RESUMO
The periodontal biomechanical environment is very difficult to investigate. By the complex geometry and composition of the periodontal ligament (PDL), its mechanical behavior is very dependent on the type of loading (compressive versus tensile loading; static versus cyclic loading; uniaxial versus multiaxial) and the location around the root (cervical, middle, or apical). These different aspects of the PDL make it difficult to develop a functional biomaterial to treat periodontal attachment due to periodontal diseases. This review aims to describe the structural and biomechanical properties of the PDL. Particular importance is placed in the close interrelationship that exists between structure and biomechanics: the PDL structural organization is specific to its biomechanical environment, and its biomechanical properties are specific to its structural arrangement. This balance between structure and biomechanics can be explained by a mechanosensitive periodontal cellular activity. These specifications have to be considered in the further tissue engineering strategies for the development of an efficient biomaterial for periodontal tissues regeneration.
Assuntos
Ligamento Periodontal , Fenômenos BiomecânicosRESUMO
Anchorage devices are increasingly used in orthodontics, and their clinical performance is directly dependent on the tissue response to these devices. This study aims to identify assessment parameters for evaluating tissue reactions around orthodontically loaded implants and to propose parameters to be included in a standardized method. Several electronic databases (PubMed, ScienceDirect, the Cochrane database) were explored for papers from January 1999 to December 2009. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement was used as a guideline for the methodology of systematic reviews. Twenty-five publications were selected from 123 potentially relevant abstracts. The selected studies mainly aimed to answer a clinical question and particularly the ability of immediate loading in orthodontics. Very few studies aimed to understand the healing mechanism around the devices leading to a lack of information on this topic. The most frequent combination of assessment methods was clinical evaluation, histology/histomorphometry and intravital bone labeling. Although the dog model is mainly used, pigs represent an interesting animal model, especially when studying devices in growing bone. Despite the extensive use of miniscrews in growing individuals, only few studies have included young subjects in their protocol. Moreover, in such studies, an oral hygiene program is absolutely necessary to avoid complications. Finite element analysis could improve the knowledge of the relationship between design and bone reaction; unfortunately, this elaborated method is complex and impossible to perform routinely. For standardization, the authors recommend to include specific criteria in study protocols when assessing tissue response to orthodontically loaded devices.
