Dynamic biomechanical changes of clear aligners during extraction space closure: Finite element analysis.

INTRODUCTION: Clear aligners (CAs) have recently become popular and widely used orthodontic appliances. Research on CA biomechanics has become a focal point in orthodontics to improve the efficiency of CA treatment and address challenging issues, such as extraction. The biomechanical characteristics of CAs in space closure have been reported. However, previous studies have mainly focused on static biomechanical analysis that cannot demonstrate the dynamic biomechanical changes in CAs during space-closing. Given that these biomechanical changes can be significant and have considerable clinical value, this study aimed to investigate these characteristics. METHODS: Sequential extraction space-closing models were derived from included patient data and refined using modeling and CA design software. A finite element analysis was performed to obtain biomechanical raw data. This study introduced a dual coordinate system and space geometry analysis to demonstrate the biomechanical properties accurately. RESULTS: As space closure progressed, the instantaneous tooth displacements increased, indicating an enhanced space closure force because of the increased strain in the CA extraction area. Meanwhile, the central axis of rotation of the anterior teeth continuously moved toward the labial-apical direction, showing a gradually enhanced vertical and torque control effect. CONCLUSIONS: During space closure, CAs undergo specific biomechanical changes, including increased contraction and control forces on both sides of the gap. These biomechanical effects are beneficial to alleviate the roller coaster effect gradually. Meanwhile, more reasonable staging design strategies can be proposed on the basis of this biomechanical mechanism.

Different biomechanical effects of clear aligners in closing maxillary and mandibular extraction spaces: Finite element analysis.

INTRODUCTION: Compared with fixed treatments, clear aligners (CAs) have the advantages of comfort, esthetics, and hygiene, and are popular among patients and orthodontists. However, CAs exhibit control deficiencies in extraction patients because of insufficient root control and retention effects. These deficiencies can magnify biomechanical differences in bimaxillary dentition, further causing different orthodontic requirements between maxillary and mandibular dentition. This study aimed to elaborate on the biomechanical characteristics of bimaxillary dentition in extraction space closure and provided feasible biomechanical compensation strategies for use in clinical practice. METHODS: We constructed a 3-dimensional (3D) bimaxillary model based on patient data. Several 3D modeling-related software was used to generate a standard first premolar extraction model, CAs, and attachments. Subsequently, finite element analysis was performed to demonstrate the biomechanical effects. RESULTS: The maxillary and mandibular dentition showed a roller coaster effect during space closure. Compared with the maxillary dentition, the mandibular posterior teeth exhibited stronger relative anchorage causing greater anterior teeth retraction. The tipping and vertical movements of the anterior teeth were related to tooth length. The longer the anterior tooth, the less tipping and greater vertical displacement occurred. Generally, when having the same retraction distance, the mandibular dentition exhibited greater retroclination and fewer extrusions. Both mechanical and retention compensations should be considered to prevent these unwanted tipping movements. Adding specific attachments to bimaxillary dentitions compensated for the retention and root control deficiencies of CAs. CONCLUSIONS: When applying CAs to extraction patients, different biomechanical effects can present in the bimaxillary dentition because of specific dentition morphologies. To effectively treat these patients, mechanical compensation through overcorrection of the target position should be designed on the basis of bimaxillary control deficiencies, and retention compensation by adding specific attachments should also be considered according to the overcorrections.

Finite element analysis of the biomechanical effect of clear aligners in extraction space closure under different anchorage controls.

INTRODUCTION: Clear aligners (CAs) have attracted increasing attention from patients and orthodontists because of their excellent esthetics and comfort. However, treating tooth extraction patients with CAs is difficult because their biomechanical effects are more complicated than those of traditional appliances. This study aimed to analyze the biomechanical effect of CAs in extraction space closure under different anchorage controls, including moderate, direct strong, and indirect strong anchorage. It could provide several new cognitions for anchorage control with CAs through finite element analysis, further directing clinical practice. METHODS: A 3-dimensional maxillary model was generated by combining cone-beam computed tomography and intraoral scan data. Three-dimensional modeling software was used to construct a standard first premolar extraction model, temporary anchorage devices, and CAs. Subsequently, finite element analysis was performed to simulate space closure under different anchorage controls. RESULTS: Direct strong anchorage was beneficial for reducing the clockwise occlusal plane rotation, whereas indirect anchorage was conducive for anterior teeth inclination control. In the direct strong anchorage group, an increase in the retraction force would require more specific anterior teeth overcorrection to resist the tipping movement, mainly including lingual root control of the central incisor, followed by distal root control of the canine, lingual root control of the lateral incisor, distal root control of the lateral incisor, and distal root control of the central incisor. However, the retraction force could not eliminate the mesial movement of the posterior teeth, possibly causing a reciprocating motion during treatment. In indirect strong groups, when the button was close to the center of the crown, the second premolar presented less mesial and buccal tipping but more intrusion. CONCLUSIONS: The 3 anchorage groups showed significantly different biomechanical effects in both the anterior and posterior teeth. Specific overcorrection or compensation forces should be considered when using different anchorage types. The moderate and indirect strong anchorages have a more stable and single-force system and could be reliable models in investigating the precise control of future tooth extraction patients.

Effect of intervention using a messaging app on compliance and duration of treatment in orthodontic patients.

OBJECTIVES: This study aims to determine the effectiveness of a messaging app (WeChat) in improving patients' compliance and reducing the duration of orthodontic treatment (DOT). MATERIALS AND METHODS: A randomized controlled trial was performed in a dental hospital and a clinic from August 2012 to May 2015. Orthodontic patients were included at the beginning of treatment. Patients with multiphase treatment or braceless technique were excluded. Participants were randomized to WeChat group (received regular reminders and educational messages) or control group (received conventional management) and were followed up until the treatment was completed. Primary outcome measure was DOT. Others were late and failed attendance, bracket bond failure, and oral hygiene condition. RESULTS: One hundred twelve patients in each group participated and completed the trial. DOT in WeChat group were 7.3 weeks shorter (P = 0.007). There were less failed attendance (3.1 vs. 10.9 %, P < 0.001), late attendance (20.1 vs. 29.9 %, P < 0.001), and bracket bond failure (11.8 vs. 16.1 %, P < 0.001) in WeChat group than control. There was no difference in orthodontic plaque index nor modified gingivitis index between the two groups before and after treatment. Number of failed attendances was identified as an independent factor affecting DOT (P = 0.004; HR = 0.89, 95 % CI 0.84 to 0.95). CONCLUSIONS: The intervention with WeChat is effective in reducing the treatment duration and bracket bond failure, and improving the attendance in orthodontic patients. CLINICAL RELEVANCE: DOT can be reduced by improving patient's compliance. The messaging app is useful for outpatient education and management.

Validation of the American Board of Orthodontics Objective Grading System for assessing the treatment outcomes of Chinese patients.

INTRODUCTION: Orthodontics in China has developed rapidly, but there is no standard index of treatment outcomes. We assessed the validity of the American Board of Orthodontics Objective Grading System (ABO-OGS) for the classification of treatment outcomes in Chinese patients. METHODS: We randomly selected 108 patients who completed treatment between July 2005 and September 2008 in 6 orthodontic treatment centers across China. Sixty-nine experienced Chinese orthodontists made subjective assessments of the end-of-treatment casts for each patient. Three examiners then used the ABO-OGS to measure the casts. Pearson correlation analysis and receiver operating characteristic curve analysis were conducted to evaluate the correspondence between the ABO-OGS cast measurements and the orthodontists' subjective assessments. RESULTS: The average subjective grading scores were highly correlated with the ABO-OGS scores (r = 0.7042). Four of the 7 study cast components of the ABO-OGS score-occlusal relationship, overjet, interproximal contact, and alignment-were statistically significantly correlated with the judges' subjective assessments. Together, these 4 accounted for 58% of the variability in the average subjective grading scores. The ABO-OGS cutoff score for cases that the judges deemed satisfactory was 16 points; the corresponding cutoff score for cases that the judges considered acceptable was 21 points. CONCLUSIONS: The ABO-OGS is a valid index for the assessment of treatment outcomes in Chinese patients. By comparing the objective scores on this modification of the ABO-OGS with the mean subjective assessment of a panel of highly qualified Chinese orthodontists, a cutoff point for satisfactory treatment outcome was defined as 16 points or fewer, with scores of 16 to 21 points denoting less than satisfactory but still acceptable treatment. Cases that scored greater than 21 points were considered unacceptable.

Different biomechanical effects of clear aligners in bimaxillary space closure under two strong anchorages: finite element analysis.

BACKGROUND: Clear aligner (CA) treatment has been gaining popularity, but the biomechanical effects of CAs in bimaxillary dentition have not been thoroughly investigated. Direct and indirect strong anchorages are two common anchorage control methods, but the underlying biomechanical mechanism has not yet been elucidated. This study aimed to investigate the different biomechanical effects of CAs in closing the bimaxillary space under different anchorage controls, further instructing the compensation strategies design and strong anchorage choice in clinical practice. METHODS: Three-dimensional (3D) bimaxillary models of different anchorage controls were created based on cone-beam computed tomography and intraoral scan data. Four first premolars were extracted using 3D modeling software. Finite element analysis was conducted to simulate the space closure process of the CAs. RESULTS: In the two strong anchorage groups, the bimaxillary dentition presented different movement patterns during the space closure process, and the lower dentition was more vulnerable to elastic force. From the vertical view, direct strong anchorage with elastic force had the advantage of flattening the longitudinal occlusal curve and resisting the roller-coaster effects, whereas indirect strong anchorage could lead to a deep longitudinal occlusal curve. From the sagittal view, indirect strong anchorage with metallic ligaments had a greater instantaneous anchorage protection effect, particularly in the lower dentition, which reduced the mesial movement of the posterior teeth by nearly four times that of the direct anchorage group. In addition, indirect strong anchorage presented better anterior teeth torque/tipping control, while direct strong anchorage could aggravate lingual tipping of the upper central incisors. Due to the differences in anterior-posterior anchorage and arch shape, compared with the upper dentition, anchorage preservation and vertical control effects were amplified in the lower dentition. CONCLUSIONS: The biomechanical effects of CAs differed between the two strong anchorage groups. Due to the differences in dentition morphology, anterior-posterior anchorage, and dental arch shape, CAs present different biomechanical effects in bimaxillary space closure. Orthodontists should consider the corresponding mechanical compensation according to specific anchorage control methods and dentitions.

Orthodontic retreatment of an adult woman with mandibular backward positioning and temporomandibular joint disorder: A case report.

BACKGROUND: The role of occlusal factors on the occurrence of temporomandibular joint disorders (TMDs) is still unclear and it is tricky for orthodontists to treat malocclusions in patients with TMDs. We report the case of the second orthodontic treatment of an adult female with Class II division 2 malocclusion associated with TMD. With the removal of anterior occlusal interference, TMD symptoms were alleviated and cone beam computed tomography (CBCT) images showed the bilateral condyles shifted forward. CASE SUMMARY: This case report presented an orthodontic retreatment of an adult female with TMD and mandibular backward positioning based on CBCT examination and Joint Space Index (JSI) analysis. The left and right JSI values of -38.5 and -52.6 indicated that the position of bilateral condyles had posterior displacement. Ten years prior to this evaluation, she underwent orthodontic treatment resulting in the extraction of two upper premolars and one lower central incisor. The joint symptoms, including pain and sounds, were alleviated along with verified mandibular forward repositioning by extraction of another lower central incisor. CONCLUSION: Mandibular backward positioning could be associated with TMD. JSI analysis based on CBCT is a convenient way to examine condylar positions quantitatively.

[From fundamental research to clinical development: a review of orthodontics].

In recent years, new approaches to the diagnosis and treatment of malocclusion have emerged. The diagnostic and therapeutic techniques of orthodontics have evolved from two dimensions to five dimensions with the development of computer technology, auto-machining and imaging. Furthermore, interdisciplinary study has become the driving force for the advancement of fundamental research in orthodontics. The mechanisms of malocclusion and orthodontic tooth movement have been extensively studied to the details at the level of cells and molecules.

[Differences in maxillary growth vector of skeletal class I with various vertical growth types before and after growth spurts].

OBJECTIVE: To identify the differences in maxillary growth vector with different vertical skeletal patterns of skeletal class I before and after growth spurts. METHODS: One hundred and ninety four cases with different vertical skeletal patterns of skeletal class I were selected and categorized into six groups according to their vertical skeletal patterns and cervical vertebral stages: cervical vertebral maturation stage (CVMS)1,2-horizontal pattern (n=30); CVMS1,2-average pattern (n=32); CVMS1, 2-vertical pattern (n=33); CVMS5, 6-horizontal pattern (n=34); CVMS5, 6-average pattern (n=29); and CVMS5, 6-vertical pattern (n=36). Lateral cephalograms were taken on all of the cases. The angle SN-C axis (theta) and angel PP-C axis (alpha) were measured. RESULTS: (1) The skeletal class I with a vertical growth pattern had larger angle SN-C axis than those with a horizontal or average growth pattern before growth spurts (P(average-vertical) < 0.05, P(horizontal-vertical) < 0.001). (2) The skeletal class I with a vertical growth pattern had the largest angle SN-C axis after growth spurts, followed by those with an average growth pattern. Those with a horizontal growth pattern had the smallest angle SN-C axis. The differences were statistically significant (P(horizontal-average) < 0.05, P(horizontal-vertical) < 0.001, P(average-vertical) < 0.001). (3) The skeletal class I with the same vertical growth pattern had slightly larger angle SN-C axis after growth spurts than before growth spurts, but without statistical significance. (4) The skeletal class I had relatively stable angle PP-C axis and no significant differences were found before and after growth spurts or among those with various vertical skeletal facial types. CONCLUSION: The magnitude of angle SN-C axis is closely associated with vertical growth patterns and is weakly influenced by maxillofacial growth and development.

[Experts consensus on diagnostic and therapeutic strategies for malocclusions at early developing stage].

Early orthodontic intervention remains a controversial notion in current dental care regime. Whilst early orthodontic treatment for children is the province for orthodontic specialists, a growing number of general practitioners, who may not possess sufficient specialty knowledge, are also involved, raising the concerns about the propriety and quality of their treatment modalities. However, orofacial development of children and adolescents is in a very complicated environment. Comprehensive theoretical knowledge and a great wealth of practical experience are required to ensure the final treatment effect. The possible complications should be kept under control and fully informed to patients and their parents. In order to unify and standardize early orthodontic treatment protocol and help to promote healthy and orderly development of early orthodontic treatment, this consensus summarized the practical experience of orthodontic experts from many famous colleges and affiliated hospitals for clinical reference.

Research progress on two-component signal transduction systems in Porphyromonas gingivalis.

Porphyromonas gingivalis (P. gingivalis), a Gram-negative oral anaerobe, is considered to be a major pathogenic agent involved in the onset and progression of chronic periodontitis. P. gingivalis must be able to perceive and respond to the complicated changes in host to survive the environmental challenges, in which the two-component signal transduction systems (TCSs) play critical roles by connecting input signals to cellular physiological output. Canonical TCS consists of a sensor histidine kinase and a cognate response regulator that functions via a phosphorylation cascade. In this review, the roles of TCSs in P. gingivalis were demonstrated by illustrating the target genes and modulation modes, which may help elucidate the underlying mechanisms in future studies.

[Histological study of miniscrew implanted in lower mandibles of juvenile and adult Beagle dogs].

OBJECTIVE: To examine the histological discrepancies between juvenile and adult Beagle dogs at different concrescence times after miniscrew implants. METHODS: Miniscrew implants were performed in six juvenile Beagle dogs and six adult Beagle dogs. The space between the fourth premolar root and first molar root, and the spaces in distal and mesial of M1 root were picked up for the implants of the 48 miniscrews. The lower jaw specimens including the miniscrews were harvested 3 and 12 weeks after the implants for the histological examinations and bone implant contact (BIC) calculations. RESULTS: There was no miniscrew falling off or becoming loose. The miniscrews had favorable biological consistencies with the tissues around them. The osteoblasts and osteoclasts showed active functions in the peri-bones of the minisrews. The BIC became higher when the healing time was prolonged. The juvenile Beagle dogs had lower BIC than the adults 3 weeks after the implants. But the BIC of the juvenile dogs surpassed the adults 12 weeks after the implants. CONCLUSION: The osseointegration of the miniscrews is hindered by the poorer bone quality of the juvenile Beagle dogs. But the early osseointegration deficiency can be made up by the rapid development and growth of the bones of the juvenile dogs.

[Adjunctive interventions to accelerate orthodontic tooth movement].

Orthodontic treatment is a time-consuming process whose duration usually takes 2-3 years. In general, long-term treatment duration possesses higher risks of complications, which may have adverse impact on patients. Therefore, exploring safe and effective adjunctive interventions to accelerate orthodontic tooth movement and shortening the treatment duration are of profound clinical significance. Currently, numerous adjunctive interventions have been generated and developed to accelerate orthodontic tooth movement, which can be divided into two main categories: surgical and non-surgical. However, an intervention that is widely accepted as a routine practice in orthodontic clinic is lacking. This article aims to review com-mon adjunctive interventions used to accelerate orthodontic tooth movement. This review can be used as a basis to guide clinical practice, shorten treatment duration, and improve patients' prognosis.

[Research progress on the relationship between centric relation and orthodontic treatment].

Centric relation (CR) is one of the core research contents in orthodontics, prosthodontics, and gnathology, acting as an important physiological factor in reconstructing the occlusion and adjusting the occlusal relationship. For over a century, CR is still a controversial subject in dentistry. CR has been redefined for several times, and recently, its application has been widened in orthodontics, including orthodontic diagnosis, clinical examination and analysis, and treatment goals. The purpose of this article is to review the definition of CR, its relationship with malocclusion, and the application of this relationship in orthodontic treatment.

[A comparison of methods for predicting the dentition space for Chinese population].

OBJECTIVE: The aim of the study was to find the most reliable method used for space analysis for Chinese population. METHODS: 140 study models in accordance with the conclusion standards were measured using a calibrated digital caliper with an accuracy of 0.01 mm and the statistic comparision and analysis had been done between the predictions and measurements. The methods were "West China Moyers", "Tanaka -Johnston", "Bachmann", "Gross and Hasund", "Trankmann". RESULTS: All the methods tend to under-estimate the mesiodistal crown diameters of the permanent canines and premolars(MDD). The under-estimated predictive scale in the method of Trankmann is the largest while in the method of Moyers is the least. CONCLUSION: The method proposed by Moyers that was improved by West China School of Stomatology, Sichuan University proved to be most reliable in this study which showed the greatest correltion. However, the reliability of the method of Trankmann which seems to be the most unfit for Chinese population is the lowest.

Forward deviation of the mandibular condyle enhances endochondral ossification of condylar cartilage indicated by increased expression of type X collagen.

OBJECTIVE: Using type X collagen as a marker, this research was designed to examine the alteration of condylar growth in response to mandibular condylar forward positioning. METHODS: One hundred female Sprague-Dawley rats with 5 weeks of age were randomly divided into five experimental and five control groups. In the experimental groups, bite jumping appliances created forward positioning of the condyle. The experimental rats, together with the age-matched controls, were sacrificed on days 3, 7, 14, 21 and 30, respectively. Tissue sections were cut in the sagittal plane through the mandibular condyle and were processed for in situ hybridization and immunostaining of type X collagen and then for quantitative imaging analyses. RESULTS: (1) Both type X collagen mRNA in situ hybridization signals and type X collagen immunostaining were localized within the hypertrophic zone of the condylar cartilage. (2) With condylar forward positioning, the level of type X collagen mRNA signals (8,541 +/- 74 microm(2) at peak) was 300% higher than that in the controls (2,117 +/- 78 microm(2) at peak); type X collagen immunostaining in condylar advancing groups (54,864 +/- 134 microm(2) at peak) was 254% more than that in the controls (15,470 +/- 121 microm(2) at peak). (3) The amount of type X collagen mRNA signals and immunostaining in experimental and control groups reached the highest levels at day 14 and day 21, respectively, indicating that an increase in endochondral ossification occurred 21 days after condylar forward deviation. CONCLUSION: Condylar forward repositioning provokes an enhanced maturation of condylar chondrocytes resulting in increased synthesis of type X collagen, a extracellular protein that attributes to endochondral ossification.

[Effects of mechanical tensile stress on the expression of ICAM-1 mRNA in osteoblasts differentiated from rBMSCs].

OBJECTIVE: To investigate the correlation between mechanical tensile stress and the expression of ICAM-1 mRNA in osteoblasts differentiatd from rBMSCs and elucidate the mechanism for osteoclastogenesis regulated by osteoblasts in bone modeling and remodeling during the process of orthodontic tooth movement. METHODS: rBMSCs-derived osteoblasts were isolated and cultured in vitro, and were subjected to static mechanical tensile stress of 1,3,5 kPa or dynamic tensile stress of 3, 5 kPa at 0.017 Hz with the use of cellular tension-stress system for 24 h. Controls were without any stress. Cells were collected at 0 h, 3 h, 6 h, 9 h, 12 h, 24 h and 48 h after stress loading. The expression patterns of ICAM-1 mRNA were examined by semiquantitative RT-PCR assay. RESULTS: ICAM-1 mRNA level significantly decreased after mechanical tensile stress loading, either dysamic or static, compared with controls; the effects of inhibition positively correlated with the magnitude of stress (5 kPa>3 kPa>1 kPa). The inhibition effects of dynamic tensile stress groups exceeded the corresponding static stress (3,5 kPa dynamic stress>3,5 kPa static stress respectively). The expression of ICAM-1 mRNA significantly decreased at 3 h, reached the minimun transcription, as low as 23% of that of control, at 12 h, and then slightly rebounded and stayed at a considerably lower and stable level. CONCLUSION: Mechanical tensile stress can regulate osteoclastogenesis by inhibiting the expression of ICAM-1 in osteoblasts derived from rBMSCs, it can lead to a better understanding of the molecular basis for osteoblast-osteoclast communication in bone resorption induced by application of mechanical tensile stress during orthodontic tooth movement.

[Effects of osteoporosis on experimental tooth movement in aged rats].

OBJECTIVE: To examine the experimental tooth movement and recruitment of new osteoclasts in aged variotomized (OVX) rats. METHODS: Eighty-two 3-month female virgin health rats were divided into two groups. Each group was divided into seven sub-groups of tooth movement: 0,1,3,5,7,10 and 14 days. The tooth movement and the population of osteoclasts were measured and comparatively analyzed. RESULTS: The osteoporosis rats showed larger and faster tooth movement (P<0.05). In the osteoporosis group, the instantaneous tooth movement lasted longer time and traversed larger distance, the delay period was shorter, the population of osteoclasts was larger and displayed a faster recruitment. CONCLUSION: These findings indicate that osteoporosis accelerates tooth movement in aged OVX rats.

Colour stabilities of three types of orthodontic clear aligners exposed to staining agents.

The aim of this study was to evaluate and compare the colour stabilities of three types of orthodontic clear aligners exposed to staining agents in vitro. Sixty clear orthodontic aligners produced by three manufacturers (Invisalign, Angelalign, and Smartee) were immersed in three staining solutions (coffee, black tea, and red wine) and one control solution (distilled water). After 12-h and 7-day immersions, the aligners were washed in an ultrasonic cleaner and measured with a colourimeter. The colour changes (ΔE*) were calculated on the basis of the Commission Internationale de I'Eclairage L*a*b* colour system (CIE L*a*b*), and the results were then converted into National Bureau of Standards (NBS) units. Fourier transformation infrared (FT-IR) spectroscopy and scanning electron microscopy (SEM) were conducted to observe the molecular and morphologic alterations to the aligner surfaces, respectively. The three types of aligners exhibited slight colour changes after 12 h of staining, with the exception of the Invisalign aligners stained with coffee. The Invisalign aligners exhibited significantly higher ΔE* values (ranging from 0.30 to 27.81) than those of the Angelalign and Smartee aligners (ΔE* values ranging from 0.33 to 1.89 and 0.32 to 1.61, respectively, P<0.05). FT-IR analysis confirmed that the polymer-based structure of aligners did not exhibit significant chemical differences before and after the immersions. The SEM results revealed different surface alterations to the three types of aligner materials after the 7-day staining. The three types of aesthetic orthodontic appliances exhibited colour stability after the 12-h immersion, with the exception of the Invisalign aligners stained by coffee. The Invisalign aligners were more prone than the Angelalign and Smartee aligners to pigmentation. Aligner materials may be improved by considering aesthetic colour stability properties.

[Effects of the directions of an extraoral retractive force on the displacement of and stress distribution in palate].

OBJECTIVE: The aim of this study was to assess the effects of varying retractive force directions on the displacement of and stress distributions in palate. METHODS: A three-dimensional finite element model of the nasomaxillary complex was created, consisting of 1638 isoparametric elements and 1827 nodes. An extraoral retractive force of 9.8N was applied to the upper canines in 3 different directions, i.e. parallel, 30 degrees upwards and downwards to the functional occlusal plane. Then we investigated the nature of stress distributions, the directions and amounts of displacement in palate by finite element analysis. RESULTS: In the midpalatal suture and transpalatal suture, all displacement directed to bone suture and increased gradually when the retractive force direction ranged from +30 degrees to -30 degrees. In the midmost part of palate, correlation between stress distributions and retractive force directions was not significant. Relatively compressive stresses were induced in the front and middle of the midpalatal suture, whereas nearly no stress was induced in the back. In the lateral part of palate, compressive stresses were nearly equal to tensile stresses in the front, while tensile stresses were induced in the middle and back. Meanwhile, there was no significant correlation between stress distributions and force directions. CONCLUSION: This study showed that the directions of retractive force had obvious effects on displacement but but little effect on stress distributions.