En masse maxillary dentition distalization with clear aligners using infrazygomatic mini-implants: A finite element study

Objective: Considering the success of infrazygomatic mini-implants in conjunction with traditional braces, this study aimed to evaluate the efficacy of infrazygomatic mini-implants in en masse maxillary distalization utilizing clear aligner therapy. Methods: In a three-dimensional finite element study, we evaluated the en masse maxillary dental distalization through the use of infrazygomatic mini-implants equipped with varying force-application arm lengths (0 mm, 4 mm, and 8 mm). Vertical, sagittal, and horizontal displacements were quantified. Results: Intrusion was observed in the incisors at all force application arm lengths (0 mm, 4 mm, and 8 mm), with similar sagittal displacement tendencies and labial crown tipping. Among all maxillary teeth, only the canine exhibited distalization of both the crown and root. Distalization of the posterior teeth was achieved, with the greatest magnitude of distalization occurring at the 0-mm force application arm length, which was characterized by minimal tipping and reduced vertical movements compared to the other force application arm lengths. Conclusions: The findings indicate that infrazygomatic mini-implants represent a viable approach for facilitating targeted tooth movement in clear aligners across various force-application arm lengths. These results may inform orthodontic treatment strategies in non-extraction cases.