Stress Analysis of PDL and Apical Foramen in Traumatized Teeth With Incisal/Cervical Fiber Splinting: A Finite...

Healing of the periodontal ligament (PDL) and pulp vitality is critical for successful management of traumatic dental injuries (TDI), which could be compromised due to adverse stress distributions caused by occlusal forces. As a common treatment to stabilize traumatized teeth, the impact of fiber splinting locations on the masticatory stress distribution in the PDL and dental pulp has not reached a consensus. The biomechanical effects of incisal and cervical fiber splinting on stress distribution in traumatized teeth were investigated in this study.

A cone-beam computed tomography (CBCT) scan of the patient's maxilla was processed using Mimics 22.0, Geomagic Wrap 2017, and SolidWorks 2018 to rebuild three-dimensional finite element models. The fiber splints were modeled by bonding strips near the labial surfaces at the incisal and cervical regions of the anterior teeth. Three locations on the palatal surface: the incisal ridge, incisal third, and cervical third regions were loaded with force to simulate mastication. The ultimate stress distributions were analyzed by ANSYS 2021 R1.

Comparative analysis of stress distribution caused by simulated occlusal forces revealed that incisal splinting consistently reduced stress concentration more effectively than cervical splinting on the PDL and apical foramen of traumatized teeth. The mean stress values in the PDL of traumatized teeth were 183,972 Pa (without splinting), 132,216 Pa (cervical splinting), and 75,294 Pa (incisal splinting). Compared to the CS group, the mean value of the four traumatized incisors' PDL in the IC group was decreased by 43%. The mean stress values around the apical foramen of traumatized teeth were 1,010,861 Pa (without splinting), 670,261 Pa (cervical splinting), and 415,661 Pa (incisal splinting). Compared to the CS group, the mean value around the apical foramen of the four traumatized teeth in the IC group was decreased by 37%.

This study demonstrates that incisal splinting provides superior biomechanical advantages over cervical splinting by mitigating harmful stress concentrations on the PDL and dental pulp (apical foramen), potentially accelerating the PDL healing process and preserving pulp vitality in TDI.

Compared to cervical splinting, the biomechanical advantages of incisal splinting reduce stress concentration more effectively to improve prognosis in TDI.