Splint stiffness and extension effects on a simulated avulsed permanent incisor-A patient-specific finite element analysis.

Autor: Vilela ABF; Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia, Uberlândia, Brazil., Soares PBF; Department of Periodontology and Implantology, Dental School, Federal University of Uberlândia, Uberlândia, Brazil., Beaini TL; Department of Preventive and Social Dentistry, Federal University of Uberlândia, Uberlândia, Brazil., Versluis A; Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA., Soares CJ; Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia, Uberlândia, Brazil.
Jazyk: angličtina
Zdroj: Dental traumatology : official publication of International Association for Dental Traumatology [Dent Traumatol] 2022 Feb; Vol. 38 (1), pp. 53-61. Date of Electronic Publication: 2021 Jul 26.
DOI: 10.1111/edt.12705
Abstrakt: Background/aim: Splinting is an important procedure after avulsion. However, the role of splint stiffness and extension is not fully understood. The aim of this study was to evaluate the effect of splint stiffness and extensions on the mobility and stress on an injured tooth under physiological biting load.
Materials and Methods: Three-dimensional (3D) finite element models were created from a cone beam computer tomogram of a patient with normal occlusion. An avulsion injury of the right central incisor was created with a 1000 N load application on the palatal of the injured tooth, causing increased socket width. Splints made from four materials were tested: 0.9 mm diameter wire-composite splint (WCS1), 0.4 mm diameter wire-composite splint (WCS2), 1.0 mm diameter nylon-composite splint (NCS), and a 2 mm high by 0.2 mm thick plastic strip composite splint (PSS). Three splint extensions (involving 6, 5, and 3 teeth) were evaluated. Mobility of the avulsed tooth and the maximum principal stress distributions in the adjacent teeth were calculated.
Results: The injured incisor tooth mobility was not affected by the splint extensions. The NCS and PSS stabilized the avulsed incisor but allowed, respectively, 10 and 20 times more mobility under horizontal loading than the WCS1, which inhibited most mobility, while the WCS2 allowed double the mobility compared with WCS1. The NCS and PSS allowed more tooth mobility, mainly in the extrusion direction. Splints were 2-3 times more effective in limiting mobility under intrusive loads than extrusive loads. High levels of stress were found at the base of the composite attachments in the adjacent incisors.
Conclusion: Splinting an avulsed tooth to one or two teeth bilaterally using a nylon splint or a plastic strip is appropriate for tooth stabilization and should be recommended over the 0.4mm wire-composite splint, while the 0.9 mm orthodontic wire is too rigid and not recommended.
(© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: