{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:02:34Z","timestamp":1790845354297,"version":"4.1.0"},"reference-count":38,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"st1\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To analyze the biomechanical system of anterior retraction with clear aligner therapy (CAT) with and without an anterior mini-screw and elastics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Models including a maxillary dentition (without first premolars), maxilla, periodontal ligaments (PDLs), attachments, and aligners were constructed and imported to finite element software. Three model groups were created: (1) control (CAT alone), (2) labial elastics (CAT with elastics between the anterior mini-screw and buttons on central incisors), and (3) linguoincisal elastics (CAT with elastics between the anterior mini-screw and precision cuts on the lingual sides of the aligner). Elastic forces (0\u2013300 g, in 50 g increments) were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CAT alone caused lingual tipping and extrusion of the incisors. Labial elastics caused palatal root torquing and intrusion and mesial tipping of the central incisors, while linguoincisal elastics produced palatal root torquing and intrusion of both central and lateral incisors. Second premolars were intruded in all three groups, with less intrusion in the linguoincisal elastics group. For the control group, stress was concentrated on both labial and lingual root surfaces, alveolar ridge, and cervical and apical PDLs. Stress was more concentrated in the labial elastics group and less concentrated in the linguoincisal elastics group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CAT produced lingual tipping and extrusion of incisors during anterior retraction. Anterior mini-screws and elastics can achieve incisor intrusion and palatal root torquing. Linguoincisal elastics are superior to labial elastics with a lower likelihood of buccal open bite. Root resorption and alveolar defects may occur in CAT, more likely for labial elastics and less likely for linguoincisal elastics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/120420-982.1","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T16:11:19Z","timestamp":1622563879000},"page":"794-803","source":"Crossref","is-referenced-by-count":85,"title":["Effectiveness of an anterior mini-screw in achieving incisor intrusion and palatal root torque for anterior retraction with clear aligners:"],"prefix":"10.2319","volume":"91","author":[{"given":"Lu","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianyun","family":"Kuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-91-6-794-b01","series-title":"Angle Orthod","first-page":"454","article-title":"Initial force systems during bodily tooth movement with plastic aligners and composite attachments: a three-dimensional finite element analysis","volume":"85","author":"Pablo Gomez","year":"2015","unstructured":"Pablo Gomez\n              J,\n            \n            \n              Marcelo Pena\n              F,\n            \n            \n              Martinez\n              V,\n            \n            \n              Giraldo\n              DC,\n            \n            \n              Ivan Cardona\n              C.\n            \n          \n          Initial force systems during bodily tooth movement with plastic aligners and composite attachments: a three-dimensional finite element analysis.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2015;\n\t\t\t\t\t85:\n\t\t\t\t\t454\u2013\n\t\t\t\t\t460."},{"key":"i0003-3219-91-6-794-b02","series-title":"Eur J Orthod","first-page":"607","article-title":"Torquing an upper central incisor with aligners-acting forces and biomechanical principles","volume":"32","author":"Hahn","year":"2010","unstructured":"Hahn\n              W,\n            \n            \n              Zapf\n              A,\n            \n            \n              Dathe\n              H,\n            \n            et al.\n          \n          Torquing an upper central incisor with aligners-acting forces and biomechanical principles.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2010;\n\t\t\t\t\t32:\n\t\t\t\t\t607\u2013\n\t\t\t\t\t613."},{"key":"i0003-3219-91-6-794-b03","series-title":"Angle Orthod","first-page":"679","article-title":"Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign","volume":"89","author":"Dai","year":"2019","unstructured":"Dai\n              FF,\n            \n            \n              Xu\n              TM,\n            \n            \n              Shu\n              G.\n            \n          \n          Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2019;\n\t\t\t\t\t89:\n\t\t\t\t\t679\u2013\n\t\t\t\t\t687."},{"issue":"(3 suppl)","key":"i0003-3219-91-6-794-b04","series-title":"J Evid Based Dent Pract","first-page":"192","article-title":"Implant interactions with orthodontics","volume":"12","author":"Celenza","year":"2012","unstructured":"Celenza\n              F.\n            \n          \n          Implant interactions with orthodontics.\n\t\t\t\t\tJ Evid Based Dent Pract.\n\t\t\t\t\t2012;\n\t\t\t\t\t12(3 suppl):\n\t\t\t\t\t192\u2013\n\t\t\t\t\t201."},{"key":"i0003-3219-91-6-794-b05","series-title":"J Clin Orthod","first-page":"23","article-title":"Treatment of challenging malocclusions with Invisalign and miniscrew anchorage","volume":"48","author":"Lin","year":"2014","unstructured":"Lin\n              JC,\n            \n            \n              Tsai\n              SJ,\n            \n            \n              Liou\n              EJ,\n            \n            \n              Bowman\n              SJ.\n            \n          \n          Treatment of challenging malocclusions with Invisalign and miniscrew anchorage.\n\t\t\t\t\tJ Clin Orthod.\n\t\t\t\t\t2014;\n\t\t\t\t\t48:\n\t\t\t\t\t23\u2013\n\t\t\t\t\t36."},{"key":"i0003-3219-91-6-794-b06","series-title":"Int J Numer Method Biomed Eng","first-page":"e2839","article-title":"Computational design and engineering of polymeric orthodontic aligners","volume":"33","author":"Barone","year":"2017","unstructured":"Barone\n              S,\n            \n            \n              Paoli\n              A,\n            \n            \n              Razionale\n              AV,\n            \n            \n              Savignano\n              R.\n            \n          \n          Computational design and engineering of polymeric orthodontic aligners.\n\t\t\t\t\tInt J Numer Method Biomed Eng.\n\t\t\t\t\t2017;\n\t\t\t\t\t33:\n\t\t\t\t\te2839."},{"key":"i0003-3219-91-6-794-b07","series-title":"Angle Orthod","first-page":"247","article-title":"Clear aligner orthodontic therapy of rotated mandibular round-shaped teeth: a finite element study","volume":"90","author":"Cortona","year":"2020","unstructured":"Cortona\n              A,\n            \n            \n              Rossini\n              G,\n            \n            \n              Parrini\n              S,\n            \n            \n              Deregibus\n              A,\n            \n            \n              Castroflorio\n              T.\n            \n          \n          Clear aligner orthodontic therapy of rotated mandibular round-shaped teeth: a finite element study.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2020;\n\t\t\t\t\t90:\n\t\t\t\t\t247\u2013\n\t\t\t\t\t254."},{"key":"i0003-3219-91-6-794-b08","series-title":"Am J Orthod Dentofacial 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resistance","volume":"94","author":"Schmidt","year":"2019","unstructured":"Schmidt\n              F,\n            \n            \n              Lapatki\n              BG.\n            \n          \n          Effect of variable periodontal ligament thickness and its non-linear material properties on the location of a tooth's centre of resistance.\n\t\t\t\t\tJ Biomech.\n\t\t\t\t\t2019;\n\t\t\t\t\t94:\n\t\t\t\t\t211\u2013\n\t\t\t\t\t218."},{"key":"i0003-3219-91-6-794-b10","series-title":"Prog Orthod","first-page":"3","article-title":"A finite element analysis of the effects of archwire size on orthodontic tooth movement in extraction space closure with miniscrew sliding mechanics","volume":"20","author":"Kawamura","year":"2019","unstructured":"Kawamura\n              J,\n            \n            \n              Tamaya\n              N.\n            \n          \n          A finite element analysis of the effects of archwire size on orthodontic tooth movement in extraction space closure with miniscrew sliding mechanics.\n\t\t\t\t\tProg Orthod.\n\t\t\t\t\t2019;\n\t\t\t\t\t20:\n\t\t\t\t\t3."},{"key":"i0003-3219-91-6-794-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"316","article-title":"Torque control of the maxillary incisors in lingual and labial orthodontics: a 3-dimensional finite element analysis","volume":"135","author":"Liang","year":"2009","unstructured":"Liang\n              W,\n            \n            \n              Rong\n              Q,\n            \n            \n              Lin\n              J,\n            \n            \n              Xu\n              B.\n            \n          \n          Torque control of the maxillary incisors in lingual and labial orthodontics: a 3-dimensional finite element analysis.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2009;\n\t\t\t\t\t135:\n\t\t\t\t\t316\u2013\n\t\t\t\t\t322."},{"key":"i0003-3219-91-6-794-b12","series-title":"J Mech Behav Biomed 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   Parrini\n              S,\n            \n            \n              Castroflorio\n              T,\n            \n            \n              Deregibus\n              A,\n            \n            \n              Debernardi\n              CL.\n            \n          \n          Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2015;\n\t\t\t\t\t85:\n\t\t\t\t\t881\u2013\n\t\t\t\t\t889."},{"key":"i0003-3219-91-6-794-b14","series-title":"J Orthod","first-page":"29","article-title":"A validated finite element method study of orthodontic tooth movement in the human subject","volume":"28","author":"Jones","year":"2001","unstructured":"Jones\n              ML,\n            \n            \n              Hickman\n              J,\n            \n            \n              Middleton\n              J,\n            \n            \n              Knox\n              J,\n            \n            \n              Volp\n   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        \n            \n              Qi\n              R,\n            \n            \n              Liu\n              C.\n            \n          \n          Root resorption in orthodontic treatment with clear aligners: a systematic review and meta-analysis.\n\t\t\t\t\tOrthod Craniofac Res.\n\t\t\t\t\t2019;\n\t\t\t\t\t22:\n\t\t\t\t\t259\u2013\n\t\t\t\t\t269."},{"key":"i0003-3219-91-6-794-b18","series-title":"Turk J Orthod","first-page":"103","article-title":"Root resorption in orthodontics","volume":"29","author":"Dindaroglu","year":"2016","unstructured":"Dindaroglu\n              F,\n            \n            \n              Dogan\n              S.\n            \n          \n          Root resorption in orthodontics.\n\t\t\t\t\tTurk J Orthod.\n\t\t\t\t\t2016;\n\t\t\t\t\t29:\n\t\t\t\t\t103\u2013\n\t\t\t\t\t108."},{"key":"i0003-3219-91-6-794-b19","series-title":"Imaging Sci Dent","first-page":"147","article-title":"External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation","volume":"42","author":"Nanekrungsan","year":"2012","unstructured":"Nanekrungsan\n              K,\n            \n            \n              Patanaporn\n              V,\n            \n            \n              Janhom\n              A,\n            \n            \n              Korwanich\n              N.\n            \n          \n          External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation.\n\t\t\t\t\tImaging Sci Dent.\n\t\t\t\t\t2012;\n\t\t\t\t\t42:\n\t\t\t\t\t147\u2013\n\t\t\t\t\t154."},{"key":"i0003-3219-91-6-794-b01","series-title":"Angle Orthod","first-page":"454","article-title":"Initial force systems during bodily tooth movement with plastic aligners and composite attachments: a three-dimensional finite element analysis","volume":"85","author":"Pablo Gomez","year":"2015","unstructured":"Pablo Gomez\n              J,\n            \n            \n              Marcelo Pena\n              F,\n            \n            \n              Martinez\n              V,\n            \n            \n              Giraldo\n              DC,\n            \n            \n              Ivan Cardona\n              C.\n            \n          \n          Initial force systems during bodily tooth movement with plastic aligners and composite attachments: a three-dimensional finite element analysis.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2015;\n\t\t\t\t\t85:\n\t\t\t\t\t454\u2013\n\t\t\t\t\t460."},{"key":"i0003-3219-91-6-794-b02","series-title":"Eur J Orthod","first-page":"607","article-title":"Torquing an upper central incisor with aligners-acting forces and biomechanical principles","volume":"32","author":"Hahn","year":"2010","unstructured":"Hahn\n              W,\n            \n            \n              Zapf\n              A,\n            \n            \n              Dathe\n              H,\n            \n            et al.\n          \n          Torquing an upper central incisor with aligners-acting forces and biomechanical principles.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2010;\n\t\t\t\t\t32:\n\t\t\t\t\t607\u2013\n\t\t\t\t\t613."},{"key":"i0003-3219-91-6-794-b03","series-title":"Angle Orthod","first-page":"679","article-title":"Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign","volume":"89","author":"Dai","year":"2019","unstructured":"Dai\n              FF,\n            \n            \n              Xu\n              TM,\n            \n            \n              Shu\n              G.\n            \n          \n          Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2019;\n\t\t\t\t\t89:\n\t\t\t\t\t679\u2013\n\t\t\t\t\t687."},{"issue":"(3 suppl)","key":"i0003-3219-91-6-794-b04","series-title":"J Evid Based Dent Pract","first-page":"192","article-title":"Implant interactions with orthodontics","volume":"12","author":"Celenza","year":"2012","unstructured":"Celenza\n              F.\n            \n          \n          Implant interactions with orthodontics.\n\t\t\t\t\tJ Evid Based Dent Pract.\n\t\t\t\t\t2012;\n\t\t\t\t\t12(3 suppl):\n\t\t\t\t\t192\u2013\n\t\t\t\t\t201."},{"key":"i0003-3219-91-6-794-b05","series-title":"J Clin Orthod","first-page":"23","article-title":"Treatment of challenging malocclusions with Invisalign and miniscrew anchorage","volume":"48","author":"Lin","year":"2014","unstructured":"Lin\n              JC,\n            \n            \n              Tsai\n              SJ,\n            \n            \n              Liou\n              EJ,\n            \n            \n              Bowman\n              SJ.\n            \n          \n          Treatment of challenging malocclusions with Invisalign and miniscrew anchorage.\n\t\t\t\t\tJ Clin Orthod.\n\t\t\t\t\t2014;\n\t\t\t\t\t48:\n\t\t\t\t\t23\u2013\n\t\t\t\t\t36."},{"key":"i0003-3219-91-6-794-b06","series-title":"Int J Numer Method Biomed Eng","first-page":"e2839","article-title":"Computational design and engineering of polymeric orthodontic aligners","volume":"33","author":"Barone","year":"2017","unstructured":"Barone\n              S,\n            \n            \n              Paoli\n              A,\n            \n            \n              Razionale\n              AV,\n            \n            \n              Savignano\n              R.\n            \n          \n          Computational design and engineering of polymeric orthodontic aligners.\n\t\t\t\t\tInt J Numer Method Biomed Eng.\n\t\t\t\t\t2017;\n\t\t\t\t\t33:\n\t\t\t\t\te2839."},{"key":"i0003-3219-91-6-794-b07","series-title":"Angle Orthod","first-page":"247","article-title":"Clear aligner orthodontic therapy of rotated mandibular round-shaped teeth: a finite element study","volume":"90","author":"Cortona","year":"2020","unstructured":"Cortona\n              A,\n            \n            \n              Rossini\n              G,\n            \n            \n              Parrini\n              S,\n            \n            \n              Deregibus\n              A,\n            \n            \n              Castroflorio\n              T.\n            \n          \n          Clear aligner orthodontic therapy of rotated mandibular round-shaped teeth: a finite element study.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2020;\n\t\t\t\t\t90:\n\t\t\t\t\t247\u2013\n\t\t\t\t\t254."},{"key":"i0003-3219-91-6-794-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"e59","article-title":"Three-dimensional modeling and finite element analysis in treatment planning for orthodontic tooth movement","volume":"139","author":"Ammar","year":"2011","unstructured":"Ammar\n              HH,\n            \n            \n              Ngan\n              P,\n            \n            \n              Crout\n              RJ,\n            \n            \n              Mucino\n              VH,\n            \n            \n              Mukdadi\n              OM.\n            \n          \n          Three-dimensional modeling and finite element analysis in treatment planning for orthodontic tooth movement.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2011;\n\t\t\t\t\t139:\n\t\t\t\t\te59\u2013\n\t\t\t\t\te71."},{"key":"i0003-3219-91-6-794-b09","series-title":"J Biomech","first-page":"211","article-title":"Effect of variable periodontal ligament thickness and its non-linear material properties on the location of a tooth's centre of resistance","volume":"94","author":"Schmidt","year":"2019","unstructured":"Schmidt\n              F,\n            \n            \n              Lapatki\n              BG.\n            \n          \n          Effect of variable periodontal ligament thickness and its non-linear material properties on the location of a 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