A finite element analysis of the maxillary first molar PDL with maxillary protraction in a mixed dentition Class III malocclusion.

Objectives: To analyze the stress distribution on the PDL of the maxillary first molar in a mixed dentition Class III malocclusion, using a Hyrax-type appliance and maxillary protraction.
Setting and Sample Population: A Class III malocclusion in the mixed dentition was reconstructed based on CBCT images.
Material and Methods: The 3D FEM comprised the maxilla, alveolar bone, right first permanent molar teeth, and PDL and consisted of 1 133 497 nodes and 573 726 elements. Maxillary protraction force was applied to a hook positioned close to the deciduous canines with 600 g and at 15°, 30°, and 45° downward angles to the maxillary occlusal plane.
Results: Analysis was carried out from the top and buccal view of the sagittal plane. The magnitude of the stresses at 15°, 30°, and 45° of protraction angulation resulted in the highest stress magnitude being in the region between the distobuccal and palatal roots, as well as on the distal surface of the mesial root. The vector direction in this area showed traction and mesial movement. With 30° and 45° protraction angulations, the stress was located only between the distobuccal and palatal roots, and the vector direction was more extrusive at 15°.
Conclusions: The suggested orthodontic movement is in the mesial direction with a small amount of extrusion with 15° angulation and greater extrusion with 30° and 45°.
(© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)