En-masse Retraction of the Maxillary Anterior Teeth by Applying Force from Four Different Levels - A Finite Element Study.

OBJECTIVE: To find out if it is possible to control maxillary anterior teeth in sagittal and vertical plane during retraction by altering the vertical levels of force application in the posterior region, i.e. identifying the type of movement of the maxillary anterior teeth which occurs when force would be applied from four different levels i.e. High, Medium, and Low pull Implants and from a conventional Molar hook and also to quantify the retraction and intrusion components of force thus setting a guideline for the implant height placement.

MATERIALS AND METHODS: A Finite Element Model of maxillary dentition along with alveolar bone, brackets and wire was developed with defined material properties. The model was analysed to calculate the displacement when force was applied from different levels.

RESULTS: From all points of force application, anterior teeth tipped lingually in the sagittal plane, whereas in the vertical plane extrusion was seen when retracted from molar hook and intrusion was seen when retracted from implants. For every mm of apical displacement of implant, the retraction component of force reduces approximately by around 1% and intrusion component of force increases approximately by around 0.3%.

CONCLUSION: Based on the results of this study we can reckon that by changing the position of implant in vertical plane one will have very little effect on the type of tooth movement. As the point of force application moves apically, type of tooth movement in the sagittal plane remained almost constant and in vertical plane intrusion is slightly increased.