The effects of material and structural properties of the periodontal ligament in mechanical function of tooth-PDL-bone complex in dental trauma: A sensitivity study using finiteelement analysis.

Periodontal ligament (PDL) plays a crucial role in transferring load from tooth to its adjacent bone, and its role is more pronounced in case of trauma, due to its shock-absorbing character, which has not been fully understood yet. Different constitutive models have correlated mechanical function of PDL with its anisotropic, inhomogeneous, non-linear elastic nature, and it was variably modeled using Finite Element (FE) simulations of dental trauma. Furthermore, since capturing accurate dimension of PDL is difficult, various thicknesses were considered for PDL in FE reconstruction process. In this study, the sensitivity of FE analyses to variation in mechanical properties, including a large range of elastic properties for a linear elastic model, also a hyper-elastic material model, and various thicknesses of PDL was investigated by developing a CT-based FE model of tooth-PDL-bone complex. Results of this study highlighted the crucial role of PDL in absorption and dissipation of energy, as well as in stress distribution within alveolar bone during dental trauma. It was observed that as Young's modulus of PDL decreases and its thickness increases, its shock-absorbing capacity would be escalated. Moreover, it was found that inclusion of PDL reduces the maximum von Mises stress exerted on the alveolar bone by about 60% in some areas, compared to the case in which the PDL is absent. Results of this work underscore the need of presenting comprehensive constitutive models to describe mechanical behavior of PDL, with the goal of understanding the behavior of a tooth-PDL-bone complex in pathological conditions, such as trauma.