Evaluating anchorage loss in upper incisors during distalization of maxillary posterior teeth using clear aligners in adult patients: A prospective randomized study


Korean Journal of Orthodontics, vol.54, no.2, pp.117-127, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 54 Issue: 2
  • Publication Date: 2024
  • Doi Number: 10.4041/kjod23.150
  • Journal Name: Korean Journal of Orthodontics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.117-127
  • Keywords: Anchorage, Clear aligner, Distalization
  • Karadeniz Technical University Affiliated: Yes


Objective: To evaluate the effect of clear aligner treatment and differential sequence distalization of maxillary posterior teeth on anchorage loss in the upper incisors (U1s). Methods: This study used lateral cephalometries and digital models of 12 patients treated with 33% sequential distalization (group 1, mean age: 22.9 ± 0.7 years, five males, seven females) and 12 treated with 50% sequential distalization (group 2, mean age: 25.83 ± 0.5 years, three males, nine females) acquired before and after distalization of upper second premolars (U5) and upper first molars (U6) and upper second molars (U7). The amount of distalization was determined as 2.5 mm in both the groups. Independent Samples t test was used to compare normally distributed parameters. Mann– Whitney U and Wilcoxon tests were used to compare parameters that were not normally distributed. Results: In both groups, the posterior teeth significantly moved by tipping distally and the U1s were displaced anteriorly. Increase in maxillary posterior transverse width (P < 0.001) and distopalatal rotation were observed in U5, U6, and U7 after distalization. It was also observed that U1 was significantly more proclined (1.82°; P < 0.001) and protruded (0.62 mm; P < 0.001), and the overjet (0.45 mm; P < 0.001) increased more in group 1 than in group 2. Conclusions: After sequential distalization of maxillary posterior teeth, more anchorage loss was observed in the anterior region in group 1 than in group 2.