Influence of impacted canines on the stress distribution during dental trauma with and without a mouthguard.

Abstract

Maxillary canines have a high incidence of impaction which may be associated with unexpected damage during maxillofacial trauma. The aim of this study was to evaluate how an impacted canine could influence the stress distribution in the dentoalveolar complex during a simulated impact before and after surgical removal plus the protective effect offered by a mouthguard. Cross-sectional finite element models of the central incisor and support structures of a patient with an impacted canine in a transverse position were made using ImageJ and Marc/Mentat software. The following impact conditions were simulated: (a) incisor with impacted canine; (b) incisor with surgical socket after impacted canine extraction; and (c) incisor after bone healing. The impacts were also simulated with a 3mm custom-fitted ethylene vinyl acetate mouthguard. A non-linear dynamic impact finite element analysis was performed in which a rigid object hit the model at 1m/s. Maximum and minimum principal stresses as well as von Mises stresses were analyzed. Higher values of compressive and tensile stresses occurred on the cortical bone in the models after impacted canine extraction. The highest stress concentrations in the enamel and dentin structures were observed after bone healing. The mouthguard reduced the stress in the alveolar bone and dental structures. Use of mouthguards during impact reduced the compressive and tensile stresses in the alveolar bone, mainly in the fragile regions of the impacted canine or surgical socket.