Tooth displacement in shortened dental arches: a three-dimensional finite element study.

STATEMENT OF PROBLEM: Some patients may opt for a prosthetic rehabilitation without replacing all missing teeth, finishing treatment with a reduced dental arch. This choice may be due to biologic reasons or financial restrictions. It is unclear if a reduced dental arch functions as well as a complete dental arch. PURPOSE: The purpose of this study was to analyze whether shortened dental arches could result in tooth displacement. MATERIAL AND METHODS: Four different 3-dimensional maxillary and mandibular arches with different levels of arch length reduction were created. In all models, anatomic structures that represent the temporomandibular joint, cortical and cancellous bone, enamel, dentin, and periodontal ligament were modeled. Mechanical properties were attributed to each anatomic component, and a total occlusal load of 100 N on masseter, temporal, and medial pterygoid muscles was simulated for each model. The MSC. Patran software was used for the preprocessing and postprocessing of the biomechanical analysis of the models. One complete dental arch was used as the control. RESULTS: The simulations showed that shortened dental arches presented greater tooth displacements than those found in a complete dental arch. The changes in mandibular tooth position were greater than those observed in the maxillary arches. In finite element models 1 and 2, the largest maxillary displacements were found for posterior teeth. CONCLUSIONS: Decreasing numbers of occlusal units resulted in increasing amounts of displacements of the remaining teeth, which may compromise dental stability in patients with shortened dental arches.

Influence of the expansion screw height on the dental effects of the hyrax expander: a study with finite elements.

INTRODUCTION: Our objective was to evaluate the influence of the expansion screw height of a hyrax expander on the degree of dental inclination during rapid maxillary expansion by using the finite element method. METHODS: The hyrax expander and the maxillary arch were modeled by using Solidworks software (Dassault Systèmes, Paris, France). Three distinct finite element method models were created by simulating different screw heights relative to the plane that intersected the center of resistance of the maxillary first molars. These 3 relative positions were 10 mm below the maxillary first molars' center of resistance, at the same level as the maxillary first molars' center of resistance, and 10 mm above the maxillary first molars' center of resistance. The initial activation of the expanders was simulated, and tooth displacements for each finite element method model were registered in the buccolingual, corono-apical, and mesiodistal directions. RESULTS: The simulations tested showed that the 3 hyrax screw heights had different dental tipping tendencies. When the screw was simulated below the maxillary first molars' center of resistance, buccal tipping of the crowns and lingual tipping of the roots were registered. This tendency decreased when the screw was simulated at the same level as the maxillary first molars' center of resistance. However, when the screw was simulated above the maxillary first molars' center of resistance, the tipping tendency was inverted, with the crowns displaying lingual tipping and the roots displaying buccal tipping. CONCLUSIONS: These findings might explain the importance of carefully planning the height of the hyrax expander screw, since, depending on this position, different tooth movements can be achieved. From an orthopedic perspective, the ideal screw position might be slightly above the maxillary first molars' center of resistance; this would generate less dental tipping.

Stress patterns on implants in prostheses supported by four or six implants: a three-dimensional finite element analysis.

PURPOSE: Using the three-dimensional finite element method (FEM), this study compared the biomechanical behavior of the "All-on-Four" system with that of a six-implant-supported maxillary prosthesis with tilted distal implants. The von Mises stresses induced on the implants under different loading simulations were localized and quantified. MATERIALS AND METHODS: Three-dimensional models representing maxillae restored with an "All-on-Four" and with a six-implant-supported prosthesis were developed in three-dimensional design software and then transferred into FEM software. The models were subjected to four different loading simulations (full mouth biting, canine disclusion, load on a cantilever, load in the absence of a cantilever). The maximum von Mises stresses were localized and quantified for comparison. RESULTS: In both models, in all loading simulations, the peak stress points were always located on the neck of the distal tilted implant. The von Mises stress values were higher in the "All-on-Four" model (7% to 29%, higher, depending on the simulation). In the presence of a cantilever, the maximum von Mises stress values increased by about 100% in both models. CONCLUSIONS: The stress locations and distribution patterns were similar in the two models. The addition of implants resulted in a reduction of the maximum von Mises stress values. The cantilever greatly increased the stress.