Effect of Orthodontic Bracket Type and Mouthguard Presence on the Stress and Strain during a Frontal Impact.

Júlio César De Carvalho Alves,Antheunis Versluis,Carlos José Soares,Gilberto Antônio Borges,Crisnicaw Veríssimo

doi:10.1590/0103-6440202002818

Abstract

The aim of this study was to analyze the influence of orthodontic bracket type (metallic or ceramic) and mouthguard on biomechanical response during impact. Two-dimensional plane-strain models of a patient with increased positive overjet of the maxillary central incisor was created based on a CT scan, simulating the periodontal ligament, bone support, gingival tissue, orthodontic brackets (metallic or ceramic) and mouthguard. A nonlinear dynamic impact finite element analysis was performed in which a steel object hit the model at 1 m/s. Stress distributions (Von Mises and Modified Von Mises) and strain were evaluated. Stress distributions were affected by the bracket presence and type. Models with metallic and ceramic bracket had higher stresses over a larger buccal enamel impact area. Models with ceramic brackets generated higher stresses than the metallic brackets. Mouthguards reduced the stress and strain values regardless of bracket type. Mouthguard shock absorption were 88.37% and 89.27% for the metallic and ceramic bracket, respectively. Orthodontic bracket presence and type influenced the stress and strain generated during an impact. Ceramic brackets generated higher stresses than metallic brackets. Mouthguards substantially reduced impact stress and strain peaks, regardless of bracket type.

Highlights

IntroductionSome studies showed that there is a higher risk for dental traumas in patients with malocclusions that are undergoing orthodontic treatment [2]
Dental and oral facial injuries are common during sports practice [1]
In the dentin structure there was no substantial effect for the bracket presence/type (Fig. 4)

Summary

Introduction

Some studies showed that there is a higher risk for dental traumas in patients with malocclusions that are undergoing orthodontic treatment [2]. Class II malocclusions with positive overjet are more susceptible to sustain dental injuries because of the maxillary incisor protrusion [3,4]. These malocclusions or skeletal deformities are associated and can be classified into two clinically relevant subgroups: A) Anterior projection of the maxillary teeth (Overjet); and B) Relationship of discrepancy between the maxillary bones (maxilla and jaw) [5]. Maxillary protrusions are associated with inadequate or poor lip coverage that increases the risk for anterior dental trauma. It is reported that an overjet larger than 6 or 7 mm increases the risk for dental trauma, and when the overjet is more than 6 mm, frequently the consequences of the dental trauma are more severe [5]

Objectives

Methods

Results

Conclusion