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Caragiuli M, Candelari M, Zalunardo F, Bruno G, De Stefani A, Brunzini A, Mandolini M. Effects of Oral Appliances for Obstructive Sleep Apnoea in Reduced Periodontium: A Finite Element Analysis. Int Dent J 2024:S0020-6539(24)00139-4. [PMID: 38839530 DOI: 10.1016/j.identj.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/21/2024] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND AND OBJECTIVE In the literature, no studies correlate the effects of mandibular advancement devices (MADs) with different titration systems to periodontitis. Through a finite element analysis (FEA), this study investigates the effects generated on periodontal ligaments (PDLs) and teeth by four commercial MADs in periodontal health and with 15% bone resorption. METHODS Four MADs (Somnodent Flex™, Somnodent Avant™, Orthoapnea™, and Herbst™) were digitalised starting from the impressions of a patient's dental arches. A force of 11.18 N, representing an advancement of 9.5 mm, was applied, and a FEA was subsequently performed. After measuring the stresses and displacements on the PDLs and teeth in healthy periodontal conditions, the vertical dimension of the alveolar bone was reduced by 15%, and measurements were repeated. RESULTS In terms of PDL stress, Herbst™ is the device which guarantees a more uniform increment in case of the first stage of periodontitis (+7% for mandibular and maxillary PDLs compared to the healthy condition). For Somnodent™ devices, the PDLs stress increment is almost null for mandibular PDLs but much higher than Herbst™ for maxillary PDLs (+17% and +21% for Flex™ and Avant™). Orthoapnea™ determines a PDL stress augmentation between the other devices (+16% and +7%, respectively, for maxillary and mandibular PDLs). Concerning teeth movement, Herbst™ and Orthoapnea™ determine a lower and more uniform displacement than Somnodent devices. CONCLUSIONS The stress distribution and teeth displacement are strictly related to MAD geometry. Since its minor effects on teeth and PDLs, the Herbst™ could be more appropriate in patients with periodontitis.
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Affiliation(s)
- Manila Caragiuli
- Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, Ancona, Italy.
| | - Mara Candelari
- Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Francesca Zalunardo
- Department of Neuroscience, Dental Clinic, Section of Dentistry, University of Padua, Padua, Italy
| | - Giovanni Bruno
- Department of Neuroscience, Dental Clinic, Section of Dentistry, University of Padua, Padua, Italy; Department of Industrial Engineering, University Tor Vergata, Rome, Italy
| | - Alberto De Stefani
- Department of Neuroscience, Dental Clinic, Section of Dentistry, University of Padua, Padua, Italy; Department of Pharmacological Sciences, University of Padua, Padua, Italy
| | - Agnese Brunzini
- Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Marco Mandolini
- Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, Ancona, Italy
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Salazar D, Rossouw PE, Javed F, Michelogiannakis D. Artificial intelligence for treatment planning and soft tissue outcome prediction of orthognathic treatment: A systematic review. J Orthod 2024; 51:107-119. [PMID: 37772513 DOI: 10.1177/14653125231203743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND The accuracy of artificial intelligence (AI) in treatment planning and outcome prediction in orthognathic treatment (OGT) has not been systematically reviewed. OBJECTIVES To determine the accuracy of AI in treatment planning and soft tissue outcome prediction in OGT. DESIGN Systematic review. DATA SOURCES Unrestricted search of indexed databases and reference lists of included studies. DATA SELECTION Clinical studies that addressed the focused question 'Is AI useful for treatment planning and soft tissue outcome prediction in OGT?' were included. DATA EXTRACTION Study screening, selection and data extraction were performed independently by two authors. The risk of bias (RoB) was assessed using the Cochrane Collaboration's RoB and ROBINS-I tools for randomised and non-randomised clinical studies, respectively. DATA SYNTHESIS Eight clinical studies (seven retrospective cohort studies and one randomised controlled study) were included. Four studies assessed the role of AI for treatment decision making; and four studies assessed the accuracy of AI in soft tissue outcome prediction after OGT. In four studies, the level of agreement between AI and non-AI decision making was found to be clinically acceptable (at least 90%). In four studies, it was shown that AI can be used for soft tissue outcome prediction after OGT; however, predictions were not clinically acceptable for the lip and chin areas. All studies had a low to moderate RoB. LIMITATIONS Due to high methodological inconsistencies among the included studies, it was not possible to conduct a meta-analysis and reporting biases assessment. CONCLUSION AI can be a useful aid to traditional treatment planning by facilitating clinical treatment decision making and providing a visualisation tool for soft tissue outcome prediction in OGT. REGISTRATION PROSPERO CRD42022366864.
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Affiliation(s)
- Daisy Salazar
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Paul Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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Zhao W, Lou Y, Yan W. Evaluation of stress and displacement of maxillary canine during the single canine retraction in the maxillary first premolar extraction cases- A finite element study. Clin Oral Investig 2024; 28:206. [PMID: 38459220 DOI: 10.1007/s00784-024-05590-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/25/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES This finite element study aimed to simulate maxillary canine movement during anterior teeth retraction. MATERIALS AND METHODS Three methods of maxillary canine movement including miniscrew sliding with high hooks (MSH), miniscrew sliding with low hooks (MSL), and the traditional sliding method (TS) without using miniscrews were simulated using three-dimensional finite element analysis. The initial displacement of the maxillary canine, the maximum principal stress of the periodontal ligament and the Von Mises stress were calculated. RESULTS The distolingual tipping movements of the canine were shown in three movement modes. MSH showed a small tendency to lingual tipping movement and a extrusion movement while MSL had the largest lingual inclination. TS demonstrated a tendency toward distolingual torsion displacement. Compressive stress values were mainly concentrated in the range - 0.003 to -0.006 MPa. For tensile stress, the distribution of MSH and MSL was concentrated in the range 0.005 to 0.009 MPa, TS was mainly distributed about 0.003 MPa. Von Mises equivalent stress distribution showed no significant difference. CONCLUSIONS The loss of tooth torque was inevitable, irrespective of which method was used to close the extraction space. However, miniscrew application and higher hooks reduced the loss of torque and avoided lingual rotation. CLINICAL RELEVANCE This study shows that miniscrew implants with different hooks can better control the movement of the maxillary canines. The non-invasive nature of the finite element analysis and its good simulation of dental stress and instantaneous motion trend have a clinical advantage in the analysis of tooth movement.
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Affiliation(s)
- Wenbo Zhao
- School of Stomatology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, 150000, China
| | - Yu Lou
- School of Stomatology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, 150000, China
| | - Weijun Yan
- School of Stomatology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, 150000, China.
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Inan A, Gonca M. Effects of aligner activation and power arm length and material on canine displacement and periodontal ligament stress: a finite element analysis. Prog Orthod 2023; 24:40. [PMID: 38008884 PMCID: PMC10678869 DOI: 10.1186/s40510-023-00492-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/16/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND This study aimed to assess the impact of aligner activation and power arm length and material on canine and aligner displacement, von Mises stress in the power arm, and principal stress in the periodontal ligament (PDL) during canine tooth distalization using finite element analysis (FEA). The effects of aligner activation and power arm length were primary outcomes, while the effect of the power arm material was a secondary outcome. METHODS Aligner activation (0.1 mm or 0.2 mm) was applied without using a power arm in two models. The effects of aligner activation, power arm length (12, 13, or 14 mm) and power arm material (stainless steel [SS] or fiber-reinforced composite [FRC]) on canine distalization were investigated in 12 models by evaluating displacement and stress via ALTAIR OptiStruct analysis. RESULTS Greater canine displacement was observed in all models with 0.2 mm than 0.1 mm of aligner activation. When models with the same aligner activation were compared, reduced mesiodistal tipping, increased palatal tipping, and increased extrusion of the canine cusp were observed with increasing power arm length. Moreover, the von Mises stress increased as the power arm length increased. Increasing the aligner activation and power arm length increased the maximum principal stress in the PDL. Power arms of the same length in both materials showed the same results in terms of canine displacement, clear aligner displacement, and maximum principal stress in the PDL. However, under conditions of equal length and aligner activation, the von Mises stress of the SS power arm was higher than that of the FRC power arm. CONCLUSION Using a power arm in canine distalization reduced mesiodistal tipping but increased palatal tipping and extrusion of the canine cusp. Aligner activation and additional force increased tooth movement and principal stress in the canine PDL. FRC power arms exhibited less von Mises stress than SS power arms.
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Affiliation(s)
| | - Merve Gonca
- Department of Orthodontics, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey.
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Zhang X, Li MQ, Guo J, Yang HW, Yu J, Li GJ. An analysis of the optimal intrusion force of the maxillary central incisor with root horizontal resorption using the finite element method and curve fitting. Comput Methods Biomech Biomed Engin 2021; 25:1471-1486. [PMID: 34964691 DOI: 10.1080/10255842.2021.2017904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There are no studies on the optimal intrusion force in orthodontic patients with the existing root resorption (RR). The study aimed to analyze the optimal intrusion force for central incisors with existing horizontal root resorption using the finite element method (FEM). We calculated the optimal intrusion force using the finite element method and curve fitting. We found that with the increase of the maxillary central incisor's root horizontal resorption length, the optimal intrusion force interval's median gradually increases. If the resorption length is more significant than 1/2 of the root length, it is not recommended to use intrusion force theoretically.
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Affiliation(s)
- Xin Zhang
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Min-Qi Li
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Jie Guo
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Heng-Wei Yang
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Jian Yu
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Guo-Ju Li
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
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Using FEM to Assess the Effect of Orthodontic Forces on Affected Periodontium. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11167183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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.
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