Initial stress produced in the periodontal membrane by orthodontic loads in the presence of varying loss of alveolar bone: a three-dimensional finite element analysis.

The aim of this study was to investigate the stress components (S1 and S3) that appear in the periodontal membrane (PDM), when subjected to transverse and vertical loads equal to 1 N. A further aim was to quantify the alteration in stress that occurs as alveolar bone is reduced in height by 1, 2.5, 5, 6.5, and 8 mm, respectively. Six three-dimensional (3D) finite element models (FEM) of a human maxillary central incisor were designed. The models were of the same configuration except for the alveolar bone height. Special attention was paid to changes of the stress components produced at the cervical, apical, and sub-apical levels. In the absence of alveolar bone loss, a tipping force of 1 N produced stresses, which reached 0.072 N/mm2 at the cervical margin, up to 0.0395 N/mm2 at the apex and up to 0.026 N/mm2 sub-apically. In the presence of 8 mm of alveolar bone loss, the findings were -0.288, 0.472, and 0.722 N/mm2, respectively. Without bone loss, an intruding force of the same magnitude produced stresses of -0.0043, -0.0263, and 0.115 N/mm2, respectively, for the same areas and sampling points. In the presence of 8 mm of alveolar bone loss the findings were -0.019, -0.043, and 0.185 N/mm2 for intrusive movement. The results showed that alveolar bone loss caused increased stress production under the same load compared with healthy bone support (without alveolar bone resorption). Tipping movements resulted in an increased level of stress at the cervical margin of the PDM in all sampling points and at all stages of alveolar bone loss. These increased stress components were found to be at the sub-apical and apical levels for intrusive movement.