Using FEM to Assess the Effect of Orthodontic Forces on Affected Periodontium

Abstract

Orthodontic treatment in patients with no periodontal tissue breakdown vs. horizontal bone loss should be approached with caution even though it can bring significant benefits in terms of periodontal recovery and long-term success. We used the finite element method (FEM) to simulate various clinical scenarios regarding the periodontal involvement: healthy with no horizontal bone loss, moderate periodontal damage (33%) and severe horizontal bone loss (66%). Afterwards, forces of different magnitudes (0.25 N, 1 N, 3 N, and 5 N) were applied in order to observe the behavioral patterns. Through mathematical modeling, we recorded the maximum equivalent stresses (σ ech), the stresses on the direction of force application (σ c) and the displacements produced (f) in the whole tooth–periodontal ligament–alveolar bone complex with various degrees of periodontal damage. The magnitude of lingualization forces in the lower anterior teeth influences primarily the values of equivalent tension, then those of the tensions in the direction in which the force is applied, and lastly those of the displacement of the lower central incisor. However, in the case of the lower lateral incisor, it influences primarily the values of the tensions in the direction in which the force is applied, then those of equivalent tensions, and lastly those of displacement. Anatomical particularities should also be considered since they may contribute to increased periodontal risk in case of lingualization of the LLI compared to that of the LCI, with a potential emergence of the “wedge effect”. To minimize periodontal hazards, the orthodontic force applied on anterior teeth with affected periodontium should not exceed 1 N.

Effects of Periodontal Splints on Biomechanical Behaviors in Compromised Periodontal Tissues and Cement Layer: 3D Finite Element Analysis

“…Oblique loading resulted in higher stress values on periodontal tissues, cement layers, and splints than those caused by vertical loading, which is in accordance with previous studies [ 29 , 30 ]. The highest equivalent stress may lead to periodontal hazards [ 13 , 30 ]. Emphasis should be placed on the importance of avoiding or reducing oblique loading.…”

“…Finite element analysis (FEA) is a non-invasive tool for use in the study of biomechanics and the effect of mechanical strength on biological systems [ 12 ]. In dentistry, FEA has been used to estimate stress distribution in periodontium [ 13 ]. As the periodontal ligament (PDL) is the most crucial component of periodontium, the inclusion of the PDL in an FEA model yields more reliable results.…”

Comparative Analysis of Periodontal Pain Using Two Different Orthodontic Techniques, Fixed Multibrackets and Removable Aligners: A Longitudinal Clinical Study with Monthly Follow-Ups for 12 Months

“…In these patients, there can be a high prevalence of periodontal pathology. Careful attention should be paid to patients with reduced periodontium, in whom there is a higher risk of gingival recession [40,41]. The periodontal biotype and the health status of the periodontium may influence the level of pain described by patients during orthodontic treatment [42,43].…”

The Impact of the COVID-19 Pandemic on Dentistry and Dental Education: A Narrative Review

“…Diagnostics based on salivary matrix metalloproteinases (MMPs) that can successfully quantify periodontal inflammation should be cautiously used because of potential contamination risks [ 35 , 36 , 37 ]. To overcome these hazards, other methods have been employed, such as the finite element method (FEM), which uses mathematical models to simulate clinical reality and does not involve patient contact [ 38 , 39 ]. FEM proved to be an extremely useful and reliable alternative option during the COVID-19 pandemic by providing optimal prognoses and validating different protocols of treatment in various dental specialties, such as periodontics, orthodontics or prosthodontics [ 39 , 40 , 41 , 42 , 43 ].…”