The use of finite element analysis in

dentistry and orthodontics: Critical

points for model development and
interpreting results
Dan L Romanyk, Behzad Vafaeian, Owen Addison, and Samer Adeeb

Objective: This paper highlights common procedures for establishing a well-

constructed FEA problem using a representative dental geometry, and dis-
cusses how results can be interpreted to understand the validity of methods
and the scope over which the results are valid.
Materials and Methods: A representative multi-rooted tooth geometry was
generated to study the difference in mesh-density convergence when applying
a 1 N occlusal force to a single node versus being distributed over a region.
Additionally, a representative tooth-periodontal ligament (PDL)-bone complex
was generated with a distributed 500 N occlusal load. PDL Young’s modulus
values were varied to demonstrate how changing properties influenced simu-
lation outcomes.
Results: The mesh density convergence study illustrated the divergent stress
response when exposed to a point load as compared to the convergent
response using a distributed load. Studying the tooth-PDL-bone complex
showed that changing PDL properties had a substantial effect on tooth dis-
placement and maximum stress within the PDL and nearby bone, but had less
influence on stresses within the bone farther away from the PDL.
Conclusions: The research illustrated the importance of proper FEA problem
definition as it pertains to ensuring validity of results and that they truly
reflect the overall goals of the analysis. (Semin Orthod 2020; 26:162–173) ©
2020 Elsevier Inc. All rights reserved.

Introduction the periodontal ligament mechanical response

he ability of researchers to study a range of
T problems in solid mechanics through finite
element analysis (FEA), including those relevant to
dentistry and orthodontics, has significantly
increased with advances in computational power
and software usability. Problems such as correlating
Department of Mechanical Engineering/Faculty of Engineering
and School of Dentistry/Faculty of Medicine and Dentistry, Univer-
sity of Alberta, Edmonton, Alberta, Canada; Department of Civil
Engineering/Faculty of Engineering, University of Alberta, Edmon-
ton, Alberta, Canada; Centre for Oral, Clinical & Translational Sci-
ences, King’s College London, London, United Kingdom;
Department of Civil Engineering/Faculty of Engineering, University
of Alberta, Edmonton, Alberta, Canada.
Corresponding author. E-mail: dromanyk@ualberta.ca
© 2020 Elsevier Inc. All rights reserved.
1073-8746/12/1801-$30.00/0
https://doi.org/10.1053/j.sodo.2020.06.014
with subsequent bone remodeling during ortho-
dontic treatment, or investigating the nonlinear
mechanics of orthodontic archwires, have become
less daunting with such advances. While this is gen-
erally seen as a great advancement in methods, it is
also of utmost importance that the reader under-
stands the methods utilized in formulating a FEA
problem and solution such that the results and dis-
cussion may be taken within the proper context.
This is especially true for the clinician or clinical
researcher attempting to interpret FEA results and
integrate them in an applied manner. The overall
goals of this manuscript are to highlight the true
purpose for utilizing FEA solution methods, give
an overall understanding of how solutions are
achieved, and describe basic foundational tools a
reader may utilize toward interpreting both the
methods and results of a FEA study.

162 Seminars in Orthodontics, Vol 26, No 3, 2020: pp 162
173

 The use of finite element analysis in dentistry and orthodontics
In the study of mechanical response of materi-
als to applied external loading, investigators may
employ experimental, analytical, and/or numeri-
cal methods to ascertain the stress-strain state of
a material, or materials, in question. Experimen-
tal methods utilizing a physical specimen, as
opposed to a computational model, are ideal in
many senses in that they represent the true phys-
ics of the problem and, under the notion they
are conducted properly, yield data that are free
of assumptions to draw conclusions. Unfortu-
nately, experimental methods may suffer from
limitations in certain applications when con-
fronted with complex geometries (e.g. complex
shapes, multi-material systems, etc.), costly mate-
rials, time-exhaustive preparation and proce-
dures (e.g. a fatigue test running for millions of
cycles), and a general inability to measure the
desired phenomena.
When limitations of experimental methods
exceed the benefit they can provide, or are unable
to measure the variable in question, investigators
are driven toward alternative mathematical pre-
dictive approaches through analytical and numer-
ical techniques. Analytical and numerical
approaches contrast experiments in that they uti-
lize an approximated geometry and user-defined
properties as opposed to directly measuring phe-
nomena using a physical sample. They generally
rely on assumptions such as geometry, how the sys-
tem will deform, and material properties, but they
allow for determination of variables in question
where many experimental approaches do not.
Analytical techniques rely on the closed form solu-
tion to a mathematical problem, which only per-
tains to a number of special cases where problem
geometry and material properties can reasonably
be reduced down to a simplified problem allowing
for solution. Finally, where experimental and ana-
lytical techniques are limited, numerical
approaches provide an approximated solution to
a specified analytical problem definition. Indeed,
approximations must be handled appropriately in
order to yield valid results from the analysis (e.g.
within reasonable tolerance and conversion) but,
if performed appropriately and under reasonable
assumptions, they can allow investigators to draw
valuable conclusions from their mechanical analy-
sis which would otherwise not be possible.
Speaking specifically to the field of dentistry
and orthodontics, analysis of stresses and strains
163
generated in oral and dental structures following
functional loading have been reported for over
75 years. Experiments have been conducted to
better understand how natural tissues respond to
mechanical and thermal loading, or to inform
the development of a wide range of devices that
are used routinely in oral and dental interven-
tions. The majority of early literature was depen-
dent on photo-elastic methods that measured
changes in optical properties of an object under
deformation. However, photo-elastic studies are
limited by the complexity of the analysis when
applied to irregular three-dimensional struc-
tures. In 1973, Farah et al., applied a stress analy-
sis method that had been originally developed
for the aerospace industry to give insight into the
stresses generated in a loaded restored first
molar tooth.1 The Finite Element Analysis (FEA)
method, a numerical approach, has since
become widely used to address many biomechan-
ical problems and is commonly reported in the
dental literature.
The use of FEA in many areas of research has
increased greatly with improved development of
software and increased computational capacity,
and the fields of dentistry and orthodontics are
no exception. A PubMed literature search from
2008 to present, using the search terms [“finite
element analysis” OR “finite element model” OR
“finite-element” OR “FEA”] AND “Dentistry”
identified over 2000 discrete manuscripts. This
number represents a »2.5-fold increase in the
total of scientific outputs applied to dental prob-
lems using FEA methods when compared with
the previous decade. While FEA is undoubtedly a
valuable research method, interpretation of FEA-
based studies is often limited by a lack of experi-
mental detail and justification of the assumptions
and approximations that the investigators have
made. Furthermore, for the methodological-
unfamiliar reader, it can be difficult to critically
appraise FEA studies, limiting their impact on
evidence based clinical decision making.
Within the context considered here, FEA is
utilized as a numerical analysis tool in solid
mechanics when the solution to problems using
other methods, namely analytical techniques, is
not possible or realistic as a result of geometry,
material properties, boundary conditions, or any
combination of these factors. To illustrate this
concept in the mathematical sense, first consider
164 Romanyk et al
the equilibrium equation for a static continuous
body using a spatial description:
! » !
0 ¼ div s þr b ð1Þ
!
where 0 is the zero vector (a vector identically
!
consisting of zeros in all directions), b is the
body force vector (e.g. gravitational or magnetic
»
forces), r is the density, and div s is the diver-
»
gence of the Cauchy stress tensor, s (in essence,
a vector arising through differentiation of the
Cauchy stress tensor with respect to spatial posi-
tion).2 Eq. (1) may reduce in complexity depend-
ing on assumptions surrounding a physical
system making it easier to work with; however, it
is important to understand that it presents the
full mathematical representation of static equilib-
rium for a continuous body which is utilized in
FEA solutions. The set of partial differential
equations (PDEs) from Eq. (1) govern the bal-
ance of forces within a static body and, if broken
down into components, will generate a set of
equations that will equate to the number of
dimensions considered in the physical problem
(e.g. in three dimensions, three PDEs will result
from Eq. (1)). While certainly integral to prob-
lems in solid mechanics, Eq. (1) only considers
bodily forces and stresses while giving no men-
tion to deformation or strain which may be
»
achieved by relating the stress tensor, s , to the
»
strain tensor, e , through what is known as a con-
stitutive equation. A constitutive equation repre-
sents the physical nature of the material (e.g.
anisotropic, linear elastic, etc.) and is defined by
the investigator to interpret the problem physics
mathematically. The problem physics will dictate
which factors are necessary in the constitutive
relationship. For instance, strain-rate (i.e. how
fast a material is deformed) would be considered
for viscoelastic materials but not for linear elastic
ones. While, in practice, Eq. (1) is rarely dealt
with in the presented form, it is important to
keep it in mind when understanding the general
necessity for FEA methods.
Should a physical problem generate more
unknowns than available equations, or the solu-
tion to Eq. (1) becomes realistically too complex,
then alternative approaches must be utilized.
More specifically, attaining the exact problem
solution that satisfies the PDE generated in Eq.
(1), which is also known as the ‘strong form’ of a
solution, may be unattainable or realistically too
difficult. As such, a ‘weak form’ of Eq. (1) is gen-
erated which may result in an approximate but
valid solution. A detailed discussion of strong
and weak forms of solution will not be consid-
ered here but, in general, the ‘strong form’ solu-
tion to a problem must satisfy Eq. (1) throughout
the entire domain of the problem while the
‘weak form’ may satisfy Eq. (1) in certain cases
but not over the entire domain. In the case of
Eq. (1), a ‘weak form’ for solids can be generated
through what is known as the principle of virtual
work, and is given as:
Z Z Z
!T ! !T ! !T !
d e sdV
d u bdV
d u tdG
V V G
¼0 ð2Þ
!T
where d e is the transpose of a vector representa-
!
tion of the virtual strain components, s is a vec-
!T
tor representation of the stress components, d u
is the transpose of the virtual displacement vec-
! !
tor, b is the body force vector, t is the vector of
tractions acting on the external boundary surface
of the body, V is the volume of the body, and G is
the external boundary surface.3 When all possi-
ble virtual displacement vector fields are consid-
ered, Eqs. (1) and (2) are, in fact, equivalent.
However, by limiting the possible displacements
in Eq. (2) to a class or family of simple displace-
ment fields (termed trial or shape functions), an
approximate solution that satisfies the “weak
form” can be obtained. A full derivation and
background discussion of Eq. (2) will not be con-
sidered here, but interested readers are encour-
aged to source additional reference texts for
further material.3 It is, however, important that
the reader understand that FEA in solid mechan-
ics relies on the solution to the integral equation
in Eq. (2) after limiting the displacement func-
tions to a simple form (such as piecewise affine
functions), which is in fact a ‘weak solution’ to
the static equilibrium PDE in Eq. (1).
When utilizing a FEA approach, the physical
problem geometry is discretized into elements
which may be 1-, 2-, or 3-dimensional depending
on the problem geometry and assumptions. Adja-
cent elements are connected through common
points known as nodes, which allow for calcu-
lated forces and displacements to be transferred
between elements in the solution of the FEA
problem. In this way, achievable elemental
 The use of finite element analysis in dentistry and orthodontics
solutions are obtained throughout the discre-
tized geometry which are then combined to
obtain an approximated solution to the global
problem. By assuming the trial or shape func-
tions for displacement within an element (i.e.
that the displacement within an element can be
described by a given function), then the strain
may be calculated through the displacements.
Finally, through the constitutive relationship, the
stress can be determined. In using this discre-
tized approach and asserting that the combined
solution of elements satisfies Eq. (2) or, at least
that Eq. (2) is minimized within a specified
threshold, the FEA method can be used to inves-
tigate problems in solid mechanics.
While the first FEA research in dentistry was
conducted without computers, existing computers
and developed software tools have made FEA a
user-friendly tool with which to solve complex
problems allowing for expedient problem defini-
tion and solution. This is certainly a major advan-
tage in many ways; though, the more user-friendly
tools also allow for analysis without necessarily
understanding the background workings and
mathematics that occur during problem solution.
Considering Eq. (2), it is evident that assumptions
made about the boundary of a problem will
impact the integral equation directly through
both tractions and the integration over the
boundary. Material properties and considerations
(e.g. linear elastic, isotropic, homogeneous, etc.)
will influence the constitutive equations which are
used in direct calculation of stress from strain.
Many other examples of how user-defined param-
eters will influence the inner workings of FEA
could further be named; however, the point of dis-
cussion is that the FEA solution will be made
based on parameters the user has defined. As
such, it is of utmost importance that the true phys-
ics be defined accordingly when posing a FEA
problem, and that any specified parameters align
sufficiently with the FEA study goals. Over-simplifi-
cations, invalid assumptions, and improper repre-
sentation of problem physics can all lead to FEA
results that do not necessarily emulate the true
solid mechanics problem in question.
The purpose of this study is to utilize a repre-
sentative tooth-periodontal ligament (PDL)-
bone model to elucidate common factors for
consideration when formulating a FEA problem
and interpreting the subsequent results. It is not
the intent to provide a “cook book recipe” on
165
how to formulate or interpret every possible FEA
problem in orthodontics, or dentistry in general.
Rather, this manuscript will consider the subjects
of mesh density and results convergence, effect
of load application on results, and how material
properties may influence results depending on
the region of interest. The presented study will
provide the non-expert, clinician or researcher,
with a basic set of tools they may use when inter-
preting published results from the literature or
considering their own FEA problem.
Materials and methods
Effect of mesh density and load application on a
representative tooth
For a correctly modeled physical phenomenon,
one of the foremost concerns with FEA modeling
is generating a quality FEA mesh with the proper
choice of FEA size to produce accurate results.
The error associated with the size of the finite
elements is referred to as the discretization error.
Theoretically, the smaller the finite elements, the
less discretization error and hence, the more
accurate results are expected. Determining the
error is practically difficult a priori; however, a
mesh convergence test can be performed upon
completion of a simulation to demonstrate that
the simulated result asymptotically converges to
a finite value. In a mesh convergence test, differ-
ent mesh densities (number of elements per unit
volume) for the same model geometry are gener-
ated by decreasing the element sizes. A finite ele-
ment parameter such as element stress or
element energy for a single element or group of
elements is obtained and plotted versus the mesh
densities of the models. For a mesh that has been
deemed to converge to a finite value, the selected
parameter, or parameters, will remain
unchanged within a specified threshold level as
mesh density is altered.
A common FEA case where mesh density con-
vergence poses a problem is when a load has been
applied in a concentrated manner on a single
node. To demonstrate the effect of a concen-
trated point load on resulting mesh convergence,
three-dimensional FE models of a human molar
were generated. A load of 1 N was applied on the
crown in the forms of a concentrated point load
and a distributed load over a region of interest
(ROI). Simple boundary conditions (fixed in all
166 Romanyk et al
Fig. 1. (Top) Schematic of applied loading and
boundary conditions imposed on the tooth for a point
load and distributed load; (Bottom) Representative
images showing mesh distributions tested at 6 and
3184 elements/mm3.
directions) of displacement were applied to the
root region. Seven identical geometric models
having increasing uniform mesh densities from 6
to 3184 elements/mm3 were generated. Boundary
conditions, applied loads, and representative
meshes are illustrated in Fig. 1. Linear tetrahedral
Fig. 2. (Left) Simplified model of a human molar and surrounding PDL in alveolar bone, location of the bound-
ary conditions, and the material properties; (Right) Section of the model showing a typical generated mesh.
elements and linearly elastic material for the den-
tin were utilized. Maximum von Mises stress in the
ROI was the FEA parameter chosen to study mesh
density convergence. A von Mises stress is a singu-
lar ‘equivalent’ stress typically calculated for com-
parison against a yield stress for failure analysis.
Due to the convenience of having a singular stress
value, von Mises stresses are commonly used in
the literature; however, it should be understood
that its primary use is for failure analysis and it
does not represent a physical stress state within
the material as principal stresses, for example, do.
All FEA was conducted using Abaqus software
(3DS, MA, USA).
Effect of mesh density on a representative tooth-
PDL-bone complex
To demonstrate a typical mesh sensitivity analysis
in the case of a more complex dental structure, a
FE model consisting of the previously studied
molar geometry, surrounding PDL, and a block
of alveolar bone was generated as shown in
Fig. 2. The PDL was assigned a 0.2 mm thickness
and prescribed to have a perfect (ideal) bond
with the molar and the bone throughout the
analysis. In other words, the PDL shared finite
element nodes with the molar root and the bone
at common interfaces which guaranteed continu-
ous displacement components in the model. A
distributed load representing a bite force of
500 N was assumed to be exerted on the tooth
(Fig. 2). Linearly elastic, isotropic, and homoge-
neous material properties for each component
were assumed and are reported in Fig 2.
To perform the mesh sensitivity analysis, an ini-
tial coarse mesh of 4-node linear tetrahedral ele-
ments was generated for the model components.
 The use of finite element analysis in dentistry and orthodontics
Tetrahedral elements can properly resolve the
complex and unstructured geometry of the
model, hence their use here. A section of the
model showing a typical mesh generated for the
dentoalveolar structure’s components is provided
in Fig. 2. Common FEA results of interest in such
a problem include tooth displacement and
stresses within the different components. As such,
the displacement magnitude of the tooth centroid
(i.e. center of mass) and the maximum von Mises
stress were selected as convergence indicators.
Pursuant to initial simulations, the PDL mesh was
locally refined through the PDL thickness and in
the regions of observed stress concentration. The
mesh generation automatically generated rela-
tively finer mesh in the areas of higher geometric
curvature. Since the model’s components had
shared common interfaces with each other, refin-
ing one’s mesh led to finer meshes in the adjacent
material as can be noted in Fig 2. Mesh refine-
ments were continually made until a converged
mesh density was observed.
Effect of material properties on FEA simulation
results
The selection of material properties in a FEA
study is vital when considering the accuracy of
simulation results. When considering multi-mate-
rial structures, it is particularly important to
select individual material properties that clearly
align with the study goals to obtain accurate
results in the region of interest. The tooth, PDL,
alveolar bone FEA model developed in the pre-
ceding section was utilized to study how altering
PDL material properties changed results in the
different sections of the model. A substantial
range of linear elastic material properties have
been reported for the PDL in the literature,4 and
these were used as a guide in selecting the four
PDL Young’s moduli for investigation as
10,000 MPa, 1750 MPa, 50 MPa, and 6.9 MPa. For
the first case, being an extreme one, it was
assumed that the root directly attached to the
alveolar bone (i.e. the PDL was assumed to have
the mechanical properties of bone). The three
other cases considered reported Young’s moduli
covering the range of values in the literature.
The generated FE models were again analyzed
under a locally distributed simulated bite force
of 500 N, as in Fig. 2. Displacement of the tooth
centroid and von Mises stresses in the root at the
167
PDL interface, in the PDL, and in the surround-
ing bone were obtained from each simulation
case to observe their sensitivity to changing PDL
properties.
Results and discussion
Effect of mesh density and load application on a
representative tooth
The objective of the first FEA study presented
was to illustrate the effect of load application on
potential mesh density convergence measures
for a representative crown geometry. Fig. 3 illus-
trates the von Mises stress distribution and maxi-
mum value within the specified ROI for cases
where the crown was exposed to a concentrated
force on a singular node and a distributed load
over a prescribed area. Immediately, from the
results it is apparent that as the mesh density is
increased, there is a substantial difference in
mesh density convergence behavior between the
two cases. While the maximum von Mises stress
in the ROI under a distributed load converged to
a finite value, the concentrated load produced a
maximum stress that continually increased
through the mesh density analysis with no imme-
diate signs of reaching convergence. Addition-
ally, the maximum stress magnitude generated
through a distributed load is orders of magnitude
less at »0.3 MPa than when a concentrated load
is applied where results show a continually
increasing trend nearing 200 MPa in the last sim-
ulation tested.
Strictly considering convergence tests, this anal-
ysis directly points to the importance of under-
standing the physics of the problem and how this
translates into the numerical FEA solution. Dur-
ing the process of increasing mesh density, the
associated surface area and volume of a given ele-
ment will decrease. By definition, if the area over
which a force is applied decreases, the resulting
stress will increase. In the case of attaching a con-
centrated force to a singular node, as the associ-
ated elemental surface area and volume
decreases, the stress will continually rise. Con-
versely, by assigning the equivalent load over a
given ROI, the forces are distributed evenly
among nodes within the prescribed area. As the
mesh density is increased, so are the number of
nodes within the ROI, which decreases the magni-
tude of force assigned to a given node. Thus, as
168 Romanyk et al

Fig. 3. Maximum von Mises stress distributions (Top) and convergence graphs (Bottom) within the ROI for a rep-
resentative molar when exposed to a singular concentrated force and a distributed load.

elemental surface area and volume are decreased,
the applied nodal force also decreases. In this
way, studying mesh density convergence within
the ROI leads to a divergent solution when apply-
ing a singular concentrated load and convergent
behavior with a distributed load.
Considering the physics of most problems in
mechanics, rarely would a force truly be applied
over such a small region that it could be realisti-
cally assumed as being applied at a single node.
Classical analytical mechanics commonly
assumes concentrated forces to be applied at a
point (e.g. beam and plate theories); however, as
has been illustrated here, when utilizing FEA as a
tool, there are numerical consequences to
assuming point-wise application of loads that
manifest in the results. Should the results of
interest be at or near the region of load applica-
tion, then it is paramount that the true physics of
how the load is applied be replicated. It is critical
that mesh density convergence criteria be care-
fully selected to not include numerical artifacts
in the evaluation of mesh quality. In the case pre-
sented here, if maximum von Mises stress over
the entire geometry were to be inspected as the
criteria, then the point load application would
never show convergence.
While it is generally advisable to avoid the
application of point loads, it should be consid-
ered that if the mechanics of interest are
 The use of finite element analysis in dentistry and orthodontics 169

“sufficiently far” from the location of load appli- Effect of mesh density on a representative tooth-
cation, then the results will be independent of PDL-bone complex
the manner in which the load is applied. This is
To illustrate a sample mesh density convergence
known as Saint-Venant’s Principle.5 Translating
study for a more complex multi-material model,
this principle to FEA, if the user is not interested
a representative tooth-PDL-bone complex
in results at or near the location of load applica-
exposed to a 500 N bite force, as shown in Fig. 2,
tion, then simplifying assumptions may be valid.
was considered. The mesh densities and their
For instance, if stress distribution within the PDL
corresponding tooth centroid displacements and
were of interest in this problem as opposed to
von Mises stress distributions of the root are
the ROI selected, then use of a point load may
depicted in Fig. 4. The magnitude of the tooth
be appropriate; however, it is prudent that this
centroid displacement, j Uc j , and the maximum
simplification be investigated and justified to
von Mises stress sufficiently reached a converged
ensure accuracy of results. It must also be men-
value when the density denoted by mesh #3 was
tioned that use of concentrated loads can result
chosen. Further refinement of the mesh
in excessive local element distortion leading to
changed the convergence indicators by less than
failure of the FEA simulation to solve.

Fig. 4. (Top) Mesh densities for the tooth-PDL-bone complex components; (Middle) Distal and inferior views of
von Mises stress distribution plots for the root; (Bottom) Convergence graphs showing the change in the values of
tooth centroid displacement and maximum von Mises stress with changing mesh density in the tooth component.
170 Romanyk et al

0.5%. The results also demonstrated that the
location of the maximum stress may vary by mesh
refinement. This further illustrates that a coarse
mesh, not resolving the geometry sufficiently,
can significantly affect the predicted stress distri-
bution and magnitude.
Given that results in both the tooth structure
and the PDL were of interest, it was also neces-
sary to study mesh density convergence within
the PDL structure. The results of the mesh sensi-
tivity analysis focusing on the von Mises stress of
the PDL are demonstrated in Fig. 5. The sensitiv-
ity analyses demonstrated that a single-layer
(tetrahedral) mesh (mesh #1 and mesh #2)
through the PDL thickness could not capture the
variation of stress inside the PDL. Once the layer
of the mesh was increased to two layers, a signifi-
cant difference in the stress distributions was
observed when comparing the results of mesh #2
with mesh #3. In particular, a single-layer mesh
could not differentiate the stress of the medial
from the stress of the lateral PDL. This suggested
that two or more layers of elements in the PDL
thickness were needed toward an accurate simu-
lation of the PDL stress. Therefore, the PDL
mesh was refined to 3 layers with higher density

Fig. 5. (Top) Mesh densities for the tooth-PDL-bone complex components; (Middle) Distal and inferior views of
von Mises stress distribution plots for the PDL; (Bottom) Convergence graphs showing the change in maximum
von Mises stress with changing mesh density in the PDL component.
 The use of finite element analysis in dentistry and orthodontics 171

as well (mesh #4). Consequently, the maximum
von Mises stress changed by 1.5% which was
deemed acceptable to suggest convergence. In
order to assess the sufficiency of the mesh refine-
ment in the area of stress concentration, the
mesh was furthur refined locally. The region of
stress concentration for the mesh refinement is
shown by a rectangle in Fig. 5. The latter mesh
refinement did not show any change in the maxi-
mum stress (less than 0.1%) (Fig. 6).
The tooth-PDL-bone complex mesh density
convergence study presented here signifies the

Fig. 6. Simulated magnitude of tooth displacement and von-Mises stress of the root (Top), PDL (Middle), and
surrounding bone near the tooth (Bottom).
172 Romanyk et al
importance of investigating the convergence
behavior of all results of interest, and how various
components of a multi-material complex may
require differing approaches. Studying the con-
vergence plots in Figs. 4 and 5, it can be seen
that the tooth and PDL structures exhibited dif-
ferent trends of convergence as the mesh density
was increased. Further to this, while the PDL is
substantially smaller in size/volume than the
tooth, the final PDL mesh density was 7007 ele-
ments/mm3 as compared to the 1356 elements/
mm3 used in the tooth structure. Furthermore,
the PDL required local mesh refinement in areas
of sharp geometry change and heightened stress
magnitude. These points highlight the need to
investigate both individual regions and compo-
nents of multi-material complexes to ensure
mesh density convergence throughout the
model. This is particularly true of regions where
the results are of interest. Although the finite ele-
ment method produces a continuous inter-ele-
ment displacement (deformation) field over the
computational medium, the strain and stress
fields may not necessarily be continuous due to
the inter-element slope discontinuity of the dis-
placement field. In this case, mesh refinement
will also lead to mitigate the degree of the discon-
tinuity (i.e. the jump in the values of strain and
stress of two elements at their common inter-
face). Usually finite element post processing
algorithms average the strain and stress fields
over the computational domains to produce con-
tinuous contours. While this averaging of the
stress and strain fields may not affect reported
numerical values (e.g. maximum elemental
stress, or stress at a specific element), the reader
should understand that, in the FEA solution, the
stresses and strains are discontinuous and the
resulting fringe plots (for example, Figs. 3-5) are
generally subjected to a post-processing, making
them appear continuous. The model developed
here will be used in the proceeding section to
investigate the influence of PDL properties on
results within the tooth-PDL-bone complex.
Effect of material properties
The simulated von Mises stresses of the root at
the root-PDL interface, PDL at the PDL-bone
interface, and bone are depicted in Fig. 5 along
with the magnitude of displacement of the tooth
centroid for varying PDL elastic moduli. The
results indicated that choosing different elastic
mechanical properties for the PDL significantly
altered the simulated stresses within the PDL
and displacement of the tooth centroid. The
results show that more compliant PDL (i.e. PDL
with smaller Young’s modulus) leads to larger
area of stress distribution both at the root-PDL
and PDL-bone interfaces. This is a result of larger
volume of a softer PDL participating in stress
transmission between the structures as the lower
modulus values result in greater PDL deforma-
tion under the same load. The tooth displace-
ment became larger for the models with softer
PDL material such that the displacement magni-
tude corresponding to the softest PDL was 8 times
larger than that of the stiffest one. In contrast,
when studying the bone stresses away from the
tooth in Fig 5, the change in PDL modulus had
very little effect on resulting stresses.
The FEA study investigating the effect of PDL
properties on results within a tooth-PDL-bone
complex have elucidated some key considera-
tions around problem definition and interpreta-
tion of results. Changing of PDL properties had
a significant effect on tooth centroid movement,
von Mises stresses in the tooth at the root-PDL
interface, within the PDL, and in bone near the
PDL. In the general sense of using FEA as a tool,
this analysis clearly points to the necessity of
understanding the material properties assigned
within a model and how they may implicate
results. Speaking directly to the model utilized
here, if results within or near the PDL were of
interest, then it would be paramount that the
local material properties be truly representative
of problem physics. Conversely, when looking at
the stress results within the bone at a significant
distance from the PDL, there is limited differ-
ence as properties change. The analysis per-
formed here was to illustrate how simplifications
may be made depending on study goals. It is vital
to understand that the results here pertain to a
specific loading scenario and constraints, and
each study should be considered individually to
fully understand how local constraints and mate-
rial properties influence results of interest.
Other advanced considerations and clinical
applications
The analyses performed here have only covered
a small portion of many aspects that could be
 The use of finite element analysis in dentistry and orthodontics
discussed regarding FEA studies and interpreta-
tion of their results. Only linear elastic, isotropic,
and homogeneous properties were used in this
analysis. Material models can increase in com-
plexity through varying levels of anisotropy,
introduction of time-dependent (i.e. viscoelastic-
ity) and/or nonlinear (e.g. hyperelasticity) prop-
erties, and other similar factors. Fixed and ideal
bonding constraints were used here, but other
more intricate contact problems and boundary
conditions can be employed to replicate varying
problem physics. The tools available to users of
typical FEA software are vast in nature; however,
as the problem physics replicated in the FEA
study becomes more complex, so do the consid-
erations around solution convergence and
understanding of the results. Simply because a
FEA solution is reached, it does not imply mesh
convergence or accuracy of findings relative to
the physical problem. The study presented here
has illustrated some of the fundamental consid-
erations surrounding more simplified analyses,
and adding to problem complexity serves to exac-
erbate such points of consideration.
It is of course not suggested here that increas-
ing FEA model fidelity to better represent the
physical problem should be avoided. For
instance, should the transient response of PDL
tissue during orthodontic load application be of
interest, then utilizing a representative viscoelas-
tic material model is essential. The purpose of
this study is to serve as a baseline consideration
for those less versed in FEA methods when inter-
preting findings from such studies. As shown
here, demonstrating mesh density convergence,
understanding the effect of load application and
boundary conditions on results of interest, and
utilizing appropriate material properties are all
critical for a sufficient FEA study. Readers should
173
closely examine manuscripts for justification sur-
rounding such criteria when interpreting results.
Clinical implications
While not every scenario and topic of interest
around FEA used in dentistry could be consid-
ered in a single manuscript, the presented work
clearly elucidates several key principles to con-
sider when interpreting FEA results. Topics of
mesh density convergence within single and
multi-material complexes and the effect of mate-
rial property selection were shown to potentially
significantly influence FEA simulation results.
The points raised here could be used by clini-
cians and those less experienced with FEA meth-
ods to aid them in understanding the problem
definition and the limitations of study results.
Additionally, it points to the necessity of truly
understanding how physics of the research ques-
tion and FEA study definition must align in order
to obtain results that are indeed representative of
the research question.
References
1. Farah JW, Craig RG, Sikarski DL. Photoelastic and finite
element stress analysis of a restored axisymmetric first
molar. J Biomech. 1973;6:511–520.
2. Chadwick P. Continuum Mechanics: Concise Theory and Prob-
lems. 2nd ed. New York: George Allen & Unwin, Ltd; 1976.
3. Zienkiewicz OC, Taylor RL, Zhu JZ. The Finite Element
Method: Its Basis and Fundamentals. 6th ed. Oxford: Butter-
worth Heinemann; 2005.
4. Fill TS, Carey JP, Toogood RW, Major PW. Experimentally
determined mechanical properties of, and models for, the
periodontal ligament: critical review of current literature. J
Dent Biomech. 2011;2011: 312980.
5. Popov EP. Engineering Mechanics of Solids. 2nd ed. New Jer-
sey: Prentice-Hall Inc.; 1998.