Cortical and Trabecular Bone Stress Assessment during Periodontal Breakdown-A Comparative Finite Element Analysis of Multiple Failure Criteria.

Background and Objectives: This numerical analysis investigated the biomechanical behavior of the mandibular bone as a structure subjected to 0.5 N of orthodontic force during periodontal breakdown. Additionally, the suitability of the five most used failure criteria (Von Mises (VM), Tresca (T), maximum principal (S1), minimum principal (S3), and hydrostatic pressure (HP)) for the study of bone was assessed, and a single criterion was identified for the study of teeth and the surrounding periodontium (by performing correlations with other FEA studies). Materials and Methods: The finite element analysis (FEA) employed 405 simulations over eighty-one mandibular models with variable levels of bone loss (0-8 mm) and five orthodontic movements (intrusion, extrusion, tipping, rotation, and translation). For the numerical analysis of bone, the ductile failure criteria are suitable (T and VM are adequate for the study of bone), with Tresca being more suited. S1, S3, and HP criteria, due to their distinctive design dedicated to brittle materials and liquids/gas, only occasionally correctly described the bone stress distribution. Results: Only T and VM displayed a coherent and correlated gradual stress increase pattern for all five movements and levels of the periodontal breakdown. The quantitative values provided by T and VM were the highest (for each movement and level of bone loss) among all five criteria. The MHP (maximum physiological hydrostatic pressure) was exceeded in all simulations since the mandibular bone is anatomically less vascularized, and the ischemic risks are reduced. Only T and VM displayed a correlated (both qualitative and quantitative) stress increase for all five movements. Both T and VM displayed rotation and translation, closely followed by tipping, as stressful movements, while intrusion and extrusion were less stressful for the mandibular bone. Conclusions: Based on correlations with earlier numerical studies on the same models and boundary conditions, T seems better suited as a single unitary failure criterion for the study of teeth and the surrounding periodontium.

Effects of Increasing the Orthodontic Forces over Cortical and Trabecular Bone during Periodontal Breakdown-A Finite Elements Analysis.

Background and Objectives: Herein we used numerical analysis to study different biomechanical behaviors of mandibular bone subjected to 0.6 N, 1.2 N, and 2.4 N orthodontic loads during 0-8 mm periodontal breakdown using the Tresca failure criterion. Additionally, correlations with earlier FEA reports found potential ischemic and resorptive risks. Materials and Methods: Eighty-one models (nine patients) and 243 simulations (intrusion, extrusion, rotation, tipping, and translation) were analyzed. Results: Intrusion and extrusion displayed after 4 mm bone loss showed extended stress display in the apical and middle third alveolar sockets, showing higher ischemic and resorptive risks for 0.6 N. Rotation, translation, and tipping displayed the highest stress amounts, and cervical-third stress with higher ischemic and resorptive risks after 4 mm loss for 0.6 N. Conclusions: Quantitatively, rotation, translation, and tipping are the most stressful movements. All three applied forces produced similar stress-display areas for all movements and bone levels. The stress doubled for 1.2 N and quadrupled for 2.4 N when compared with 0.6 N. The differences between the three loads consisted of the stress amounts displayed in color-coded areas, while their location and extension remained constant. Since the MHP was exceeded, a reduction in the applied force to under 0.6 N (after 4 mm of bone loss) is recommended for reducing ischemic and resorptive risks. The stress-display pattern correlated with horizontal periodontal-breakdown simulations.

Overall stress in periodontal ligament under orthodontic movement during a periodontal breakdown.

INTRODUCTION: This research aimed to assess qualitatively and quantitatively the overall stress in the periodontal ligament during gradual periodontal breakdown (0-8 mm) under orthodontic movements. Correlations between the applied forces, the level of bone loss, the decrease of force magnitude, and the increase of stress were also assessed. METHODS: On the basis of cone-beam computed tomography examinations (voxel size, 0.075 mm), nine 3-dimensional models of a mandibular second premolar with intact periodontium were created and then individually subjected to various levels of horizontal bone loss. Orthodontic forces (intrusion at 0.2 N; extrusion, rotation, and tipping at 0.6 N; translation at 1.2 N) were applied on the brackets. Finite elements analysis was performed, and von Mises (VM) stresses were quantitatively and qualitatively determined. RESULTS: Rotation and translation induced the highest stress apically and cervically, whereas intrusion determined the lowest. Apical stress was lower than cervical stress. In intact periodontium, VM stress was under maximum hydrostatic pressure (MHP) and maximum tolerable stress (MTS). In reduced periodontium, VM stress was lower apically than MHP, whereas cervically, the rotation, translation, and tipping exceeded MHP. CONCLUSIONS: A force of 1.2 N seemed safe to be used in the intact periodontium. Forces higher than 0.6 N could produce stresses exceeding MHP and MTS endangering the reduced periodontium. VM stress failure criterion (despite its limited use) seemed to be more adequate for accurate quantitative results. An overall correlation between the applied force, VM stress increase, and periodontal breakdown applicable to all 5 movements could not be established. This was possible only for individual movements.

Compressive stress in periodontal ligament under orthodontic movements during periodontal breakdown.

INTRODUCTION: This analysis aimed to assess quantitatively and qualitatively the compressive stress (S3) in periodontal ligament in a gradual periodontal breakdown (0-8 mm) under orthodontic movements. Correlations between the applied forces, the level of bone resorption, the decrease of force magnitude, and S3 increase were also conducted. METHODS: On the basis of cone-beam computed tomography examinations (voxel size, 0.075 mm), nine 3-dimensional models of the second mandibular premolar with intact periodontium were created and then individually subjected to various levels of horizontal bone loss. Orthodontic forces (intrusion: 0.2 N; extrusion, rotation, tipping: 0.6 N; translation: 1.2 N) were applied on the brackets. Finite elements analysis was performed, and S3 stresses were quantitatively and qualitatively determined. RESULTS: Translation and rotation induced the highest stress apically and cervically, whereas intrusion determined the lowest. Apical stress was lower than cervical stress. In intact periodontium, only intrusion and extrusion exhibited S3 stresses lower (apically and cervically) than maximum hydrostatic pressure (MHP) and maximum tolerable stress (MTS). In reduced periodontium, S3 stress (except for intrusion) exceeded MHP and MTS. CONCLUSIONS: In reduced periodontium, forces of 0.2 N seems safe to be used. Forces of 0.6-1.2 N may produce stresses exceeding both MTS and MHP, endangering the periodontium. S3 failure criterion (despite its widely use) seems not to be adequate for accurate quantitative results when evaluating the stress in the periodontal ligament while remaining adequate for qualitative results. An overall correlation between the applied force, S3 increase, and periodontal breakdown applicable to all 5 movements could not be established-this was possible only for sole movements.

Finite element analysis of the dental pulp under orthodontic forces.

INTRODUCTION: To evaluate the stress at the apical third of the pulp and neurovascular bundle (NVB) during 5 types of orthodontic movement at different levels of bone loss. Furthermore, correlations among bone loss, orthodontic appliances, and stress increase were assessed. METHODS: Based on cone-beam computed tomography datasets, 10 models of the mandibular second premolar were created. Each of these models was subjected to a gradual horizontal bone loss simulation (0-8 mm). Orthodontic forces of 20 g, 60 g, and 120 g were applied during the finite element analysis (FEA). For each bone loss level, stress values were evaluated with the use of Abaqus at the apical third of the pulp and the NVB. RESULTS: The stress manifested at the apical third of the pulp was smaller than that at the NVB. The highest apical NVB stress was found for rotation (0.000546 N/mm2 for 8 mm bone loss) whereas the lowest stress resulted after translational movements (2.35E-04 MPa for 8 mm bone loss). The FEA showed that Proffit's indicated orthodontic forces did not significantly disturb the pulpal blood flow and damage the apical NVB. Up to a doubling of the NVB stress, bone loss correlated with the force reduction to obtain similar stress levels compared with teeth with no bone loss. CONCLUSIONS: The present findings indicate that the stress manifested at the apical third of the pulp is smaller than that at NVB. Rotational movements induce the highest stress and translational forces develop the lowest stress related to the physiologic capillary blood pressure. Furthermore, in situations with reduced periodontium, lower forces are needed to reach the maximum tolerable stress compared with teeth with intact periodontium.

The influence of halogen substituents on the biological properties of sulfur-containing flavonoids.

A series of halogen-substituted tricyclic flavonoids containing a 1,3-dithiol-2-ylium moiety has been synthesized from the corresponding 3-dithiocarbamic flavanones. The influence of halogen substituents on the antibacterial properties of the tricyclic flavonoids has been investigated against Staphylococcus aureus and Escherichia coli. On going from fluorine to iodine, these compounds exhibit good to excellent inhibitory properties against both Gram-positive and Gram-negative pathogens. These results suggest that size is the main factor for the change in potency rather than polarity/electronics.

Antibacterial structure-activity relationship studies of several tricyclic sulfur-containing flavonoids.

A structure-activity relationship study concerning the antibacterial properties of several halogen-substituted tricyclic sulfur-containing flavonoids has been performed. The compounds have been synthesized by cyclocondensation of the corresponding 3-dithiocarbamic flavanones under acidic conditions. The influence of different halogen substituents on the antibacterial properties has been tested against Staphylococcus aureus and Escherichia coli. Amongst the N,N-dialkylamino-substituted flavonoids, those having an N,N-diethylamino moiety exhibited good to excellent antimicrobial properties against both pathogens. Fluorine-substituted flavonoids were found to be less active than those bearing other halogen atoms.

The antibacterial properties of sulfur containing flavonoids.

Some dithiocarbamic esters bearing a flavanone backbone, as well as their corresponding 1,3-dithiolium salts were tested against Staphylococcus aureus and Escherichia coli. The 1,3-dithiolium tricyclic flavonoids display good inhibitory properties against both Gram-positive and Gram-negative pathogens.

Simulation analysis of non-respondent information in context of small domain.

In the real-world, there are various situations when all units are not accessible of the respondent called unit non-response. The effect of unit non-response is a tricky matter for estimating the total number of unit. The present work highlights the interest about subpopulations (domains) in two affairs: i. if domains total of the supportive information is accessible ii. if domains total of the supportive variable does not access. The government needs to be introducing the actual facilities in these small domains. The supportive information is used to find out the estimate of the non respondent information and to apply this information for desired domains. Sometimes, it has been found that the accessible auxiliary variable for the domains might be positive shape. Therefore, it develops an appropriate model that has positive skewness. The present context highlighted the indirect method using a power-based estimation with calibration approach. By combining power based estimation and calibration technique, it is possible to obtain more accurate estimates for intended small domains. Even the supportive information is positively biased. This approach helps us in mitigating the effect of non-respondent and improving the overall reliability of the estimators. The simulation was conducted for different sizes 70 and 90 when nonresponse variable in the study variable. The results show that investigated power-based estimate provides better option over relevant exponential, ratio, and generalized regression estimators for intended domains.

An Eco-Friendly Method to Synthesize Potent Antimicrobial Tricyclic Flavonoids.

The rapid emergence and spread of multidrug-resistant microorganisms is threatening our ability to treat common infections, with serious medical, social, and economic consequences. Despite substantial progress in the global fight against antibiotic resistance, the number of effective antibiotics is rapidly decreasing, underlying the urgent need to develop novel antimicrobials. In the present study, the green synthesis of novel iodine-substituted tricyclic flavonoids has been accomplished using an eco-friendly reagent, HPW-SiO2, as a cyclization agent for the precursor 3-dithiocarmamic flavanones. In vitro antimicrobial activity of the new compounds was evaluated using minimum inhibitory concentration (MIC) and minimum bactericidal/fungicidal concentrations. All tested compounds displayed potent inhibitory activity against all tested microbial strains, with the lowest MIC values of 0.12 µg/mL and 0.48 µg/mL recorded for compound 5c against Gram-positive bacteria Bacillus subtilis and Staphylococcus aureus. Higher MIC values (7.81 µg/mL) were registered for several flavonoids against Gram-negative bacteria Escherichia coli and Acinetobacter pittii. No inhibitory activity was evidenced against Pseudomonas aeruginosa strain. The highest antifungal activity was displayed by flavonoid 5d against Candida krusei (MIC = 3.9 µg/mL). The same compound also exhibited the most potent bactericidal and fungicidal activity against Bacillus subtilis (0.9 µg/mL) and Staphylococcus aureus (1.97 µg/mL), Candida albicans, and Candida krusei (7.81 µg/mL). Based on the reported results, we believe that the novel iodine-substituted tricyclic flavonoids have good potential to become new antimicrobial agents effective against bacterial and fungal strains, including WHO-priority pathogens.

Antibacterial activities of the methanol extracts of ten Cameroonian vegetables against Gram-negative multidrug-resistant bacteria.

BACKGROUND: Many edible plants are used in Cameroon since ancient time to control microbial infections. This study was designed at evaluating the antibacterial activities of the methanol extracts of ten Cameroonian vegetables against a panel of twenty nine Gram negative bacteria including multi-drug resistant (MDR) strains. METHODS: The broth microdilution method was used to determine the Minimal Inhibitory Concentrations (MIC) and the Minimal Bactericidal Concentrations (MBC) of the studied extracts. When chloramphenicol was used as a reference antibiotic, the MICs were also determined in the presence of Phenylalanine-Arginine ß-Naphtylamide (PAßN), an efflux pumps inhibitor (EPI). The phytochemical screening of the extracts was performed using standard methods. RESULTS: All tested extracts exhibited antibacterial activities, with the MIC values varying from 128 to 1024 mg/L. The studied extracts showed large spectra of action, those from L. sativa, S. edule, C. pepo and S. nigrum being active on all the 29 bacterial strains tested meanwhile those from Amaranthus hybridus, Vernonia hymenolepsis, Lactuca.carpensis and Manihot esculenta were active on 96.55% of the strains used. The plant extracts were assessed for the presence of large classes of secondary metabolites: alkaloids, anthocyanins, anthraquinones, flavonoids, phenols, saponins, steroids, tannins and triterpenes. Each studied plant extract was found to contain compounds belonging to at least two of the above mentioned classes. CONCLUSION: These results confirm the traditional claims and provide promising baseline information for the potential use of the tested vegetables in the fight against bacterial infections involving MDR phenotypes.

In vitro antibacterial and antibiotic-potentiation activities of four edible plants against multidrug-resistant gram-negative species.

BACKGROUND: The present study was designed to investigate the antibacterial activities of the methanol extracts of four Cameroonian edible plants, locally used to treat microbial infections, and their synergistic effects with antibiotics against a panel of twenty nine Gram-negative bacteria including Multi-drug resistant (MDR) phenotypes expressing active efflux pumps. METHODS: The broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of the extracts [alone and in the presence of the efflux pumps inhibitor (EPI) Phenylalanine-Arginine ß-Naphtylamide (PAßN)], and those of antibiotics in association with the two of the most active ones, Piper nigrum and Telfairia occidentalis. The preliminary phytochemical screening of the extracts was conducted according to the standard phytochemical methods. RESULTS: Phytochemical analysis showed the presence of alkaloids and flavonoids in all studied extracts. Other chemical classes of secondary metabolites were selectively present in the extracts. The results of the MIC determination indicated that the crude extracts from P. nigrum and V. amygdalina were able to inhibit the growth of all the twenty nine studied bacteria within a concentration range of 32 to 1024 µg/mL. At a similar concentration range (32 to 1024 µg/mL) the extract from T. occidentalis inhibited the growth of 93.1% of the tested microorganisms. At MIC/2 and MIC/5, synergistic effects were noted between the extracts from P. nigrum and T. occidentalis and seven of the tested antibiotics on more than 70% of the tested bacteria. CONCLUSION: The overall results of the present study provide information for the possible use of the studied edible plants extracts in the control of bacterial infections including MDR phenotypes.

A Novel Risk Calculator to Predict Erectile Dysfunction in HIV-Positive Men.

HIV infection is considered to be a lifelong medical condition, requiring follow-up and treatment for decades. HIV-positive men are reported to have erectile dysfunction more often than age-matched healthy controls, and improving sexuality is known to potentially improve overall health-related quality of life. The aim of this paper is to evaluate the presence of ED in HIV-positive men and the associated contributing factors and to create a statistical model to assess the risk to develop ED in this population. In a prospective study, we analyzed a group of HIV-positive men in a cross-sectional manner, looking at demographics, blood test results, and smoking habits. Data were statistically analyzed using the Kruskal-Wallis test. In our series, the overall incidence of ED was 48.5%, increasing with age. Our analysis showed no correlation with blood sugar level, but a very strong correlation with total serum lipids. We were able to develop and validate a risk calculator for ED in HIV-positive men.

Assessment of the Maximum Amount of Orthodontic Force for Dental Pulp and Apical Neuro-Vascular Bundle in Intact and Reduced Periodontium on Bicuspids (Part II).

This study examines 0.6 N-4.8 N as the maximum orthodontic force to be applied to dental pulp and apical NVB on intact and 1-8 mm reduced periodontal-ligament (PDL), in connection with movement and ischemic, necrotic and resorptive risk. In addition, it examines whether the Tresca finite-element-analysis (FEA) criterion is more adequate for the examination of dental pulp and its apical NVB. Eighty-one (nine patients, with nine models for each patient) anatomically correct models of the periodontium, with the second lower-premolar reconstructed with its apical NVB and dental pulp were assembled, based on X-ray CBCT (cone-beam-computed-tomography) examinations and subjected to 0.6 N, 1.2 N, 2.4 N and 4.8 N of intrusion, extrusion, translation, rotation, and tipping. The Tresca failure criterion was applied, and the shear stress was assessed. Forces of 0.6 N, 1.2 N, and 2.4 N had negligible effects on apical NVB and dental pulp up to 8 mm of periodontal breakdown. A force of 4.8 N was safely applied to apical NVB on the intact periodontium only. Rotation and tipping seemed to be the most invasive movements for the apical NVB. For the dental pulp, only the translation and rotation movements seemed to display a particular risk of ischemia, necrosis, and internal orthodontic-resorption for both coronal (0-8 mm of loss) and radicular pulp (4-8 mm of loss), despite the amount of stress being lower than the MHP. The Tresca failure criterion seems more suitable than other criteria for apical NVB and dental pulp.

Assessment of the Orthodontic External Resorption in Periodontal Breakdown-A Finite Elements Analysis (Part I).

This Finite Elements Analysis (FEA) assessed the accuracy of Tresca failure criteria (maximum shear stress) for the study of external root resorption. Additionally, the tooth absorption-dissipation ability was assessed. Overall, 81 models of the second mandibular premolar, out of a total of 324 simulations, were involved. Five orthodontic movements (intrusion, extrusion, rotation, translation, and tipping) were simulated under 0.6 N and 1.2 N in a horizontal progressive periodontal breakdown simulation of 0-8 mm. In all simulations, Tresca criteria accurately displayed the localized areas of maximum stress prone to external resorption risks, seeming to be adequate for the study of the resorptive process. The localized areas were better displayed in the radicular dentine-cementum component than in the entire tooth structure. The rotation and translation seem prone to a higher risk of external root resorption after 4 mm of loss. The resorptive risks seem to increase along with the progression of periodontal breakdown if the same amount of applied force is guarded. The localized resorption-prone areas follow the progression of bone loss. The two light forces displayed similar extensions of maximum stress areas. The stress displayed in the coronal dentine decreases along with the progression of bone loss. The absorption-dissipation ability of the tooth is about 87.99-97.99% of the stress.

Finite Elements Analysis of Tooth-A Comparative Analysis of Multiple Failure Criteria.

Herein Finite elements analysis (FEA) study assesses the adequacy and accuracy of five failure criteria (Von Mises (VM), Tresca, maximum principal (S1), minimum principal (S3), and Hydrostatic pressure) for the study of tooth as a structure (made of enamel, dentin, and cement), along with its stress absorption-dissipation ability. Eighty-one 3D models of the second lower premolar (with intact and 1-8 mm reduced periodontium) were subjected to five orthodontic forces (intrusion, extrusion, tipping, rotation, and translation) of 0.5 N (approx. 50 gf) (in a total of 405 FEA simulations). Only the Tresca and VM criteria showed biomechanically correct stress display during the 0-8 mm periodontal breakdown simulation, while the other three showed various unusual biomechanical stress display. All five failure criteria displayed comparable quantitative stress results (with Tresca and VM producing the highest of all), showing the rotational and translational movements to produce the highest amount of stress, while intrusion and extrusion, the lowest. The tooth structure absorbed and dissipated most of the stress produced by the orthodontic loads (from a total of 0.5 N/50 gf only 0.125 N/12.5 gf reached PDL and 0.01 N/1 gf the pulp and NVB). The Tresca criterion seems to be more accurate than Von Mises for the study of tooth as structure.

Assessment of the Maximum Amount of Orthodontic Force for PDL in Intact and Reduced Periodontium (Part I).

This study examines 0.6 N and 1.2 N as the maximum orthodontic force for periodontal ligament (PDL) at multiple levels of periodontal breakdown, and the relationships with the ischemic, necrotic, and resorptive risks. Additionally, this study evaluates if Tresca failure criteria is more adequate for the PDL study. Eighty-one 3D models (from nine patients; nine models/patients) with the 2nd lower premolar and different degrees of bone loss (0-8 mm) where subjected to intrusion, extrusion, rotation, translation, and tipping movements. Tresca shear stress was assessed individually for each movement and bone loss level. Rotation and translation produced the highest PDL stresses, while intrusion and extrusion determined the lowest. Apical and middle third PDL stresses were lower than the cervical stress. In intact periodontium, the amount of shear stress produced by the two investigated forces was lower than the 16 KPa of the maximum physiological hydrostatic pressure (MHP). In reduced periodontium (1-8 mm tissue loss), the apical amount of PDL shear stress was lower than MHP for both applied forces, while cervically for rotation, translation and tipping movements exceeded 16 KPa. Additionally, 1.2 N could be used in intact periodontium (i.e., without risks) and for the reduced periodontium only in the apical and middle third of PDL up to 8 mm of bone loss. However, for avoiding any resorptive risks, in the cervical third of PDL, the rotation, translation, and tipping movements require less than 0.2-0.4 N of force after 4 mm of loss. Tresca seems to be more adequate for the study of PDL than other criteria.

Orthodontic Internal Resorption Assessment in Periodontal Breakdown-A Finite Elements Analysis (Part II).

This finite elements analysis (FEA) assessed the accuracy of maximum shear stress criteria (Tresca) in the study of orthodontic internal surface resorption and the absorption-dissipation ability of dental tissues. The present study was conducted over eighty-one models totaling 324 simulations with various bone loss levels (0-8 mm), where 0.6 N and 1.2 N were applied in the intrusion, extrusion, rotation, tipping, and translation movements. Tresca criteria displayed localized high-stress areas prone to resorption for all situations, better visible in the dentine component. The internal resorptive risks are less than external ones, seeming to increase with the progression of the periodontal breakdown, especially after 4 mm. The internal and external surface high-stress areas are strictly correlated. The qualitative stress display for both forces was almost similar. The rotation and tipping displayed the highest resorptive risks for the pulp chamber, decreasing with bone loss. The resorptive risks seem to increase along with the progression of periodontal breakdown if the same applied force is kept. The dentine resemblance to ductile based on its high absorption-dissipation ability seems correct. Tresca seems to supply a better predictability of the prone-to-resorption areas than the other failure criteria.

Ultrasound markers in early diagnosis of asymptomatic chronic hepatitis. A prospective study.

Introduction: Nowadays, chronic viral hepatitis represents one of the most common pathological entities with over 400 million cases worldwide, with high diagnosis and treatment cost, severe complications in late stages and an annual death-rate around 1 million. The purpose of this study was to identify noninvasive ultrasound markers in order to establish an early diagnosis in asymptomatic chronic hepatitis. Methods: We enrolled in a prospective study 111 patients diagnosed with asymptomatic chronic hepatitis: 53 patients with hepatitis B (group A) and 58 patients with hepatitis C (group B). All patients underwent ultrasound exam; we evaluated the dimensions of the left hepatic lobe, right hepatic lobe, caudate lobe, portal vein, liver stiffness, presence of hepatic hilar lymph nodes, number and dimensions of the adenopathies. Results: Increased liver size was found in over 16% of patients in group A and over 20% of patients in group B. We registered an enlarged portal vein in 3.77% of patients in group A and in 3.45% of patients in group B. Adenopathies were found in 64.16% of group A and 82.76% of group B. Using long adenopathic axis as marker, we obtained a NPV over 0.9, PPV of 0.5 in the detection of chronic hepatitis B and a PPV of 0.9 in the detection of chronic hepatitis C in asymptomatic patients, a specificity of 0.98 for both chronic hepatitis B and C, a sensitivity of 0.81 for group B and 0.64 for group A. Conclusions: The presence of hilar liver adenopathies represents an important marker in detecting asymptomatic chronic viral hepatitis.

Assessment of the Best FEA Failure Criteria (Part II): Investigation of the Biomechanical Behavior of Dental Pulp and Apical-Neuro-Vascular Bundle in Intact and Reduced Periodontium.

The aim of this study was to biomechanically assess the behavior of apical neuro-vascular bundles (NVB) and dental pulp employing Tresca, Von Mises, Pressure, S1 and S3 failure criterions in a gradual periodontal breakdown under orthodontic movements. Additionally, it was to assess the accuracy of failure criteria, correlation with the maximum hydrostatic pressure (MHP), and the amount of force safe for reduced periodontium. Based on cone-beam computed tomography, 81 3D models of the second lower premolar were subjected to 0.5 N of intrusion, extrusion, rotation, tipping, and translation. A Finite Elements Analysis (FEA) was performed. In intact and reduced periodontium apical NVB, stress (predominant in all criteria) was significantly higher than dental pulp stress, but lower than MHP. VM and Tresca displayed identical results, with added pulpal stress in translation and rotation. S1, S3 and Pressure showed stress in the apical NVB area. 0.5 N seems safe up to 8 mm periodontal breakdown. A clear difference between failure criteria for dental pulp and apical NVB cannot be proved based only on the correlation quantitative results-MHP. Tresca and VM (adequate for ductile materials) showed equivalent results with the lowest amounts of stress. The employed failure criteria must be selected based on the type of material to be analyzed.