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ORIGINAL ARTICLE

A nonlinear finite element analysis of the


periodontal ligament under orthodontic tooth
loading
Stephanie R. Toms, DDS, PhD,a,b and Alan W. Eberhardt, PhDa
Birmingham, Ala

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

ness (T) was the average of 4 evenly spaced caliper


measurements of the tooth thickness. Stress area (AS)
for extrusive loading was defined as AS ⫽ TP. Stress
was calculated as the applied force/AS, and elongation
(⌬l) was the actuator displacement (Fig 2). Extrusive
shear strain was the angular deformation of the liga-
ment, ␥ ⫽ tan⫺1(⌬l/ WL).29
Fixtures were fabricated to clamp the bony part of
each specimen firmly and allow for extrusive loading of
the specimens immersed in saline solution (Fig 2).
Custom washers were machined to closely approximate
the contour of each PDL section and support as much
bone as possible. The specimens were centered under
an indentor that was attached to the actuator of a
materials-testing machine (MTS 858 Mini Bionix,
MTS, Eden Prairie, Minn). The tissue was cyclically
loaded for 3 cycles to the strain required to produce
0.05 MPa ligament stress. Load-displacement data for
each specimen were taken from at least the third cycle
of loading.29
An FE model was created with commercial soft-
ware (Cosmos/M, version 2.5, Structural Research and
Analysis, Los Angeles, Calif) for each transverse sec-
tion, based on the measured dimensions (Fig 3, A).
Symmetry of the root about the long axis was assumed
Fig 1. A, Isometric view of transverse section of tooth,
in these axisymmetric models. Mechanical properties
PDL, and bone of harvested mandibular premolar. B, for dentin and bone were taken from previous FE
Example of digital photograph of specimen from which studies12 (Table I). Nonlinear mechanical properties
PDL and tooth dimensions were measured. were assigned to the FE model of the PDL based on our
experimental data of applied load as a function of tooth
displacement.29 A detailed explanation of how the
elastic modulus and Poisson’s ratio on the center of nonlinear mechanical properties were developed is
rotation of a canine.9 provided in the Appendix. The FE prediction of load
Recently, we quantified nonlinear elastic and aniso- and displacement were compared for each transverse
tropic stress-strain behavior of the PDL of cadaveric specimen (Fig 3, B), thereby validating the assigned
mandibular premolars for low force.29 In this study, we nonlinear mechanical properties.
sought to incorporate this experimental data of PDL Two-dimensional plane-strain FE models of the
geometry and nonlinear stress-strain characteristics as intact mandibular premolar were then constructed (Fig
input to an FE model of a tooth, ligament, and bone 4) by stacking the models of the transverse sections of
structure to compare stresses and deformations with tooth, PDL, and bone. One model had a nonuniform
models of uniform PDL thickness and linear mechani- PDL thickness based on the geometry of the cadaveric
cal properties. specimen. The PDL thickness was 0.291 mm at the
lingual and buccal cervical margins, 0.204 mm at
MATERIAL AND METHODS midroot, and 0.300 mm at the apex. A second model
A mandibular premolar from a 24-year-old male was developed that had a PDL of uniform (250 ␮m)
cadaver was sliced transversely into sections approxi- thickness, as assumed by other investigators.7,8,30 The
mately 0.85 mm thick (Fig 1, A).29 Digital photographs models had 1674 eight-node quadrilateral elements and
of the specimens (Fig 1, B) were taken from apical and 5205 nodes, with a high density of elements in the PDL,
coronal views, from which tooth perimeter (P) and PDL where large displacement gradients were anticipated.
dimensions were measured with Sigma Scan 4.0 soft- Either linear or nonlinear mechanical properties
ware (Jandel, Chicago, Ill). PDL thickness (WL) for were assigned to the PDL. Linear mechanical proper-
each view was taken as the average of 8 evenly spaced ties of the PDL were calculated as the secant modulus
measurements around the perimeter. Specimen thick- of the elastic stress-strain curves at 0.05 MPa stress for
American Journal of Orthodontics and Dentofacial Orthopedics Toms and Eberhardt 659
Volume 123, Number 6

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

Finite element models included in the


Table II.
parametric analysis of stresses in periodontal
ligament of a mandibular premolar
Study Load Description

Linear/uniform Extrusive Linear elastic PDL,


uniform PDL
thickness (0.25 mm)
Linear/nonuniform Extrusive Linear elastic PDL,
nonuniform PDL
thickness
Nonlinear/Extrusion Extrusive Nonlinear elastic PDL,
nonuniform PDL
thickness
Nonlinear/Tipping Tip Nonlinear elastic PDL,
nonuniform PDL
thickness

vical margin, apex, and buccocervical margin were


plotted (Fig 6) for the uniform and nonuniform thick-
ness models. At all locations, the stress distributions
across the PDL for the uniform thickness model were
similar to the distributions for the nonuniform thickness
Fig 4. Two-dimensional FE model of mandibular premo- model; however, the curves were not coincident. The
lar subjected to extrusive or tipping orthodontic loading at average stresses across the PDL space were calculated
occlusogingival midpoint on buccal (B) aspect of crown.
(Table III). The average difference in P1 was calculated
PDL thickness in this parametric analysis was either
0.25-mm uniform thickness or nonuniform (not shown).
to be between 17.25% and 35.27% for the 3 regions.
Mechanical properties (MP) of PDL depended on ana- The average difference in P3 varied from 14.14% to
tomic location. Buccocervical margin (BCM), linguocervi- 44.49%, and von Mises varied from 18.05% to 26.63%.
cal margin (LCM), and apex areas are identified. Substantial differences were found in P1 at the lingual
cervical margin (35.27%), in the von Mises stresses at
the apex (26.63%), and in P3 at the buccocervical
measure of 3-dimensional distortional stress) in the margin (44.49%).
center of the PDL as predicted by the models. In The nonlinear, nonuniform model with an extrusive
addition, instantaneous centers of rotation of the man- load predicted the highest P1 stresses at the apex (111
dibular premolar were calculated for each 0.1-N incre- kPa), but much smaller magnitudes (⬍26.4 kPa) for the
ment of loading, as done previously.13 midroot and cervical margin locations on both buccal
and lingual aspects (Fig 5, A). The P3 stresses were
RESULTS lowest at the linguocervical margin (7.98 kPa) (Fig 5,
For the cases of extrusion, maximum principal B). The von Mises stresses were highest at the apex
stresses (P1) and minimum principal stresses (P3) for (29.3 kPa) and near zero in the midroot regions;
the uniform and nonuniform linear models followed however, they increased at the buccocervical margin
similar curves for all regions along the root. As indi- (8.99 kPa) and linguocervical margin (3.82 kPa) (Fig 5,
cated in Figure 5, A, P1 values were less than 38.6 kPa C).
at all locations and were highest at the apex. P3 values The nonlinear, nonuniform model with a tipping
were likewise lowest at the linguocervical margin load predicted the greatest P1 stresses at the buccocer-
(⫺11.6 kPa) (Fig 5, B). The von Mises stress curves vical margin (73.5 kPa) (Fig 5, A). The model predicted
were similar for the uniform and nonuniform thickness the lowest P3 stresses immediately adjacent to the apex
models; however, the peak stresses occurred approxi- on the buccal side (⫺117 kPa) and at the linguocervical
mately midroot on the buccal aspect (17.7 kPa for margin (⫺71.5 kPa) (Fig 5, B). The von Mises stresses
nonuniform and 14.8 kPa for uniform thickness) (Fig 5, were greatest at the lingual and buccocervical margins
C). (24.9 kPa) (Fig 5, C).
Stresses (P1, P3, and von Mises) across the PDL The instantaneous center of rotation (ICR) for the
thickness from the tooth to the bone at the linguocer- linear, nonuniform model was located on the midline of
American Journal of Orthodontics and Dentofacial Orthopedics Toms and Eberhardt 661
Volume 123, Number 6

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

P1 P3 von Mises P1 P3 von Mises P1 P3 von Mises

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

All stresses are expressed as kPa.

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
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June 2003

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American Journal of Orthodontics and Dentofacial Orthopedics Toms and Eberhardt 665
Volume 123, Number 6

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