## 4 Discussion
### Correlation of Iteration Time with Real Clinical Time
Thus, this approach offers a simplified, consistent, and physiologically grounded method for time-mapping in orthodontic simulations. In the present study, the estimated treatment duration for achieving a 22\({}^{\circ}\) molar uprighting was equivalent to almost 12 weeks of real clinical time. This lies in agreement with clinical studies, as molar uprighting treatment duration can vary between 2 and 5 months, depending on the severity of tilted molar angle and the appliance used for treatment [1,31,32]. An in vivo study assessed two different molar uprighting utilities using CBCT images. Molar uprighting was achieved throughout a treatment period of 4 months. These results can be possibly attributed to using less forces for molar uprighting, thereby requiring more treatment time [33]. Another biomechanical study conducted a clinical comparison of different molar uprighting techniques. They found that using a conventional molar uprighting spring achieved an 18\({}^{\circ}\) molar inclination correction within 9 weeks, while miniscrew-assisted molar uprighting achieved a faster correction of 17\({}^{\circ}\) within 7 weeks [32]. In general, the average duration for molar uprighting treatment was estimated to be between 2 and 3 months, with a mean of 24.5\({}^{\circ}\) of improvement in titled molar angulation [31]. This validates the reliability of this study's FE modeling technique in demonstrating clinically representative results. The process of clinical validation was based on conducting comparisons of current model-predicted outcomes with values reported in published clinical studies using conventional uprighting springs. The outcomes were treatment duration and the angular correction of the molar. Such comparisons focused on assessing whether the model's predictions fall within clinically observed ranges. The clinical studies utilized were selected based on the use of conventional molar uprighting springs, the availability of quantitative treatment outcomes (e.g., degree of uprighting and treatment duration), and clearly defined treatment protocols. Preference was given to studies that used CBCT or radiographic follow-up and reported angular changes pertaining to mandibular second molar. The present model predicted a \(\sim\)22\({}^{\circ}\) uprighting completed over \(\sim\)12 weeks. These values closely align with reported clinical outcomes: [PERSON] et al. (2010) observed an 18\({}^{\circ}\) uprighting in 9 weeks [32]; [PERSON] et al. (2018) reported correction over 4 months [33]; and [PERSON] et al. (2021) described an average improvement of 24.5\({}^{\circ}\) over 2-5 months [31]. This agreement supports the clinical relevance of current simulation results. The model's ability to predict treatment duration can support orthodontic clinical monitoring. As the model has shown the expected duration for uprighting a certain degree of molar tilt, it would worth conducting a progress assessment with new orthodontic records once the targeted duration has been exceeded. Additionally, future studies analyzing different severities of molar tilt, may propose an estimated duration of uprighting in each category, which can serve as guides for efficient clinical measures. This will aid in proper treatment planning in complex cases, as presenting a general treatment timeframe to patients aids in their decision-making process.