Numerical Simulation of Maxillary Anterior Teeth Retraction Utilizing Power Arms in Lingual Orthodontic Technique

Aims: It was the scope of this study to explore the biomechanical implications of retraction force application point modifications in lingual orthodontics, aiming to mitigate the bowing effect and enhance anchorage stability in the anterior teeth. Methods: Using the FE method on an idealized maxillary model, en masse retraction was simulated using a modified lingual fixed appliance including edgewise lingual brackets, a 0.017″ × 0.025″ mushroom-shaped archwire, and power arms between lateral incisors and canines, with a transpalatal arch (TPA) connecting the first molars. Applying bilateral retraction forces of 1.5 N at twelve positions, initial tooth displacements during space closure were evaluated. Results: Shifting power arms gingivally did not effectively counteract palatal tipping of incisors but reduced posterior and palatal tipping of canines with a power arm length of 11.3 mm preventing posterior tipping. Apically displacing the TPA retraction force increased mesiobuccal rotation while preventing mesial molar tipping for retraction forces applied 12.6 mm from the archwire. Conclusions: Apically shifting retraction forces can mitigate vertical bowing effects in lingual orthodontics, yet it also highlights the challenges in maintaining torque in the anterior teeth. Further research and clinical validation are essential in order to confirm these results, emphasizing the complexity and need for advanced biomechanical strategies in personalized lingual orthodontic treatments.