Fenestration and Dehiscence in Human Maxillary Alveolar Bone: An In Silico Study Using the Finite Element Method.

Abstract

Fenestration and dehiscence are alveolar bone defects. Although not considered a pathology, these alveolar bone defects end up influencing dental treatment, such as surgeries, mainly periodontal, and therefore must be considered during treatment planning. However, currently, little is known about the biomechanical origin of these bone formations. The aim of the study was to use the finite element method (FEM) to test hypotheses of predictive factors for fenestrations and dehiscence in human alveolar bone. A FEM simulation of the action of functional, parafunctional, and orthodontic occlusal loads on the upper central incisor and upper canine was performed. For the simulation, a three-dimensional model of an adult human skull, fully dented and with intact bone structure, was constructed from computed tomography images. The buccal alveolar bone lamina was evaluated considering the calculation of equivalent stresses, as well as maximum principal stresses. The action of functional and parafunctional forces on the incisal edges and the orthodontic force on the buccal face of the upper central incisor and upper canine teeth generated tensions at different levels of magnitude in the buccal bone lamina, varying in regions, at all levels of strength. Changing levels of force magnitude resulted in variations in relation to the level of deformation. The computational simulation using the FEM was able to identify a difference in stress in the alveolar bone tissue in each of the applied forces. The difference in stresses obtained may suggest the formation of dehiscence or fenestration in the region studied.