Stress-strain state biomechanical system of the maxilla and its influence on teeth immobilization in trauma

Abstract

The article presents the results of mathematical modeling of the biomechanical system (BS) of the upper jaw with a splinting structure for fixing the dentition, carried out to study the stress-strain state to improve the conditions for restoring the anatomical and functional ability of injured teeth in children. The research was carried out on the basis of a retrospective analysis of 369 medical histories of children who sought help at the trauma center of Children's Clinical Hospital No.7 in 2020-2022 with different types of dental injuries, X-ray examination data (dental/panoramic X-ray, CBCT), created three-dimensional solidstate models of the upper jaw with teeth and a splint in the CAD package CATIA. Modeling of the stress-strain state was carried out for simulation models of three BS of the upper jaw with a splinting structure of the dentition. A comparative analysis of the results of qualitative characteristics of stress fields and displacement fields showed that the highest values of displacement fields occur in the central incisors of all three systems, and the highest values of stress fields occur in the cervical areas of splinted teeth. Research has shown that the first BS model showed the lowest values of displacements and stresses compared to the second and third systems, which made it possible to determine it as optimal. To create favorable conditions for teeth immobilization, one should take into account the degree of formation of roots, the presence of contacts between teeth, the physiological distribution of the load on injured teeth and bone, and the inclusion of at least two stable teeth in the splinting system (not including injured ones). The central incisors are the most overloaded, which explains the need to remove them from the bite.