A mechanism of noncontinuous supraosseous tooth eruption

Quantification of the relative orientation and position of the mandibular condyles

The human temporomandibular joint (TMJ) is involved in vital functions such as feeding and talking, while its disorder prevalence is reported to be between 5% and 12%. Functional evaluation using quantitative motion analysis tools is interesting in order to better understand normal and abnormal TMJ behavior. But, for the same mandibular displacement, left and right condyles will most certainly give different motion representation: both condyles showing a different shape and volume, being most of the time asymmetric and highly individual. This study performs quantification on relative left and right condyle orientation and position using the spatial location of palpated anatomical landmarks (ALs) and anatomical frames (AFs), on three-dimensional (3D) models created from computerized tomography (CT) performed on 94 mandibles from Université Libre de Bruxelles bone repository, and magnetic resonance imaging (MRI) performed on 11 living subjects. Our aim was to gather as much data as possible on the morphological aspect of the condyle's orientation asymmetry within the same mandible, in order to better address the difference of motion representation that will be observed for the right and left condyles in further kinematic studies.

Inclusion of periodontal ligament fibres in mandibular finite element models leads to an increase in alveolar bone strains

Alveolar bone remodelling is vital for the success of dental implants and orthodontic treatments. However, the underlying biomechanical mechanisms, in particular the function of the periodontal ligament (PDL) in bone loading and remodelling, are not well understood. The PDL is a soft fibrous connective tissue that joins the tooth root to the alveolar bone and plays a critical role in the transmission of loads from the tooth to the surrounding bone. However, due to its complex structure, small size and location within the tooth socket it is difficult to study in vivo. Finite element analysis (FEA) is an ideal tool with which to investigate the role of the PDL, however inclusion of the PDL in FE models is complex and time consuming, therefore consideration must be given to how it is included. The aim of this study was to investigate the effects of including the PDL and its fibrous structure in mandibular finite element models. A high-resolution model of a human molar region was created from micro-computed tomography scans. This is the first time that the fibrous structure of the PDL has been included in a model with realistic tooth and bone geometry. The results show that omission of the PDL creates a more rigid model, reducing the strains observed in the mandibular corpus which are of interest when considering mandibular functional morphology. How the PDL is modelled also affects the strains. The inclusion of PDL fibres alters the strains in the mandibular bone, increasing the strains in the tooth socket compared to PDL modelled without fibres. As strains in the alveolar bone are thought to play a key role in bone remodelling during orthodontic tooth movement, future FE analyses aimed at improving our understanding and management of orthodontic treatment should include the fibrous structure of the PDL.

The biomechanical function of periodontal ligament fibres in orthodontic tooth movement

Orthodontic tooth movement occurs as a result of resorption and formation of the alveolar bone due to an applied load, but the stimulus responsible for triggering orthodontic tooth movement remains the subject of debate. It has been suggested that the periodontal ligament (PDL) plays a key role. However, the mechanical function of the PDL in orthodontic tooth movement is not well understood as most mechanical models of the PDL to date have ignored the fibrous structure of the PDL. In this study we use finite element (FE) analysis to investigate the strains in the alveolar bone due to occlusal and orthodontic loads when PDL is modelled as a fibrous structure as compared to modelling PDL as a layer of solid material. The results show that the tension-only nature of the fibres essentially suspends the tooth in the tooth socket and their inclusion in FE models makes a significant difference to both the magnitude and distribution of strains produced in the surrounding bone. The results indicate that the PDL fibres have a very important role in load transfer between the teeth and alveolar bone and should be considered in FE studies investigating the biomechanics of orthodontic tooth movement.

Tooth eruption results from bone remodelling driven by bite forces sensed by soft tissue dental follicles: a finite element analysis

Intermittent tongue, lip and cheek forces influence precise tooth position, so we here examine the possibility that tissue remodelling driven by functional bite-force-induced jaw-strain accounts for tooth eruption. Notably, although a separate true 'eruptive force' is widely assumed, there is little direct evidence for such a force. We constructed a three dimensional finite element model from axial computerized tomography of an 8 year old child mandible containing 12 erupted and 8 unerupted teeth. Tissues modelled included: cortical bone, cancellous bone, soft tissue dental follicle, periodontal ligament, enamel, dentine, pulp and articular cartilage. Strain and hydrostatic stress during incisive and unilateral molar bite force were modelled, with force applied via medial and lateral pterygoid, temporalis, masseter and digastric muscles. Strain was maximal in the soft tissue follicle as opposed to surrounding bone, consistent with follicle as an effective mechanosensor. Initial numerical analysis of dental follicle soft tissue overlying crowns and beneath the roots of unerupted teeth was of volume and hydrostatic stress. To numerically evaluate biological significance of differing hydrostatic stress levels normalized for variable finite element volume, 'biological response units' in Nmm were defined and calculated by multiplication of hydrostatic stress and volume for each finite element. Graphical representations revealed similar overall responses for individual teeth regardless if incisive or right molar bite force was studied. There was general compression in the soft tissues over crowns of most unerupted teeth, and general tension in the soft tissues beneath roots. Not conforming to this pattern were the unerupted second molars, which do not erupt at this developmental stage. Data support a new hypothesis for tooth eruption, in which the follicular soft tissues detect bite-force-induced bone-strain, and direct bone remodelling at the inner surface of the surrounding bony crypt, with the effect of enabling tooth eruption into the mouth.

Simulação 3D de movimento ortodôntico

OBJETIVO: desenvolver e validar, através do Método dos Elementos Finitos (MEF), um modelo numérico tridimensional (3D) de um incisivo central superior para simular o movimento dentário. MÉTODOS: esse modelo contempla a unidade dentária, o osso alveolar e o ligamento periodontal. Permite a simulação dos diferentes movimentos dentários e a determinação dos centros de rotação e de resistência. Limita o movimento ao espaço periodontal, registrando a direção, quantificando o deslocamento dentário e as tensões iniciais no ligamento periodontal. RESULTADOS: a análise dos deslocamentos dentários e das áreas que recebem tensões iniciais possibilita determinar os tipos de movimentos dentários. Com base nas forças ortodônticas, é possível quantificar a intensidade das tensões em cada região do dente, do ligamento periodontal ou do osso alveolar. Com base nas tensões axiais ao longo do ligamento periodontal e da tensão capilar, é possível predizer, teoricamente, as regiões em que deve ocorrer a remodelação óssea. CONCLUSÃO: o modelo foi validado pela determinação do módulo de elasticidade do ligamento periodontal de forma compatível com dados experimentais existentes na literatura. Os métodos utilizados na construção do modelo permitiram a criação de um modelo completo para uma arcada dentária, o qual possibilita realizar variadas simulações que envolvem a mecânica ortodôntica.

Asymmetric headgear for differential molar movement: a study using finite element analysis

OBJECTIVE

To compare the effects of four different asymmetric headgear systems.

DESIGN

A mathematical method for three-dimensional data called finite element analysis.

SETTING

The Orthodontic Department, the Federal University of Rio de Janeiro and the Metallurgical Engineering Department of the Fluminense Federal University.

METHODS

Four systems of delivering an asymmetrical force to headgear were studied: using face-bow arms of different lengths, a symmetric face-bow with one of the arms bent outward in relation to the internal arch, a symmetric face-bow used in combination with a transpalatal arch activated to produce an asymmetric force, and a symmetric face-bow with the outer bow soldered to the inner bow on the side where a larger force will be applied.

RESULTS

All four systems were effective in promoting asymmetric distal movement of the molars. However, the symmetrical face-bow with the outer bow soldered to the inner bow (system 4) could be used in asymmetric mechanics if the bows are soldered on the opposite side to the proposed distalization. Lateral and occlusal displacing forces were observed in all systems as well as tip-back and rotational movements.

CONCLUSION

The simulated computer model used in this investigation suggests that a face-bow with a symmetrically soldered joint and arms of equal lengths used in combination with a transpalatal arch is the best headgear option when asymmetric movement of upper molars is desired.

Periostin is expressed within the developing teeth at the sites of epithelial-mesenchymal interaction

Periostin was originally isolated as an osteoblast-specific factor that functions as a cell adhesion molecule for preosteoblasts and is thought to be involved in osteoblast recruitment, attachment, and spreading. The protein was renamed "periostin" because of its expression in the periosteum and periodontal ligament, indicating a potential role in bone and maintenance of tooth structure. Periostin has structural similarity to insect fasciclin-I and can be induced by TGF-beta and Bmp2. Because tooth and periodontium development is a well-described genetic model for organogenesis governed by a reciprocal set of epithelial-mesenchymal interactions, thought to be controlled by various TGF-beta superfamily members, we investigated whether periostin is present during tooth morphogenesis. Both periostin mRNA and protein expression were analyzed throughout normal tooth development (embryonic day [E] 9.5-newborn) and within both Bmp4- and Msx2-null embryos. Periostin mRNA is initially present within the E9.5 first branchial arch epithelium and then shifts to underlying ectomesenchyme. Both mRNA and protein are asymmetrically localized to the lingual/palatal and buccal side during the early epithelial-mesenchymal interactions. Periostin is also present in dental papilla cells and within the trans-differentiating odontoblasts during the bell and hard tissue formation stages of tooth development. We suggest that periostin plays multiple roles as a primary responder molecule during tooth development and may be linked to deposition and organization of other extracellular matrix adhesion molecules during maintenance of the adult tooth, particularly at the sites of hard-soft tissue interface.

The influence of PDL principal fibers in a 3-dimensional analysis of orthodontic tooth movement

The effects of mechanical loads on the tooth-alveolus complex are of particular concern in orthodontics. The concepts of center of resistance (CRes) and center of rotation (CRot) are used to characterize tooth responses to orthodontic loads. The mechanical environment (stresses and strains) associated with orthodontic tooth movement is a unique model in bone adaptation physiology. Numerous finite element models of varying complexity have been developed to calculate tooth movements and stress distributions within the alveolar bone and the periodontal ligament (PDL). In general, the PDL has been idealized as a homogeneous isotropic material. For this project, a 3-dimensional tooth/PDL/mandible/finite element model was developed in which, for the first time in such an analysis, the PDL's principal-fiber structure was also incorporated. Parametric analyses showed that the fiber orientation and the mechanical properties do not exert much influence on the locations of the CRes and the CRot and on the stress patterns within the bone and the PDL matrix. However, the absence of principal fibers produces not only different stress magnitudes, but also differences in stress patterns. Furthermore, the no-fiber-associated CRes and CRot are considerably separated from the cluster of fiber-influenced centers. It was concluded that it may be more realistic to incorporate "generic" principal fibers into finite element models than not to include them at all, despite the lack of reliable information about fibers.