Academic Journal
The 'Roller Coaster Effect' in Clear Aligner Premolar Extraction Cases: Posterior Open Bite and Cephalometric Risk Factors.
| Τίτλος: | The 'Roller Coaster Effect' in Clear Aligner Premolar Extraction Cases: Posterior Open Bite and Cephalometric Risk Factors. |
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| Συγγραφείς: | Zhuo Y; Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, China., Guo F; Department of Orthodontics, Stomatological Hospital Affiliated Suzhou Vocational Health College, Suzhou, China., Huang S; Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, China., Lei L; Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, China. |
| Πηγή: | Orthodontics & craniofacial research [Orthod Craniofac Res] 2026 Oct; Vol. 29 (5), pp. 899-908. Date of Electronic Publication: 2026 May 09. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Blackwell Munksgaard Country of Publication: England NLM ID: 101144387 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1601-6343 (Electronic) Linking ISSN: 16016335 NLM ISO Abbreviation: Orthod Craniofac Res Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford, UK : Blackwell Munksgaard, c2002- |
| Ιατρικοί όροι (MeSH): | Bicuspid*/surgery , Open Bite*/etiology , Tooth Movement Techniques*/instrumentation , Cephalometry* , Tooth Extraction* , Orthodontic Appliances, Removable*, Molar/pathology ; Malocclusion/therapy ; Humans ; Female ; Retrospective Studies ; Risk Factors ; Male ; Adolescent ; Child |
| Περίληψη: | Objectives: This study aimed to investigate the occurrence of the roller coaster effect (RCE) in premolar extraction cases treated with clear aligner therapy (CAT), and to identify cephalometric risk factors. Materials and Methods: Sixty five patients treated with CAT after four first premolar extractions were retrospectively analysed, including 34 with mild crowding (Mi) and 31 with moderate-severe crowding (Mo-Se). Posterior functional cusp distances (FCDs) were measured at the second premolar, mandibular first molar mesiobuccal (MB) and distobuccal (DB) cusps, and second molar on pre- and post-treatment digital models using a standardised 3D coordinate system. Results: As mesial molar movement was minimal in this cohort, post-treatment FCDs increased significantly in the Mi group at all posterior sites, with the greatest changes at the first molars (MB: 1.64 ± 1.39 mm; DB: 1.48 ± 1.55 mm; both p < 0.001), while the Mo-Se group showed an increase only at the first molar MB cusp (p < 0.001). Comparisons indicated greater FCDs increases in the Mi group than in the Mo-Se group (all p < 0.05). Correlation analysis revealed positive associations between greater upper incisor proclination (U1-NA, U1-SN) and posterior FCDs increases. The regression analysis further identified a smaller ANB angle as an independent risk factor for RCE. Conclusions: Posterior FCDs served as a simple and clinically applicable indicator of RCE, most pronounced at the first molars and in mild crowding cases. Smaller ANB angles and increased maxillary incisor proclination were associated with higher RCE susceptibility, emphasising prudent case selection in extraction-based clear aligner therapy. (© 2026 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.) |
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| Grant Information: | 0224C015 High-Level Hospital Construction Project of Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University; 82371007 National Natural Science Foundation of China |
| Contributed Indexing: | Keywords: clear aligner therapy; functional cusp distance; premolar extraction; roller coaster effect |
| Entry Date(s): | Date Created: 20260509 Date Completed: 20260904 Latest Revision: 20260906 |
| Update Code: | 20260906 |
| PubMed Central ID: | PMC13543194 |
| DOI: | 10.1111/ocr.70136 |
| PMID: | 42104855 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1601-6343 |
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| DOI: | 10.1111/ocr.70136 |