Biomechanical analysis for total distalization of the maxillary dentition: A finite element study

•We studied maxillary tooth movement at various force angulations (FAs) during distalization. •Maxillary incisors and molars showed lingual and distal tipping at all FAs, respectively. •The occlusal plane rotated clockwise at all FAs. •Medial displacement of the maxillary anterior teeth occurred because of lingual tipping. Introduction This study aimed to identify the tooth movement patterns relative to various force angulations (FAs) when distalizing the total maxillary dentition. Methods Long-term orthodontic movement of the maxillary dentition was simulated by accumulating the initial displacement of teeth produced by elastic deflection of the periodontal ligament using a finite element analysis. Distalization forces of 3 N were applied to the archwire between the maxillary canine and first premolar at 5 different FAs (−30°, −15°, 0°, 15°, and 30°) to the occlusal plane. Results Maxillary incisors and molars showed lingual and distal tipping at all FAs, respectively. At a force angulation of 30°, almost bodily distalization of the total maxillary dentition occurred, but incisors showed considerable lingual tipping because of the effect of clearance gap (0.003-in, 0.022 × 0.025-in bracket slot, 0.019 × 0.025-in archwire) and elastic deflection of the archwire. Medial displacement of the maxillary anterior teeth occurred because of lingual tipping during distalization. The occlusal plane rotated clockwise at all FAs because of extrusion of the maxillary incisors and intrusion of the maxillary second molars, and the amounts decreased as FA increased. Conclusions Tooth movement patterns during distalization of the total maxillary dentition were recognized. With an understanding of the mechanics, a proper treatment plan can be established.