Effect of loaded orthodontic miniscrew implant on compressive stresses in adjacent periodontal ligament.

Abstract

To describe the relationship between the proximity of miniscrew implants (MSIs) to the periodontal ligament (PDL) and stress in the PDL under different load magnitudes and different bone properties. Sixteen subject-specific finite element models of the region of the maxillary first molar and second premolar were developed using computed tomography images of four patients. For each patient, an MSI surface model derived from micro-computed tomography was placed at four different distances from the premolar PDL. Finite element analysis was conducted with mesial load on the MSI, increasing from 1 N to 4 N. Peak absolute compression stress (CS) was calculated at each 1 N step. Stepwise multiple regression modeling was conducted to explain compressive stress by proximity, load magnitude, and bone properties. The multiple regression model explained 83.47% of the variation of CS and included all three factors: proximity, load magnitude, and bone properties. The model expected significant interaction between the bone properties and load magnitude, implying that strong bone properties could be associated with significant increases in CS at small increases in load. To ensure the safety of adjacent roots, MSIs should be placed at least 1 mm from the roots. Assessment of alveolar bone properties is recommended when the use of MSI is intended, as some patients may present with strong bone properties and thereby a high risk of MSI-induced root resorption.