New finite element study protocol: Clinical simulation of orthodontic tooth movement

The aim of this work was to model tooth movement in a more clinically-exact fashion, thanks to the use of new IT tools and imaging systems (cone-beam). Image segmentation and 3D reconstruction now enable us to model the anatomy realistically, while finite element (FE) analysis makes it possible to evaluate stresses and their distribution on the level of the tooth, the periodontal ligament (PDL) and the alveolar bone when a force is applied. The principle is to monitor tooth movement by obtaining optical impressions at each stage of treatment. The model corresponds to a genuine clinical situation. FE analysis is correlated with the clinically-observed displacement. The protocol remains long and complex. It nevertheless makes it possible to obtain, throughout the duration of treatment, patient-specific models that can be exploited using finite element methods. It requires further validation in more thorough studies but offers interesting prospects: precise study of induced tooth movement, distribution of stresses in the PDL, and development of a customized previsualization tool.