanical effects of clear aligners in bimaxillary space closure under two strong anchorages: finite element analysis. Prog Orthod. 2022;23(1):41.","journal-title":"Prog Orthod"},{"issue":"2","key":"8588_CR33","doi-asserted-by":"publisher","first-page":"101401","DOI":"10.1016\/j.jebdp.2020.101401","volume":"20","author":"Y Liu","year":"2020","unstructured":"Liu Y, Yang ZJ, Zhou J, Xiong P, Wang Q, Yang Y, Hu Y, Hu JT. Comparison of Anchorage Efficiency of Orthodontic Mini-implant and Conventional Anchorage Reinforcement in Patients Requiring Maximum Orthodontic Anchorage: A Systematic Review and Meta-analysis. J Evid Based Dent Pract. 2020;20(2):101401.","journal-title":"J Evid Based Dent Pract"},{"issue":"1","key":"8588_CR34","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1093\/ejo\/18.1.27","volume":"18","author":"K Fushima","year":"1996","unstructured":"Fushima K, Kitamura Y, Mita H, Sato S, Suzuki Y, Kim YH. Significance of the cant of the posterior occlusal plane in class II division 1 malocclusions. Eur J Orthod. 1996;18(1):27\u201340.","journal-title":"Eur J Orthod"},{"issue":"3","key":"8588_CR35","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1111\/ocr.12616","volume":"26","author":"Y Zhu","year":"2023","unstructured":"Zhu Y, Xiong X, Yang W, Wu Y, Liu J, Ye C, Zhang Q, Han SLR, Wang J. Effect of orthodontic treatment with premolar extractions on occlusal planes: A retrospective study. Orthod Craniofac Res. 2023;26(3):356\u201363.","journal-title":"Orthod Craniofac Res"},{"issue":"5","key":"8588_CR36","doi-asserted-by":"publisher","first-page":"679","DOI":"10.2319\/090418-646.1","volume":"89","author":"FF Dai","year":"2019","unstructured":"Dai FF, Xu TM, Shu G. Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: First premolar extraction treatment with Invisalign. Angle Orthod. 2019;89(5):679\u201387.","journal-title":"Angle Orthod"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-026-08588-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08588-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08588-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:19:10Z","timestamp":1784067550000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12903-026-08588-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,14]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8588"],"URL":"https:\/\/doi.org\/10.1186\/s12903-026-08588-w","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,14]]},"assertion":[{"value":"22 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Research Ethics Committee of Shenzhen Stomatology Hospital (LLWYH-PJ-20250820-002). Written informed consent was obtained from the participant. The ethics approval and the written informed consent included the permission of using the raw data of CBCT of the patient. The study was conducted in accordance with the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1264"}}