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Corticotomy Depth as a Modulator of Orthodontic Tooth Movement and PDL Stress-A Finite Element Study
Anna Ewa Kuc1, Kamil Sybilski2, Jacek Kotuła1
1Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland.
Materials (Basel, Switzerland)
|December 11, 2025
Summary
Deeper corticotomy incisions (3 mm) significantly enhance orthodontic tooth movement by penetrating cancellous bone. However, this method does not reduce periodontal ligament stress, emphasizing the need for personalized treatment planning.
Area of Science:
- Orthodontics
- Biomechanical Engineering
- Periodontology
Background:
- Accelerated orthodontic techniques are in demand.
- Corticotomy surgery is a common adjunct to enhance tooth movement.
- Understanding the biomechanical effects of corticotomy depth is crucial.
Purpose of the Study:
- To evaluate the impact of corticotomy incision depth on tooth movement.
- To analyze stress distribution within the periodontal ligament (PDL) during orthodontic expansion.
- To investigate these effects using finite element analysis (FEA).
Main Methods:
- A 3D finite element model was created using CBCT and intraoral scans.
- Simulations included no corticotomy and 3 mm, 2 mm, and 1 mm incision depths.
- Cortical bone density variations were simulated using different Young's modulus values.
Main Results:
- A 3 mm corticotomy significantly increased crown displacement, especially in low-density bone.
- Deeper incisions altered root tipping, reducing relative root movement.
- High stress concentrations in the cervical PDL persisted, exceeding ischemic thresholds.
Conclusions:
- Corticotomy depth is a key factor in optimizing orthodontic tooth movement.
- Penetration into cancellous bone (3 mm) is necessary for enhanced displacement and Regional Acceleratory Phenomenon (RAP).
- Deeper corticotomy offers limited periodontal protection and necessitates individualized treatment planning.
