## 4 Results and Discussion
### Macro-Staging and Micro-Staging
#### 4.3.1 Macro-Staging  
Macro-staging constitutes the general biomechanics of movements that need to be prioritized to meet the objectives of the treatment plan. It provides a comprehensive view of the movements occurring in each dental arch. This generalized sectional study of the sequence analyzes the overall anchorage pattern, helping us determine if there are solid support points throughout the staging to ensure dental movement. Additionally, it must be determined whether the overall dental movement is synergistic or antagonistic, as it influences the predictability of results. To review whether a plan has appropriate macro-staging, the clinician must complete the following steps:  
Define the general biomechanics of malocclusion correction. Create the necessary conditions to make these biomechanics as predictable as possible. Establish the distribution and sources of anchorage. Define the General Biomechanics of Malocclusion Correction  
The first decision the orthodontist must make is to opt for a _simultaneous pattern_ of movements (where all or practically all teeth in the arch move at once) or a _structured pattern_ (where there are always immobile teeth acting as anchorage while others move). This decision depends on many factors, with the most relevant being the complexity of the malocclusion. Severe malocclusions requiring complex dynamics (such as distalization or closing extraction spaces) benefit from a structured pattern. Simple malocclusions that can be resolved with highly predictable movements that also create space (such as posterior expansion or proclination of anterior teeth) may benefit from a simultaneous pattern, as it reduces the number of active aligners and increases efficiency [40]. Other factors influencing decision-making include the selected sources of anchorage, the individual situation of each tooth, the bone and periodontal support, and the pattern of appliance changes. The types of movements required also impact the predictability of the macro-staging. The ability to combine synergistic movements enhances the force systems generated by the plastics and is desirable when planning. Some synergistic mechanics include posterior expansion + anterior retrusion, proclination or expansion + hinge rotation, posterior compression + anterior protrusion, posterior distalization + anterior proclination, posterior extrusion + anterior intrusion, or posterior intrusion + anterior extrusion (Figure 1A). On the other hand, antagonistic movements are not desirable, as they diminish their expression and can lead to arch collapse, causing a \"_loss of tracking_\". The orthodontist should avoid, in the analysis of the macro-staging, the simultaneous occurrence of these dynamics. Some antagonistic mechanics include posterior expansion + anterior protrusion, rotation + extrusion, posterior compression + anterior retrusion, simultaneous posterior and anterior extrusion, simultaneous posterior and anterior intrusion, or posterior distalization + palatal root torque (Figure 1B). Create the Necessary Conditions to Make These Biomechanics as Predictable as Possible  
This aspect is highly individualized to each patient, but in general, all macro-stagings benefit from establishing the timing of each movement (for example, \"_first alignment by expansion and proclination, then extrusion_\"), aiming to combine synergistic movements simultaneously and selecting the best auxiliary resources for each phase of the sequence. This implies, for example, that during the derotation of a tooth, it may have an attachment to assist with rotation, but when the planned extrusion arrives, this attachment should be replaced with one designed to assist with extrusion. Using an intermediate attachment design that can help both with rotation and extrusion will be less effective than a specific design for each phase (Figure 2). Figure 1: (**A**) Synergistic movements. (**B**) Antagonistic movements.