Abstract
Objectives
Previous studies have suggested a relationship between resorption in second molars and pressure from the eruptive force of the third molar. The aim of this study was to simulate functional forces in a mandible model by means of finite element analysis and then assess the biomechanical response produced by impacted third molars on the roots of the second molar.
Materials and methods
A cone beam computed tomography scan presenting an impacted mandibular third molar was segmented (Mimics V17 software). The modeling process was performed using the reverse engineering technique provided by the Rhinoceros 3D 5.0 software. The third molar position was changed in order to produce different inclinations of the impacted tooth. Bite forces were simulated to evaluate total deformation, the equivalent von Mises stress, minimum principal stress on hard tissue, and equivalent elastic strain on soft tissue.
Results
Areas of high energy dissipation and compression stress were detected in the second molar root, independently of the inclination of the impacted third molar. In general, the horizontal position was the situation in which major stress and the amount of deformation occurred in the second and third molar regions.
Conclusion
Impacted third molars in close proximity with the adjacent tooth can generate areas of compression concentrated at the site of contact, which suggests an involvement of mechanical factors in the triggering of resorption lesions.
Clinical relevance
The results of these computational experiments contribute to the understanding of the triggering and progression of resorptive lesions in the adjacent second molar.
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References
Sasano T, Kuribara N, Iikubo M, Yoshida A, Satoh-Kuiriwada S, Shoji N, Sakamoto M (2003) Influence of angular position and degree of impaction of third molars on development of symptoms: long-term follow-up under good oral hygiene conditions. Tohoku J Exp Med 200:75–83
Mettes TG, Nienhuijs ME, van der Sanden WJ, Verdonschot EH, Plasschaert AJ (2005) Interventions for treating asymptomatic impacted wisdom teeth in adolescents and adults. Cochrane Database Syst Rev 18:CD003879
Nunn ME, Fish MD, Garcia RI, Kaye EK, Figueroa R, Gohel A, Ito M, Lee HJ, Williams DE, Miyamoto T (2013) Retained asymptomatic third molars and risk for second molar pathology. J Dent Res 92:1095–1099
Friedman JW (2014) Letter to the editor, “Retained asymptomatic third molars and risk of second molar pathology”. J Dent Res 93:319
Nunn ME, Fish MD, Garcia RI, Kaye EK, Figueroa R, Gohel A, Ito M, Lee HJ, Williams DE, Miyamoto T (2014) Response to letter to the editor, “Retained asymptomatic third molars and risk for second molar pathology”. J Dent Res 93:320–321
Yamaoka M, Furusawa K, Ikeda M, Hasegawa T (1999) Root resorption of mandibular second molar teeth associated with the presence of the third molars. Aust Dent J 44:112–116
Al-Khateeb TH, Bataineh AB (2006) Pathology associated with impacted mandibular third molars in a group of Jordanians. J Oral Maxillofac Surg 64:1598–1602
Akarslan ZZ, Kocabay C (2009) Assessment of the associated symptoms, pathologies, positions and angulations of bilateral occurring mandibular third molars: is there any similarity? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:e26–e32
Oenning AC, Neves FS, Alencar PN, Prado RF, Groppo FC, Haiter-Neto F (2014) External root resorption of the second molar associated with third molar impaction: comparison of panoramic radiography and cone beam computed tomography. J Oral Maxillofac Surg 72:1444–1455
Oenning AC, Melo SL, Groppo FC, Haiter-Neto F (2015) Mesial inclination of impacted third molars and its propensity to stimulate external root resorption in second molars—a cone-beam computed tomographic evaluation. J Oral Maxillofac Surg 73:379–386
Matzen LH, Schropp L, Spin-Neto R, Wenzel A (2017) Use of cone beam computed tomography to assess significant imaging findings related to mandibular third molar impaction. Oral Surg Oral Med Oral Pathol Oral Radiol 124:506–516
Matzen LH, Schropp L, Spin-Neto R, Wenzel A (2017) Radiographic signs of pathology determining removal of an impacted mandibular third molar assessed in a panoramic image or CBCT. Dentomaxillofac Radiol 46:20160330
Nitzan D, Keren T, Marmary Y (1981) Does an impacted tooth cause root resorption of the adjacent one? Oral Surg Oral Med Oral Pathol 51:221–224
Bjerklin K, Ericson S (2006) How a computerized tomography examination changed the treatment plans of 80 children with retained and ectopically positioned maxillary canines. Angle Orthod 76:43–51
Alqerban A, Jacobs R, Fieuws S, Willems G (2011) Comparison of two cone beam computed tomographic systems versus panoramic imaging for localization of impacted maxillary canines and detection of root resorption. Eur J Orthod 33:93–102
Pai AV, Khosla M (2012) Root resection under the surgical field employed for extraction of impacted tooth and management of external resorption. J Conserv Dent 15:298–302
Fuss Z, Tsesis I, Lin S (2003) Root resorption—diagnosis, classification and treatment choices based on stimulation factors. Dent Traumatol 19:175–182
Jeon PD, Turley PK, Moon HB, Ting K (1999) Analysis of stress in the periodontium of the maxillary first molar with a three-dimensional finite element model. Am J Orthod Dentofac Orthop 115:267–274
Kishen A, Vedantam (2007) Hydromechanics in dentine: role of dentinal tubules and hydrostatic pressure on mechanical stress-strain distribution. Dent Mater 23:1296–1306
Hammond AS, Dumont ER, McCarthy RC (2011) The effect of unerupted permanent tooth crowns on the distribution of masticatory stress in children. PLoS One 6:e29121
Prado FB, Rossi AC, Freire AR, Ferreira Caria PH (2014) The application of finite element analysis in the skull biomechanics and dentistry. Indian J Dent Res 25:390–397
Sarrafpour B, Swain M, Li Q, Zoellner H (2013) Tooth eruption results from bone remodelling driven by bite forces sensed by soft tissue dental follicles: a finite element analysis. PLoS One 8:e58803
Knutsson K, Brehmer B, Lysell L, Rohlin M (1996) Pathoses associated with mandibular third molars subjected to removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 82:10–17
Nemcovsky CE, Libfeld H, Zubery Y (1996) Effect of non-erupted 3rd molars on distal roots and supporting structures of approximal teeth. A radiographic survey of 202 cases. J Clin Periodontol 23:810–815
Wang D, He X, Wang Y, Li Z, Zhu Y, Sun C, Ye J, Jiang H, Cheng J (2017) External root resorption of the second molar associated with mesially and horizontally impacted mandibular third molar: evidence from cone beam computed tomography. Clin Oral Investig 21:1335–1342
Hart RT, Hennebel VV, Thongpreda N, Van Buskirk WC, Anderson RC (1992) Modeling the biomechanics of the mandible: a three-dimensional finite element study. J Biomech 25:261–286
Vollmer D, Meyer U, Joos U, Vègh A, Piffko J (2000) Experimental and finite element study of a human mandible. J Craniomaxillofac Surg 28:91–96
van Essen NL, Anderson IA, Hunter PJ, Carman J, Clarke RD, Pullan AJ (2005) Anatomically based modelling of the human skull and jaw. Cells Tissues Organs 180:44–53
Proffit WR (1978) Equilibrium theory revisited: factors influencing position of the teeth. Angle Orthod 48:175–186
Steedle JR, Proffit WR (1985) The pattern and control of eruptive tooth movements. Am J Orthod 87:56–66
Sarrafpour B, Rungsiyakull C, Swain M, Li Q, Zoellner H (2012) Finite element analysis suggests functional bone strain accounts for continuous post-eruptive emergence of teeth. Arch Oral Biol 57:1070–1078
Funding
This study was supported by the Sao Paulo Research Foundation—FAPESP (post-doctoral fellowship no. 2013/12762-2 and regular support no. 2014/14409-0).
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Oenning, A.C., Freire, A.R., Rossi, A.C. et al. Resorptive potential of impacted mandibular third molars: 3D simulation by finite element analysis. Clin Oral Invest 22, 3195–3203 (2018). https://doi.org/10.1007/s00784-018-2403-4
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DOI: https://doi.org/10.1007/s00784-018-2403-4