Effect of power arm length combined with additional anterior torque on the axial orientation of the maxillary incisors during en-masse retraction: A finite element analysis

This study aimed to clarify the effect of power arm length combined with additional torque incorporated into the archwire on the controlled movement of the anterior teeth using the finite element method.An adult patient requiring medium anchorage after extraction of the maxillary first premolars was selected for this study. The power arms were placed between the lateral incisor and the canine at 3 levels: 3 mm, 6 mm, and 9 mm. A 150 g of retraction force was applied from each height of the anterior hook to the first molar tube, with 0°, 5°, and 10° of applied lingual root torque on the incisors.A 3-mm hook with 10° of applied torque, a 6-mm hook with 5° of applied torque, or a 9-mm hook with no extra torque constituted the best combinations targeted at controlling the inclination of incisors during retraction. Extrusion and distal tipping of the canine were observed. Moreover, mesial tipping and mesiopalatal rotation of the molar were unavoidable. Finally, intercanine and intermolar widths were decreased.Adding extra torque on the incisors or using high torque brackets is recommended for patients with maxillary first premolar extraction.