Biomechanical behavior of periodontally compromised dento-alveolar complex before and after regenerative therapy - a proof of concept

Introduction/Objective Finite element analysis (FEA) is mathematical method which can be used for the assessment of biomechanical behavior of dento-alveolar complex. The objectives were to analyze biomechanical behavior changes of teeth and supporting tissues under occlusal load in cases of horizontal and vertical alveolar bone loss, to assess potential impact of tooth displacement and altered stress distribution on further damage, and to evaluate the impact of regenerative periodontal therapy. Methods Three patient-specific three-dimensional finite element (3D FE) models were developed from the acquired cone beam computed tomography, comprising the patient's upper left canine, first and second premolar, and adjacent bone. Model 1 represented horizontal bone loss. Model 2 included intrabony defect along distal aspect of tooth #24. Model 3 represented situation six months after the regenerative periodontal surgery. Displacement, Von Mises, and principal stresses were evaluated through FEA, under moderate vertical occlusal load. Results FEA demonstrated that in the model with vertical bone loss significant tooth displacement was present, even though the clinically evident tooth mobility was absent. Biomechanical behavior and stress distribution of teeth and surrounding tissues under moderate occlusal load was much more altered in case with vertical bone loss in comparison with horizontal bone loss. Six months following the regenerative therapy, the values of all evaluated parameters were noticeable reduced. Conclusion Regenerative periodontal therapy improved the biomechanical characteristics of the affected teeth and the related periodontal structures.