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The Influence of PDL Principal Fibers in A 3-Dimensional Analysis of Orthodontic Tooth Movement
The Influence of PDL Principal Fibers in A 3-Dimensional Analysis of Orthodontic Tooth Movement
The effects of mechanical loads on the tooth-alveolus complex are of particular concern in orthodontics. The
concepts of center of resistance (CRes) and center of rotation (CRot) are used to characterize tooth
responses to orthodontic loads. The mechanical environment (stresses and strains) associated with
orthodontic tooth movement is a unique model in bone adaptation physiology. Numerous finite element
models of varying complexity have been developed to calculate tooth movements and stress distributions
within the alveolar bone and the periodontal ligament (PDL). In general, the PDL has been idealized as a
homogeneous isotropic material. For this project, a 3-dimensional tooth/PDL/mandible/finite element model
was developed in which, for the first time in such an analysis, the PDL’s principal-fiber structure was also
incorporated. Parametric analyses showed that the fiber orientation and the mechanical properties do not
exert much influence on the locations of the CRes and the CRot and on the stress patterns within the bone
and the PDL matrix. However, the absence of principal fibers produces not only different stress magnitudes,
but also differences in stress patterns. Furthermore, the no-fiber–associated CRes and CRot are considerably
separated from the cluster of fiber-influenced centers. It was concluded that it may be more realistic to
incorporate “generic” principal fibers into finite element models than not to include them at all, despite the lack
of reliable information about fibers. (Am J Orthod Dentofacial Orthop 2001;120:272-9)
O
rthodontic tooth movement is often described In the bone research community, mechanical-load
in terms of the location of the center of rotation transduction into bone response has been the subject of
(CRot). The CRot is an imaginary point, not intense investigation. Orthopedic long-bone models
necessarily on the tooth, about which the tooth can be predominate, although orthodontic models offer unique
considered to have purely rotated.1 The center of resis- and powerful alternatives. The periodontal ligament
tance (CRes) is defined as any point along the line of (PDL) transmits functional and orthodontic forces to
action of a force that causes pure translation of the the alveolar bone. It is believed that the resulting
tooth. If the line of action of a force passes through the stresses or strains within the PDL and the bone control
CRes, then the tooth will undergo pure translation— the bone-modeling process. Calculations using finite
that is, the CRot approaches infinity. In general, if the element method (FEM) models of varying complexity
line of action of a force does not go through the CRes, and verisimilitude have been used to investigate the
then the tooth undergoes a combination of translation relationship between the changed mechanical environ-
and rotation. (Any combination of displacements can ment and the bone response.2-6
be reduced to an equivalent pure rotation about some Virtually all models have shared the assumption
CRot.) that the PDL is homogenous and isotropic. But histo-
logic studies have clearly demonstrated that the PDL is
From the Biomechanics and Biomaterials Research Center, Indiana University-
Purdue University, Indianapolis, Ind. a fiber-reinforced structure.7-9 Presumably, the princi-
Supported by NIH/NIDR (DE11058). pal fibers resist tensile forces, whereas the other com-
aGraduate student in mechanical engineering, Purdue University, West
ponents resist compressive stresses.
Lafayette, Ind.
bAssociate Professor of Orthodontics, Indiana University School of Dentistry, The purposes of this study were to investigate the
and of Mechanical Engineering, Purdue University School of Engineering and possible structural roles of the PDL’s principal fibers
Technology. in influencing the locations of the CRot and the CRes,
Reprint requests to: Dr Thomas R. Katona, Department of Oral Facial Devel-
opment, Indiana University School of Dentistry, 1121 W Michigan St, Indi- and the effects of the fibers on the stress fields within
anapolis, IN 46202; e-mail, tkatona@iupui.edu. the PDL and the adjacent bone. A 3-dimensional FE
Submitted, September 2000; revised and accepted, February 2001. model of the root/PDL/mandible structure was built,
Copyright © 2001 by the American Association of Orthodontists.
0889-5406/2001/$35.00 + 0 8/1/116085 and, for the first time in this type of study, the PDL’s
doi:10.1067/mod.2001.116085 principal-fiber structure was also simulated with spe-
272
American Journal of Orthodontics and Dentofacial Orthopedics Qian, Chen, and Katona 273
Volume 120, Number 3
Table I.Fiber density and area (estimates based on pic- Table III. Combinations of fiber properties used in
tures in Auyeung7) parametric calculations; in addition to 5 cases in Table,
Region Density (/100 µm) Area (µm2) results for traditional no-fiber case and another model
with only principal fibers (no-NPFM case; 45° and
Coronal and middle 22.1 9.0 E = 30 MPa) were obtained
Apical 13.2 16.6
Angulation (in degrees)
but not both. We followed traditional practice when we Fig 5. Oblique principal PDL fiber attachment away from
assumed that the NPFM would behave as a homoge- apical region. Reinforcements in “skew”-type elements
nous and isotropic material. are arranged in layers whose angulations are defined by
Although actual oblique fiber orientation and stiff- f/L ratio.
ness vary along the root,8 the orientation and stiffness
were assumed to be constant, except at the apical
region. (The effects of this assumption are examined in orders of magnitude greater than the fiber values (Table
the parametric analysis.) Although the principal fibers II), so that even relatively large changes in bone stiff-
behave nonlinearly,12 we assumed that they are linearly ness are unlikely to have a significant effect; and (2)
elastic. The absence of principal fiber stiffness in com- the results are primarily analyzed in a relative sense. As
pression is reflected in this model. Two FEM parame- an example, an alteration in bone properties may
ters (fiber density and fiber intersection area) had to be slightly move the calculated CRes locations, but the
defined to numerically simulate the principal fibers. relative differences in the locations computed for dif-
These approximations (based on pictures from Auyeung ferent fiber properties/orientations would be much less
et al7) are shown in Table I. affected.
The mechanical properties (Table II) were collated Table III presents the combinations of fiber angula-
from the literature and our previous work. Unfortu- tions and stiffnesses used in the parametric study. For
nately, there are no universally accepted bone property comparisons with previous approaches, the CRes, the
values; the literature is replete with many possibilities. CRot, and the stresses were also calculated with the tra-
However, for this study, a parametric analysis of the ditional “no-fiber” (NPFM only) simplification. In
effects of fiber variability, we believed that bone- addition, the center locations were determined with
property changes had a minimal effect. This can be only fiber support (the no-matrix, or no-NPFM assump-
rationalized in 2 ways: (1) bone stiffness values are tion).
American Journal of Orthodontics and Dentofacial Orthopedics Qian, Chen, and Katona 275
Volume 120, Number 3
B
Fig 8. MAX in (A) lamina dura and (B) PDL NPFM change with oblique fiber angulation (30°, 45°,
60°, no-fiber) along path from distal coronal to apical to mesial coronal.
the CRes and the CRot moved away from the apex by principal stress (MIN), and the maximum shear stress
an additional 0.65 mm and 0.87 mm, respectively. (SHR) in the NPFM and the lamina dura. The results
Calculations were performed with only fiber from the distal and mesial sides of the root (Fig 2) are
(Young’s modulus = 30 MPa and angulation = 45°) sup- displayed because they have the highest magni-
port to help ascertain the relative influence of the tudes.13
NPFM. These results are also depicted in Fig 6, A and With the fiber Young’s modulus fixed (30 MPa),
B. The CRot is displaced by only 0.12 mm apically, but stresses were calculated for 30°, 45°, and 60° oblique
the CRes is 3.52 mm closer to the root tip. The results fiber angulations (ie, f/L = 0.70, 0.47, and 0.13 in Fig
presented in Fig 6, A and B, are combined in Fig 7. 5) and without fibers. The values of MAX in the distal
and mesial regions of the lamina dura and the NPFM
Stress distributions in bone and NPFM are shown in Fig 8, A and B, respectively. These graphs
The stress parameters we calculated were the show that the principal oblique fiber angulation does
maximum principal stress (MAX), the minimum not change the general overall stress patterns in the
American Journal of Orthodontics and Dentofacial Orthopedics Qian, Chen, and Katona 277
Volume 120, Number 3
B
Fig 9. As in Fig 8, except with varied fiber Young’s modulus (E = 90, 30, and 10 MPa, and no fiber).
DISCUSSION
PDL and the bone, but it does change the stress magni-
tudes. Similar effects are exhibited by the MIN and the The ability to characterize, calculate, and predict
SHR. functional and orthodontic tooth movements and the
Fiber orientation was defined as 45° to study the concomitant stresses within the alveolar bone and the
influence of the principal PDL fiber Young’s modulus. PDL are important in clinical dentistry and bone
For the no-fiber model and fibers with Young’s modulus research. The parametric analyses indicate that prin-
10, 30, and 90 MPa, the MAX in the distal and mesial cipal-fiber angulation and stiffness influence the
regions of the lamina dura (Fig 9, A) and the NPFM (Fig tooth displacement and the mechanical environment
9, B) was calculated. In general, fiber Young’s modulus within the structures. Unfortunately, little is known
does not seem to have much qualitative impact on the about the specific attributes of the individual fibers;
stress patterns. Similar behavior is exhibited by MIN these are essential for the computations. The
and SHR. unknowns include the fiber angulations, the angula-
278 Qian, Chen, and Katona American Journal of Orthodontics and Dentofacial Orthopedics
September 2001
tion distributions and changes, and the mechanical Thus, qualitatively, principal-fiber orientation and
properties of the fibers. stiffness did not appear to play critical roles in the
Fortunately, these fiber characteristics appear to mechanics of orthodontic tooth movement. Quantita-
have minimal, probably clinically insignificant, effects tively, however, there were clear fiber angulation and
on some calculations. For instance, oblique fiber angu- stiffness effects. The no-fiber configuration accentuated
lation only slightly changed the locations of the CRes the quantitative differences.
and the CRot (Fig 6, A), and fiber stiffness had a small The fibers’ roles in other types of orthodontic tooth
effect on the CRes (Fig 6, B). On the other hand, the 9- movement (eg, lateral translation, intrusion, extrusion,
fold difference in stiffness moved the CRot about 1.1 and axial rotation) and retention should also be evalu-
mm (Fig 6, B); that may be clinically relevant. ated. Furthermore, it is conceivable that some nuances,
The overall stress patterns in the bone and the PDL such as the absence of the no-fiber peak in bone in the
were essentially unaltered by changes in fiber angula- distoapical region (Fig 8, A, and Fig 9, A), may be
tion and stiffness (Figs 8 and 9). In some studies, peak related to the specific anatomy of this root.
stress component locations were linked to root resorp-
tion and bone resorption/formation patterns.5,14 In these CONCLUSION
analyses, accurate knowledge of fiber properties may We have shown that, for quantitative studies of
not be necessary because it appears that peak locations tooth movement, the principal PDL fibers should be
are virtually independent of fiber angulation and stiff- included. Unfortunately, the necessary data about
ness. fiber orientations, distributions, and mechanical prop-
It is significant, and perhaps not surprising, that the erties, and how they change during tooth movement
traditional (ie, no-fiber) configuration behaves as an and function, are not available. However, the calcula-
“outlier.” The absence of principal fibers has a more tions (Figs 6-9) suggested that the results for the var-
profound influence on the locations of the CRes and the ious combinations of fiber orientation and stiffness
CRot than does doubling the fiber angulation (Fig 6, A) are more similar to each other than to the results from
or a 9-fold change in fiber stiffness (Fig 6, B). This is the model without any fibers (Fig 7). Thus, it may be
illustrated in Fig 7 by the relatively tightly clustered more prudent to incorporate what may be unrealistic
solid circles (the different combinations of fiber stiff- principal fibers into FE models than not to include
nesses and angulations) and the open circles (the no- them at all.
fiber configuration). We gratefully acknowledge the assistance of Dr Tod
The no-matrix (ie, only fibers in the PDL, no Curtis.
NPFM) results (the open symbols at 45° in Fig 6, A; at
30 MPa in Fig 6, B; and the open squares in Fig 7) have REFERENCES
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CORRECTION
Table I in “Effects of combined application of antimicrobial and fluoride varnishes in orthodontic patients” (Am
J Orthod Dentofacial Orthop 2001;120:28-35) was published incorrectly. The corrected table is given below.
16 15 14 13 12 11 21 22 23 24 25 26
Group 1 14.7 7.6 14.3 13.6 12.3 1.8 0.9 11.3 11.8 7.8 3.9 18.4
Group 2 16.4 6.1 7.6 15.5 19.2 5.5 4.6 20.1 11.0 14.8 6.0 15.5
Group 3 20.2 14.9 27.3 26.0 27.4 9.0 13.0 31.9 25.0 20.5 12.5 23.0
Tooth (FDI tooth number)
46 45 44 43 42 41 31 32 33 34 35 36
Group 1 29.4 13.6 21.3 12.7 8.3 4.7 2.8 0.0 15.5 25.3 20.7 38.0
Group 2 35.8 24.1 35.4 17.3 9.1 11.7 6.4 11.8 14.6 25.0 23.6 33.6
Group 3 40.9 26.1 31.3 18.8 10.4 6.7 5.7 12.2 17.8 27.8 26.9 40.0