Moga Radu-Andrei, Olteanu Cristian Doru, Delean Ada Gabriela
Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Motilor 33, 400001 Cluj-Napoca, Romania.
Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania.
J Clin Med. 2024 Nov 22;13(23):7062. doi: 10.3390/jcm13237062.
: This study assessed the biomechanical behavior of dental pulp and the neuro-vascular bundle/NVB as well as the ischemic risks during orthodontic movements in a gradual horizontal periodontal breakdown, using five methods and aiming to identify the most accurate one. : Seventy-two models of second lower premolar (from nine patients) were subjected to 3 N of intrusion, extrusion, rotation, tipping, and translation. Five numerical methods, Tresca, Von Mises/VM, Maximum and Minimum Principal, and hydrostatic pressure were used in a total of 1800 numerical simulations. The results were color-coded projections of the stress areas that were then correlated with maximum physiological hydrostatic pressure/MHP and known clinical biomechanical behavior. : During periodontal breakdown, all five methods displayed, for all movements, quantitative stresses lower than MHP, suggesting that 3 N are not inducing any local tissular ischemic risks for the healthy intact tissues. All five methods displayed rotation as the most stressful movement during periodontal breakdown, while translation was the least. The NVB was more exposed to ischemic risks than dental pulp during the periodontal breakdown due to constant tissular deformations. Only VM and Tresca methods showed translation as more prone to expose dental pulp (both coronal and radicular) to ischemic risks (than the other movements) during the periodontal breakdown simulation. However, all five methods showed intrusion and extrusion as more prone to expose the NVB to higher ischemic risks than the other movements during the periodontal breakdown simulation. : During periodontal breakdown, Tresca and Von Mises were more accurate, with Tresca being the most accurate of all.
本研究采用五种方法评估了在逐渐发生的水平牙周组织破坏过程中,牙髓和神经血管束/神经血管束(NVB)的生物力学行为以及正畸移动过程中的缺血风险,旨在确定最准确的方法。:对72个下颌第二前磨牙模型(来自9名患者)施加3N的压入、伸出、旋转、倾斜和平移力。总共进行了1800次数值模拟,使用了五种数值方法,即特雷斯卡(Tresca)、冯·米塞斯(Von Mises/VM)、最大和最小主应力以及静水压力。结果是应力区域的彩色编码投影,然后将其与最大生理静水压力/MHP和已知的临床生物力学行为相关联。:在牙周组织破坏过程中,所有五种方法对于所有移动所显示的定量应力均低于MHP,这表明3N的力不会对健康完整的组织造成任何局部组织缺血风险。在牙周组织破坏过程中,所有五种方法都显示旋转是最具压力的移动,而平移是压力最小的。由于组织持续变形,在牙周组织破坏过程中,神经血管束比牙髓更容易面临缺血风险。在牙周组织破坏模拟过程中,只有VM和特雷斯卡方法显示平移比其他移动更容易使牙髓(冠部和根部)面临缺血风险。然而,在牙周组织破坏模拟过程中,所有五种方法都显示压入和伸出比其他移动更容易使神经血管束面临更高的缺血风险。:在牙周组织破坏过程中,特雷斯卡和冯·米塞斯方法更准确,其中特雷斯卡方法是所有方法中最准确的。