Miniscrew implants have seen increasing clinical use as orthodontic anchorage devices with demonstrated stability. The focus of this study is to develop and simulate operative factors, such as load magnitudes and anchor locations to achieve desired motions in a patient-specific 3D model undergoing orthodontic treatment with miniscrew implant anchorage. A CT scan of a patient skull was imported into Mimics software (Materialise, 12.1). Segmentation operations were performed on the images to isolate the mandible, filter out noise, then reconstruct a smooth 3D model. A model of the left canine was reconstructed with the PDL modeled as a thin solid layer. A miniscrew was modeled with dimensions based on a clinical implant (BMK OAS-T1207) then inserted into the posterior mandible. All components were volumetrically meshed and optimized in Mimics software. Elements comprising the mandible bone and teeth were assigned a material based on their gray value ranges in HU from the original scan, and meshes were exported into ANSYS software. All materials were defined as linear and isotropic. A nonlinear PDL was also defined for comparison. For transverse forces applied on the miniscrew, maximum stresses increased linearly with loading and appeared at the neck or first thread and in the cortical bone. A distal tipping force was applied on the canine, and maximum stresses appeared in the tooth at the crown and apex and in the bone at the compression surface. Under maximum loading, stresses in bone were sufficient for resorption. The nonlinear PDL exhibited lower stresses and deflections than the linear model due to increasing stiffness. Numerous stress concentrations were seen in all models. Results of this study demonstrate the potential of patient-specific 3D reconstruction from CT scans and finite-element simulation as a versatile and effective pre-operative planning tool for orthodontists.
Factors affecting stresses in cortical bone around miniscrew implants
