Comparison of stress distribution in bone and miniscrew and displacement pattern of maxillary anterior teeth by two methods of en-masse retraction: A 3-D finite element analysis

2017 ◽  
Vol 3 (1) ◽  
pp. 23-30
2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Mashallah Khanehmasjedi ◽  
Sepideh Bagheri ◽  
Vahid Rakhshan ◽  
Mojtaba Hasani

Introduction. Miniscrews have proved quite effective in fixed orthodontic treatment. They can be placed in areas like palatal interradicular zones or midpalatal suture. Despite the value of these methods and their ever-increasing use, their characteristics are not assessed before when implanted in palatal interradicular areas or in the midpalatal suture. We aimed to assess, for the first time, the dynamics of full arch distalization using such miniscrews. Methods. A 3D model of maxilla with all permanent dentition was created from a CT scan volume. Tissues were segmented and differentiated. Afterward, miniscrews and appliances were designed, and the whole model was registered within a finite element analysis software by assigning proper mechanical properties to tissues and orthodontic appliances. The full arches were distalized using transpalatal arches with miniscrews as anchorage devices (in two different models). The extents of stresses and patterns of movements of various elements (teeth, miniscrews, appliances, tissues) were estimated. Results and Conclusions. Comparing the two models, it is obvious that in both models, the stress distribution is the highest in the TPA arms and the head of the miniscrew where the spring is connected. In comparison with the displacement in the X-axis, the “mesial in” rotation is seen in the first molar of both models. But there is one exception and that is the “mesial out” rotation of the right second molar. In all measurements, the amount of movement in Model 2 (with palatal interradicular miniscrews) is more than that in Model 1 (with midpalatal miniscrew). In the Y-axis, more tipping is seen in Model 2, especially the anterior teeth (detorque) and the first molar, but in Model 1, bodily movement of the first molar is more evident. Along the Z-axis, the mesial intrusion of the first molar and the distal extrusion of this tooth can be seen in both models. Again, the displacement values are higher in the second model (with interradicular miniscrews). In comparison with micromotion and stress distribution of miniscrews, in Model 1, maximum stress and micromotion is observed at the head of the miniscrew where it is attached to the spring. Of course, this amount of micromotion increases over time. The same is true for Model 2, but with a lower micromotion. As for the amount of stress, the stress distribution in both miniscrews of both models is almost uniform and rather severe.


2020 ◽  
Vol 54 (2) ◽  
pp. 106-114
Author(s):  
Udita Thakkar ◽  
Neeraj S. Patil ◽  
Ajay P. Thakkar ◽  
Shrikant S. Chitko ◽  
Pratik Jaltare

Introduction: Correction of deep bite is one of the major challenges of orthodontic treatment. Mini-implants provide stable intra-oral anchorage and facilitate the maxillary incisors to be intruded without the usual side. The purpose of this finite element study was to evaluate the stress distribution around the mini-implant during maxillary anterior intrusion under different conditions of different angulations and different positions of implant. Material and Methods: Finite element analysis was carried out. Stress under the following 4 conditions was analyzed: (a) single central implant placed at 90°, (b) single central implant placed at 120°, (c) bilaterally placed implant at 90°, and (d) bilaterally placed implant at 120°. Results: The displacement seen with 90° angulation in the single implant case is less compared with the 120° angulation case for all the 6 maxillary anterior teeth. Also, in the bilateral implant case, the Von Mises stress is less when the 90° angulation case is compared to 120° angulation case. But in bilaterally placed implant, the stress gets distributed evenly in the anterior region. The stress in 90° angulation cases seems to be concentrated at the center. Conclusion: Stresses measured on the teeth are less and distributed more evenly when the point of force application is bilateral. It was also observed that the stress increases with increase in the angulation of the implant. As the contact between the implant and the bone increases, the stability increases. Hence, the implant should be obliquely inserted into the bone. Concentrated stresses are not favorable as they can increase the risk of bone and root resorption.


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