Clinical evaluation of the centre of resistance of the upper incisors during retraction

Abstract

The aim of this study was to evaluate the movement of anterior teeth during retraction with a force applied through the assumed centre of resistance (CRe). Twenty-two subjects with a Class I or II malocclusion were included. Each subject had the two upper first premolars extracted, resulting in a symmetrical extraction space of at least 3 mm between the upper laterals and canines. The force was applied through the assumed CRe, located 9 mm gingival to the lateral tooth bracket. To examine the type of anterior tooth movement, 10 parameters were measured. A Wilcoxon test was used to determine the differences between pre- and post-retraction values, and a Mann-Whitney U-test to determine the mean differences between groups. In spite of the force application through the CRe, tipping of the anterior teeth was observed in 19 subjects and parallel movement in three patients. Consequently, the subjects were divided into two groups according to the location of the centre of rotation (CRo). In group 1 (nine cases), the CRo was located coronal to the root apex, and in group 2 (13 cases), apical to the root apex. Both groups showed a significant decrease in inclination (P < 0.01) and posterior crown movement (P < 0.01 for group 1 and P < 0.001 for group 2) of the anterior teeth. A significant posterior movement of the root apex was observed in group 2 (P < 0.001). Significant differences were found between the groups for anterior tooth inclination (P < 0.05) and root apex movement (P < 0.001). The reasons for these differences could not be conclusively determined. Even though experimental studies provide information regarding CRe location, factors such as bone support, root morphology and incisor inclination should be taken into consideration. The observation of tooth movement occurring during treatment and changes in treatment mechanics would be helpful in obtaining desired tooth movement.