Optimized Attachment to Achieve Different Buccolingual Movement of Maxillary Molars in Clear Aligner Orthodontic System: Biomechanical Analysis

The different positions and angles of attachment affecting the buccolingual movement of the maxillary molars, especially lingual tipping and negative torque movements, were biomechanically analyzed in order to determine how to better control and prevent unwanted movement of clear aligners. The aligner can be designed and placed appropriately to improve expected tooth movement. Based on mechanical principles, the force system of attachment was analyzed, and the optimum attachment position and angle for tipping and negative torque movement was determined. Attachment close to the enamel-cementum junction (ECJ) was found to achieve the best F (M/L) during negative torque movement; however, the angle should also be adjusted. Attachment close to the occlusal surface achieved greater tipping force at specific angles. When more tipping movement is required, it is recommended to place the attachment 3–5 mm from the ECJ. The angle of the attachment should be 110–120 degrees from the tooth surface. When place the attachment 4–5 mm from the ECJ, the angle of the attachment should be between 145 and 146.5 degrees.