Finite element analysis of maxillary arch distalization using skeletal anchorage at three different application regions

This study aimed to evaluate total maxillary arch distalization using three different skeletal anchorage systems-Mini Screw-Assisted Keleş Slider (MKS), infrazygomatic crest (IZC) screw, and maxillary tuberosity (MT) screw-through finite element analysis (FEA). A 3D cranio-maxillary model including dentition, periodontal ligament, and alveolar bone was constructed. For the MKS and IZC groups, forces were applied at three vertical heights (0 mm, 3 mm, and 6 mm apically), while the MT group involved three directional applications: buccal, palatal, and combined bucco-palatal. This design yielded nine distinct simulation scenarios. Tooth movements were assessed along the x (transverse), y (sagittal), and z (vertical) axes, and Von Mises stress distributions were analyzed in surrounding structures. In the MKS group, the first scenario showed the greatest molar crown displacement, while the third had the highest root-level movement. The ninth MT scenario yielded the most palatal crown displacement of incisors, while the sixth IZC scenario showed the greatest root movement. Apical force applications (MKS and IZC at 3-6 mm) allowed controlled displacement suited for Class II Division 2 malocclusions. In contrast, archwire-level and MT scenarios produced patterns favorable for Class II Division 1 cases. Anchorage type and force direction significantly affected distalization outcomes.