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Objective <p>This study evaluated changes in the mesiodistal angulation of the maxillary lateral incisors during extraction with clear aligners using panoramic images reconstructed from cone-beam computed tomography (CBCT) images and identified the main influencing factors for reducing the distal inclination of the maxillary lateral incisors during extraction.</p> Methods <p>This study analyzed 27 patients (mean age 21.1 ± 4.9&#xa0;years; 18 women, 9 men) who underwent extraction with clear aligners. In total, 54 maxillary lateral incisors were included—each patient contributed two teeth. CBCT scans were obtained at pretreatment and refinement. The projection of the midpalatal suture on the panoramic image helped measure the axial angulation of the maxillary lateral incisors. Three-dimensional reconstruction was performed using Mimics, and the maxillary structure superimpose method was employed to measure the horizontal distance of the maxillary lateral incisors. Influencing factors, including lateral incisor attachment, lateral incisor horizontal movement distance, upper dentition retraction method, and lateral incisor crown-to-root ratio, were analyzed. <i>P</i> &lt; 0.05 was considered statistically significant.</p> Results <p>Maxillary lateral incisors are prone to distal inclination during orthodontic extraction using a clear aligner (<i>P</i> &lt; 0.001). Notably, the angulation of maxillary lateral incisors significantly decreased in both groups, with larger decreases in the nonattachment groups (<i>P</i> &lt; 0.001). Significant differences were observed between different retraction methods (<i>P</i> &lt; 0.05) and horizontal movement distances of the lateral incisors (<i>P</i> &lt; 0.001), but none among the different crown-to-root ratios (<i>P</i> &gt; 0.05).</p> Conclusions <p>During extraction by clear aligner, changes in the mesiodistal angulation of the maxillary lateral incisor should be considered to ensure satisfactory treatment outcomes. By adding attachments and designing the canine first retraction method, the distal inclination of the lateral incisors can be reduced.</p>

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Mesiodistal angulation change of the maxillary lateral incisor in the extraction treatment by clear aligner- a retrospective cone-beam computed tomography study

  • 期刊论文

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  • 发表日期：

    2025年7月2日

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  • Mengdie Yan,
  • Longwen He,
  • Wenzhong Zhang,
  • Yueqiang Xie

摘要

Objective

This study evaluated changes in the mesiodistal angulation of the maxillary lateral incisors during extraction with clear aligners using panoramic images reconstructed from cone-beam computed tomography (CBCT) images and identified the main influencing factors for reducing the distal inclination of the maxillary lateral incisors during extraction.

Methods

This study analyzed 27 patients (mean age 21.1 ± 4.9 years; 18 women, 9 men) who underwent extraction with clear aligners. In total, 54 maxillary lateral incisors were included—each patient contributed two teeth. CBCT scans were obtained at pretreatment and refinement. The projection of the midpalatal suture on the panoramic image helped measure the axial angulation of the maxillary lateral incisors. Three-dimensional reconstruction was performed using Mimics, and the maxillary structure superimpose method was employed to measure the horizontal distance of the maxillary lateral incisors. Influencing factors, including lateral incisor attachment, lateral incisor horizontal movement distance, upper dentition retraction method, and lateral incisor crown-to-root ratio, were analyzed. P < 0.05 was considered statistically significant.

Results

Maxillary lateral incisors are prone to distal inclination during orthodontic extraction using a clear aligner (P < 0.001). Notably, the angulation of maxillary lateral incisors significantly decreased in both groups, with larger decreases in the nonattachment groups (P < 0.001). Significant differences were observed between different retraction methods (P < 0.05) and horizontal movement distances of the lateral incisors (P < 0.001), but none among the different crown-to-root ratios (P > 0.05).

Conclusions

During extraction by clear aligner, changes in the mesiodistal angulation of the maxillary lateral incisor should be considered to ensure satisfactory treatment outcomes. By adding attachments and designing the canine first retraction method, the distal inclination of the lateral incisors can be reduced.