Correlation between Malocclusion and Mandibular Fractures: An Experimental Study Comparing Dynamic Finite Element...

Area of Science:

• Orthodontics and Dental Traumatology
• Biomechanics and Finite Element Analysis
• Maxillofacial Surgery

Background:

• Mandibular fractures are common in maxillofacial trauma.
• Previous research focused on post-operative complications, not pre-existing risk factors.
• Clinical observation suggests poor dental contacts (malocclusions) may increase fracture risk.

Purpose of the Study:

• To investigate the hypothesis that malocclusions increase mandibular fracture risk.
• To analyze force distribution in mandibles with different occlusions using finite element models (FEMs).
• To validate simulation findings with clinical data on mandibular fractures.

Main Methods:

• Developed four FEMs from DICOM data representing different occlusions (Class I, II, III, anterior open bite).
• Simulated vertical and lateral impacts at varying speeds on FEMs to analyze stress distribution.
• Retrospectively analyzed 223 low-energy mandibular fractures, correlating occlusion type with fracture patterns (displacement, foci).

Main Results:

• FEM simulations showed higher stress in malocclusion models (Class III, open bite) during impact.
• Class I occlusion models exhibited lower stress levels, indicating a protective effect.
• Clinical data revealed significantly higher frequencies of displaced and multifocal fractures in Class II, Class III, and open bite/poor occlusal contact (POC) patients compared to Class I.

Conclusions:

• Normal occlusion (Class I) is associated with a lower risk and severity of mandibular fractures from low-energy injuries.
• Malocclusions and poor occlusal contacts significantly increase the risk of displaced and multifocal mandibular fractures.
• Virtual simulations using FEMs can predict fracture patterns, aiding in developing preventative strategies and guiding interventions.