In silico study of cuspid' periodontal ligament damage under parafunctional and traumatic conditions of whole-mouth occlusions. A patient-specific evaluation

Abstract

Background and objectiveAlthough traumatic loading has been associated with periodontal ligament (PDL) damage and therefore with several oral disorders, the damage phenomena and the traumatic loads involved are still unclear. The complex composition and extremely thin size of the PDL make experimentation difficult, requiring computational studies that consider the macroscopic loading conditions, the microscopic composition and fine detailed geometry of the tissue. In this study, a new methodology to analyse the damage phenomena in the collagen network and the extracellular matrix of the PDL caused by parafunctional and traumatic occlusal forces was proposed. MethodsThe entire human mandible and a portion thereof containing a full cuspid tooth were separately modelled using finite element analysis based on computed tomography and micro-computed tomography images, respectively. The first model was experimentally validated by occlusion analysis and subjected to the muscle loads produced during hard and soft chewing, traumatic cuspid occlusion, grinding, clenching, and simultaneous grinding and clenching. The occlusal forces computed by the first model were subsequently applied to the single tooth model to evaluate damage to the collagen network and the extracellular matrix of the PDL. ResultsEarly occlusal contact on the left cuspid tooth guided the mandible to the more occluded side (16.5% greater in the right side) and absorbed most of the lateral load. The intrusive occlusal loads on the posterior teeth were 0.77–13.3% greater than those on the cuspid. According to our findings, damage to the collagen network and the extracellular matrix of the PDL could occur in traumatic and grinding conditions, mainly due to fibre overstretching (>60%) and interstitial fluid overpressure (>4.7 kPa), respectively. ConclusionsOur findings provide important biomechanical insights into the determination of damage mechanisms which are caused by mechanical loading and the key role of the porous-fibrous behaviour of the PDL in parafunctional and traumatic loading scenarios. Besides, the 3D loading conditions computed from occlusal contacts will help future studies in the design of new orthodontics appliances and encourage the application of computing methods in medical practice.