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The stressed state of the periodontal ligament (PDL) is understood to play a critical role in the tooth
movement initiated by orthodontic treatment. Finite element simulations have been used to describe PDL
stresses for orthodontic loading; however, these models have predominantly assumed linear mechanical
properties for the PDL. The present study sought to determine the importance of using nonlinear mechanical
properties and nonuniform geometric data in computer predictions of periodontal ligament stresses and
tooth movements. A 2-dimensional plane-strain finite element model of a mandibular premolar was
constructed based on anatomic data of transverse sections of tooth, PDL, and bone from a 24-year-old
cadaveric man. A second model was constructed of the same tooth but with a PDL of uniform thickness.
Each of these was prescribed linear or nonlinear elastic mechanical properties, as obtained in our own
experiments. Predictions of the maximum and minimum principal stresses and von Mises stresses in the PDL
were determined for extrusive and tipping forces. The results indicated that biofidelic finite element models
predicted substantially different stresses in the PDL for extrusive loading than did the uniform thickness
model, suggesting that incorporation of the hourglass shape of the PDL is warranted. In addition,
incorporation of nonlinear mechanical properties for the PDL resulted in dramatic increases in the stresses
at the apex and cervical margin as compared with the linear models. (Am J Orthod Dentofacial Orthop 2003;
123:657-65)
A
pplication of light and continuous forces to the Finite element (FE) analyses offer a means of
crown of a tooth is recommended in orthodon- determining stresses in tooth, ligament, and bone struc-
tics. Under low force magnitudes, the peri- tures for a broad range of orthodontic loading scenar-
odontal ligament (PDL) vasculature is partially oc- ios. Stress profiles of the PDL have been quantified for
cluded, and cellular activity within the ligament canines,6-11 maxillary incisors,12,13 premolars,14,15 and
rescaffolds the alveolus by frontal bone resorption. In molars.16 Centers of rotation of teeth have been ana-
contrast, heavy forces are more likely to cause ischemia lytically determined,9,13,17 and the effect of bone loss
and cell death in the PDL and undermine bone resorp- has been investigated.18-20 These computer models
tion.1,2 Whereas light forces cause physiologic and generally incorporated homogeneous, isotropic, linear
steady tooth movement, heavy loads induce abrupt elastic PDL properties. Few studies have assigned
starts and stops of migration synchronous with collapse nonlinear mechanical properties to the PDL10,21,22 or
of necrosed bone and cementum.3 Thus, the stressed
nonuniform PDL geometry.12
condition of the PDL sets the stage for the ensuing
Accuracy of the computer models depends on
favorable or unfavorable tooth movement.4,5 Because
assigned constitutive properties, among other things.
of geometric and mechanical complexities, however,
Whereas the hard tissue properties have been docu-
few studies have related stress in the PDL to the applied
mented,23 a comprehensive mathematical description
orthodontic force. Clinicians therefore tend to rely on
experience when adjusting appliances. of the PDL has not been reported. This lack of
information is a source of error in computer simula-
From the University of Alabama at Birmingham, Birmingham, Alabama. tions of orthodontic tooth movement.10,11,20,24 Al-
Department of Biomedical Engineering. though the mechanical behavior of the PDL is
b
Department of Orthodontics.
Reprint requests to: Alan W. Eberhardt, PhD, HOEHN Room 370, 1075 13th
understood to be nonlinearly elastic,25-28 many in-
Street South, Birmingham, AL 35294-4440; e-mail, Aeberhar@eng.uab.edu. vestigators assign linear mechanical properties be-
Submitted, April 2002; revised and accepted, July 2002. cause of lack of scientific quantitative data.11,24
Copyright © 2003 by the American Association of Orthodontists.
0889-5406/2003/$30.00 ⫹ 0 Other investigators have performed parametric anal-
doi:10.1016/S0889-5406(03)00164-1 yses to determine the influence of the PDL linear
657
658 Toms and Eberhardt American Journal of Orthodontics and Dentofacial Orthopedics
June 2003
Fig 2. A, Specimen and test fixture. Downward motion of MTS actuator (MTS 858 Mini Bionix, MTS,
Eden Prairie, Minn) moves indenter through opening in lexan clamping plate, applying load to center
of tooth. B, Magnified view of specimen clamped between lexan and washer for loading in extrusion
before load application, and C, after loading.
Fig 3. A, Axisymmetric FE model of transverse section of experimental tooth, PDL, and bone
subjected to extrusive orthodontic loading, using nonlinear mechanical properties of PDL deter-
mined experimentally. B, Load and displacement values predicted by FE model were in agreement
with experimental data.
each section. Nonlinear mechanical properties derived Table I. Mechanical properties for the structural
for the transverse sections were assigned for the non- elements used in the current study
linear analyses.
Models were analyzed to determine (1) the effects Young’s modulus Poisson’s
Material (MPa) ratio
of PDL thickness variations around the buccolingual
plane, (2) linear versus nonlinear elastic behavior of Dentin 19600 0.3
PDL, and (3) load direction (extrusive or tipping) on Bone 13700 0.3
PDL stresses and tooth displacements (Table II). A 1-N PDL (linear elastic)
MP1 0.303 0.45
equivalent line load was delivered in 0.1-N increments MP2 0.208 0.45
to the occlusogingival midpoint of the crown, and the MP3 0.143 0.45
bone was fixed at the base of the mandible. PDL MP4 0.179 0.45
stresses were analyzed at the buccocervical margin, MP5 0.25 0.45
linguocervical margin, and apex for the uniform and PDL (nonlinear elastic) Calculated, see Appendix 0.45
nonuniform thickness models using linear mechanical Properties for the hard tissues were taken from literature. Both linear
properties. Differences in predicted stresses exceeding and nonlinear mechanical properties for PDL were based on experi-
25% were considered substantial. Comparisons were mental data.
made of the maximum and minimum principal stresses
(ie, tension or compression) and von Mises stresses (a
660 Toms and Eberhardt American Journal of Orthodontics and Dentofacial Orthopedics
June 2003
Fig 5. A, Maximum principal stresses; B, minimum principal stresses; and C, von Mises stresses in
PDL predicted by FE models of mandibular premolar subject to orthodontic force.
Average stress across the PDL from tooth to bone as predicted by FE models with uniform PDL
Table III.
thickness and nonuniform PDL thickness
Linguocervical margin Apex Buccocervical margin
Uniform ⫺2.6932 ⫺11.6090 7.7574 36.9586 28.4971 8.0320 13.2804 1.2330 10.4613
Nonuniform ⫺1.9910 ⫺9.4540 6.4919 31.5214 24.9671 6.3430 11.0600 0.8533 8.8620
Difference ⫺35.27 ⫺22.79 ⫺19.49 ⫺17.25 ⫺14.14 ⫺26.63 ⫺20.08 ⫺44.49 ⫺18.05
the tooth approximately 4.3 mm from the apex and did the midline to the lingual side of the root during load
not move during extrusive load application (Fig 7, A). application, approximately 3.8 mm from the apex (Fig
The ICR for the nonlinear, nonuniform model started at 7, B).
this point but was displaced off the midline 0.0025 mm
to the buccal side and 1 mm toward the apex during DISCUSSION
load application from 0 to 0.7 N. Additional loading As hypothesized, stresses predicted in the PDL by
redirected the ICR back to the midline of the root but to computer simulations depended on assigned mechani-
a more apical location. The nonlinear model subjected cal properties and PDL geometry. Predicted stresses
to a tipping force predicted movement of the ICR from using a uniform thickness PDL were substantially
662 Toms and Eberhardt American Journal of Orthodontics and Dentofacial Orthopedics
June 2003
Fig 6. Stresses across PDL at A, linguocervical margin; B, apex; and C, buccocervical margin.
Node 0 is at tooth and PDL interface, and node 8 is at PDL and bone interface. VON, von Mises
stresses.
Fig 7. A, ICR of mandibular premolar during application of 1 N extrusive loading in 0.1-N increments
(inset) assuming linear and nonlinear mechanical properties (MP) of PDL. B, ICR during application
of 1 N extrusive and tipping forces in 0.1-N increments (inset), assuming nonlinear mechanical
properties for PDL. Tooth is approximately 24 mm in length, and root tip is at origin. Center of
rotation deviates from long axis of tooth when nonlinear mechanical properties are used for PDL.
Center of rotation is stationary when linear mechanical properties are used.
different from stresses predicted using a nonuniform nonlinear mechanical properties were different from
thickness PDL. In addition, predicted stresses using predicted stresses using linear mechanical properties.
American Journal of Orthodontics and Dentofacial Orthopedics Toms and Eberhardt 663
Volume 123, Number 6
Maximum principal stresses in the PDL for the mately 4.3 mm from the apex and did not change
uniform linear model were highest at the apex and during extrusive load application. In contrast, the
tapered more at the linguocervical margin than at the ICR moved during load application for both the
buccocervical margin. This agrees with previous extrusive and the tipping nonlinear models. To our
findings of an asymmetric stress pattern about the knowledge, this is the first report of movement of the
long axis of the root with a 3-dimensional, linearly center of rotation within a tooth under orthodontic
elastic PDL model of a maxillary canine in extru- loading. Because the model is 2-dimensional, a
sion.8 3-dimensional biofidelic rendering of a premolar
The differences in predicted stresses for the FE may provide a better prediction of the motion of the
model with a uniform PDL thickness and nonuniform ICR during load application.
PDL thickness, in which linear mechanical proper- The present FE analyses of a mandibular premolar
ties were applied, were substantial for the linguocer- subjected to tipping and extrusive orthodontic forces
vical margin (P1), apex (von Mises), and buccocer- indicated that the inclusion of nonuniform geometry
vical margin regions (P3). These results were and nonlinear mechanical properties for the PDL sub-
expected, because stress in a mechanical system is a stantially alters predictions of stresses in the PDL.
function of its dimensions and applied load. At the Although the 2-dimensional plane-strain model cannot
apex, the P1 stresses were higher for the uniform accurately represent all aspects of a complex 3-dimen-
thickness PDL than for the nonuniform thickness sional dental structure, it suggests that behavior of the
PDL, likely a result of the narrower PDL thickness
PDL and the tooth under low force depends on the
for the uniform model. P1 stresses were likewise
mechanical properties of the soft tissue and dimensions
higher at the buccal and lingual cervical margins,
assigned to the PDL.
owing to the narrower dimension for the uniform
model. The data suggest that a PDL thickness based
on actual dental anatomy is necessary for accurate REFERENCES
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664 Toms and Eberhardt American Journal of Orthodontics and Dentofacial Orthopedics
June 2003
Table IV.Piecewise linear mechanical property values describing nonlinear elastic stress–strain behavior of PDL
(values were input to FE model)
MP1 MP2 MP3 MP4 MP5
ε ε ε ε ε
0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
0.0251 0.0008 0.0316 0.0001 0.1963 0.0019 0.1468 0.0025 0.1009 0.0030
0.0473 0.0021 0.0635 0.0004 0.2327 0.0043 0.1850 0.0062 0.1180 0.0049
0.0755 0.0050 0.1285 0.0027 0.2704 0.0098 0.2241 0.0153 0.1353 0.0080
0.1009 0.0102 0.1622 0.0068 0.2782 0.0115 0.2401 0.0218 0.1528 0.0130
0.1266 0.0197 0.1969 0.0172 0.3017 0.0187 0.2562 0.0312 0.1705 0.0212
0.1526 0.0374 0.2203 0.0315 0.3342 0.0359 0.2727 0.0446 0.1884 0.0345
0.1789 0.0706 0.2329 0.0435 0.3509 0.0497 0.2893 0.0639 0.2065 0.0562
0.1883 0.0882 0.2498 0.0664 0.3680 0.0690 0.3063 0.0915 0.2250 0.0914
0.2051 0.1309 0.2706 0.1104 0.3908 0.1057 0.3235 0.1312 0.2437 0.1488