Study on quantitative analysis of bracket-induced nonlinear response of labio-cheek soft tissue during the orthodontic process_Journal of Biomedical Engineering

Authors：

HUA Jiahao ¹ , JI Li ^2,3 , DAI Qingyuan ¹ , LIANG Zhenyu ¹ , GUO Longmei ^2,4 ,  CHEN Taicong ^1,5

1. School of Civil Engineering and Transportation, South China University of Technology, Guangzhou 510640, P. R. China;
2. The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China;
3. Guangzhou OO Stomatology Institute, Guangzhou 510080, P. R. China;
4. Guangzhou OO Medical Scientific Limited, Guangzhou 510080, P. R. China;
5. State Key Laboratory of Subtropical Building Science, Guangzhou 510640, P. R. China;

Corresponding author：

CHEN Taicong, Email: cvchentc@scut.edu.cn

Keywords：

Orthodontic bracket; Labio-cheek soft tissue; Contact; Non-linear finite element; Submodel

DOI：

10.7507/1001-5515.202210016

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In the orthodontics process, intervention and sliding of an orthodontic bracket during the orthodontic process can arise large response of the labio-cheek soft tissue. Soft tissue damage and ulcers frequently happen at the early stage of orthodontic treatment. In the field of orthodontic medicine, qualitative analysis is always carried out through statistics of clinical cases, while quantitative explanation of bio-mechanical mechanism is lacking. For this purpose, finite element analysis of a three-dimensional labio-cheek-bracket-tooth model is conducted to quantify the bracket-induced mechanical response of the labio-cheek soft tissue, which involves complex coupling of contact nonlinearity, material nonlinearity and geometric nonlinearity. Firstly, based on the biological composition characteristics of labio-cheek, a second-order Ogden model is optimally selected to describe the adipose-like material of the labio-cheek soft tissue. Secondly, according to the characteristics of oral activity, a two-stage simulation model of bracket intervention and orthogonal sliding is established, and the key contact parameters are optimally set. Finally, the two-level analysis method of overall model and submodel is used to achieve efficient solution of high-precision strains in submodels based on the displacement boundary obtained from the overall model calculation. Calculation results with four typical tooth morphologies during orthodontic treatment show that: ① the maximum strain of soft tissue is distributed along the sharp edges of the bracket, consistent with the clinically observed profile of soft tissue deformation; ② the maximum strain of soft tissue is reduced as the teeth align, consistent with the clinical manifestation of common damage and ulcers at the beginning of orthodontic treatment and reduced patient discomfort at the end of treatment. The method in this paper can provide reference for relevant quantitative analysis studies in the field of orthodontic medical treatment at home and abroad, and further benefit to the product development analysis of new orthodontic devices.

Citation： HUA Jiahao, JI Li, DAI Qingyuan, LIANG Zhenyu, GUO Longmei, CHEN Taicong. Study on quantitative analysis of bracket-induced nonlinear response of labio-cheek soft tissue during the orthodontic process. Journal of Biomedical Engineering, 2023, 40(2): 295-302. doi: 10.7507/1001-5515.202210016 Copy

1.	李俊伟, 彭烨, 尉迟晨曦, 等. U型骶骨骨折固定的有限元分析. 生物医学工程学杂志, 2019, 36(2): 223-231.
2.	赵鸣昕, 郭媛, 王长江, 等. 膝关节活动单髁假体衬垫形状及安装位置对置换后膝关节应力分布影响的有限元分析. 生物医学工程学杂志, 2022, 39(4): 660-671.
3.	秦文龙, 丛明, 任翔, 等. 基于正中咬合优化的磨牙全瓷冠应力分析. 生物医学工程学杂志, 2020, 37(5): 802-808, 817.
4.	廖蓉, 赵云凤. 义齿修复的有限元应力分析. 生物医学工程学杂志, 2010, 27(6): 1415-1419.
5.	苏杰华, 刘佳莉, 张端强, 等. 上颌前牙段阻抗中心定位的有限元研究. 生物医学工程学杂志, 2014, 31(5): 994-1000.
6.	仵健磊, 刘云峰, 李伯休, 等. 不同牙槽骨有限元模型对牙周膜生物力学响应的影响. 生物医学工程学杂志, 2021, 38(2): 295-302.
7.	吴越琳, 刘加荣. 三维有限元分析在口腔医学领域的研究进展. 口腔医学, 2021, 41(7): 659-663.
8.	Suzuki A, Masuda T, Takahashi I, et al. Changes in stress distribution of orthodontic miniscrews and surrounding bone evaluated by 3-dimensional finite element analysis. American Journal of Orthodontics and Dentofacial Orthopedics, 2011, 140(6): e273-e280.
9.	Nalbantgil D, Tozlu M, Ozdemir F, et al. FEM analysis of a new miniplate: stress distribution on the plate, screws and the bone. European Journal of Dentistry, 2012, 6(1): 9-15.
10.	Lee R J, Moon W, Hong C. Effects of monocortical and bicortical mini-implant anchorage on bone-borne palatal expansion using finite element analysis. American Journal of Orthodontics and Dentofacial Orthopedics, 2017, 151(5): 887-897.
11.	Zeno K G, Mustapha S, Ayoub G, et al. Effect of force direction and tooth angulation during traction of palatally impacted canines: a finite element analysis. American Journal of Orthodontics and Dentofacial Orthopedics, 2020, 157(3): 377-384.
12.	Moga R A, Cosgarea R, Buru S M, et al. Finite element analysis of the dental pulp under orthodontic forces. American Journal of Orthodontics and Dentofacial Orthopedics, 2019, 155(4): 543-551.
13.	解莉. 正畸托槽对口腔黏膜组织学及细胞凋亡的实验研究. 河北医科大学, 2019.
14.	赵蔚萍. 无托槽隐形矫治与直丝弓矫治患者的疼痛程度及疼痛规律的比较研究. 实用医院临床杂志, 2019, 16(5): 179-182.
15.	吉利. 牵引托槽与正畸矫正系统及其矫正方法. 中国, 201510046931. X, 2018-11-9.
16.	皮昕. 口腔解剖生理学(第6版). 北京: 人民卫生出版社, 2006: 141-143.
17.	崔世海, 段海彤, 李海岩, 等. 皮下脂肪组织本构模型及其生物力学性能研究进展. 汽车工程学报, 2019, 9(4): 277-284.
18.	Comley K, Fleck N A. A micromechanical model for the Young’s modulus of adipose tissue. International Journal of Solids and Structures, 2010, 47(21): 2982-2990.
19.	Comley K, Fleck N A. The compressive response of porcine adipose tissue from low to high strain rate. International Journal of Impact Engineering, 2012, 46: 1-10.
20.	Alkhouli N, Mansfield J, Green E, et al. The mechanical properties of human adipose tissues and their relationships to the structure and composition of the extracellular matrix. American Journal of Physiology-Endocrinology and Metabolism, 2013, 305(12): E1427-E1435.
21.	Sims A M, Stait-Gardner T, Fong L, et al. Elastic and viscoelastic properties of porcine subdermal fat using MRI and inverse FEA. Biomechanics and Modeling in Mechanobiology, 2010, 9(6): 703-711.
22.	Geerligs M, Peters G W, Ackermans P A, et al. Does subcutaneous adipose tissue behave as an (anti-) thixotropic material?. Journal of Biomechanics, 2010, 43(6): 1153-1159.
23.	Mihai L A, Chin L, Janmey P A, et al. A comparison of hyperelastic constitutive models applicable to brain and fat tissues. Journal of the Royal Society Interface, 2015, 12(110): 0486.
24.	邢斌, 汪钰程, 冯枫, 等. 托槽转矩对上颌前牙整体内收影响的三维有限元分析. 口腔医学, 2018, 38(5): 440-444.
25.	Chen J, Ahmad R, Li W, et al. Biomechanics of oral mucosa. Journal of the Royal Society Interface, 2015, 12(109): 20150325.
26.	杨新海, 曾祥龙. 中国人正常牙齿位置和形态. 北京医科大学学报, 1998, 30(6): 528-531.
27.	Leiva-Cala C, Lorenzo-Pouso A I, Centenera-Centenera B, et al. Clinical efficacy of an Aloe Vera gel versus a 0. 12% chlorhexidine gel in preventing traumatic ulcers in patients with fixed orthodontic appliances: a double-blind randomized clinical trial. Odontology, 2020, 108(3): 470-478.

1. 李俊伟, 彭烨, 尉迟晨曦, 等. U型骶骨骨折固定的有限元分析. 生物医学工程学杂志, 2019, 36(2): 223-231.
2. 赵鸣昕, 郭媛, 王长江, 等. 膝关节活动单髁假体衬垫形状及安装位置对置换后膝关节应力分布影响的有限元分析. 生物医学工程学杂志, 2022, 39(4): 660-671.
3. 秦文龙, 丛明, 任翔, 等. 基于正中咬合优化的磨牙全瓷冠应力分析. 生物医学工程学杂志, 2020, 37(5): 802-808, 817.
4. 廖蓉, 赵云凤. 义齿修复的有限元应力分析. 生物医学工程学杂志, 2010, 27(6): 1415-1419.
5. 苏杰华, 刘佳莉, 张端强, 等. 上颌前牙段阻抗中心定位的有限元研究. 生物医学工程学杂志, 2014, 31(5): 994-1000.
6. 仵健磊, 刘云峰, 李伯休, 等. 不同牙槽骨有限元模型对牙周膜生物力学响应的影响. 生物医学工程学杂志, 2021, 38(2): 295-302.
7. 吴越琳, 刘加荣. 三维有限元分析在口腔医学领域的研究进展. 口腔医学, 2021, 41(7): 659-663.
8. Suzuki A, Masuda T, Takahashi I, et al. Changes in stress distribution of orthodontic miniscrews and surrounding bone evaluated by 3-dimensional finite element analysis. American Journal of Orthodontics and Dentofacial Orthopedics, 2011, 140(6): e273-e280.
9. Nalbantgil D, Tozlu M, Ozdemir F, et al. FEM analysis of a new miniplate: stress distribution on the plate, screws and the bone. European Journal of Dentistry, 2012, 6(1): 9-15.
10. Lee R J, Moon W, Hong C. Effects of monocortical and bicortical mini-implant anchorage on bone-borne palatal expansion using finite element analysis. American Journal of Orthodontics and Dentofacial Orthopedics, 2017, 151(5): 887-897.
11. Zeno K G, Mustapha S, Ayoub G, et al. Effect of force direction and tooth angulation during traction of palatally impacted canines: a finite element analysis. American Journal of Orthodontics and Dentofacial Orthopedics, 2020, 157(3): 377-384.
12. Moga R A, Cosgarea R, Buru S M, et al. Finite element analysis of the dental pulp under orthodontic forces. American Journal of Orthodontics and Dentofacial Orthopedics, 2019, 155(4): 543-551.
13. 解莉. 正畸托槽对口腔黏膜组织学及细胞凋亡的实验研究. 河北医科大学, 2019.
14. 赵蔚萍. 无托槽隐形矫治与直丝弓矫治患者的疼痛程度及疼痛规律的比较研究. 实用医院临床杂志, 2019, 16(5): 179-182.
15. 吉利. 牵引托槽与正畸矫正系统及其矫正方法. 中国, 201510046931. X, 2018-11-9.
16. 皮昕. 口腔解剖生理学(第6版). 北京: 人民卫生出版社, 2006: 141-143.
17. 崔世海, 段海彤, 李海岩, 等. 皮下脂肪组织本构模型及其生物力学性能研究进展. 汽车工程学报, 2019, 9(4): 277-284.
18. Comley K, Fleck N A. A micromechanical model for the Young’s modulus of adipose tissue. International Journal of Solids and Structures, 2010, 47(21): 2982-2990.
19. Comley K, Fleck N A. The compressive response of porcine adipose tissue from low to high strain rate. International Journal of Impact Engineering, 2012, 46: 1-10.
20. Alkhouli N, Mansfield J, Green E, et al. The mechanical properties of human adipose tissues and their relationships to the structure and composition of the extracellular matrix. American Journal of Physiology-Endocrinology and Metabolism, 2013, 305(12): E1427-E1435.
21. Sims A M, Stait-Gardner T, Fong L, et al. Elastic and viscoelastic properties of porcine subdermal fat using MRI and inverse FEA. Biomechanics and Modeling in Mechanobiology, 2010, 9(6): 703-711.
22. Geerligs M, Peters G W, Ackermans P A, et al. Does subcutaneous adipose tissue behave as an (anti-) thixotropic material?. Journal of Biomechanics, 2010, 43(6): 1153-1159.
23. Mihai L A, Chin L, Janmey P A, et al. A comparison of hyperelastic constitutive models applicable to brain and fat tissues. Journal of the Royal Society Interface, 2015, 12(110): 0486.
24. 邢斌, 汪钰程, 冯枫, 等. 托槽转矩对上颌前牙整体内收影响的三维有限元分析. 口腔医学, 2018, 38(5): 440-444.
25. Chen J, Ahmad R, Li W, et al. Biomechanics of oral mucosa. Journal of the Royal Society Interface, 2015, 12(109): 20150325.
26. 杨新海, 曾祥龙. 中国人正常牙齿位置和形态. 北京医科大学学报, 1998, 30(6): 528-531.
27. Leiva-Cala C, Lorenzo-Pouso A I, Centenera-Centenera B, et al. Clinical efficacy of an Aloe Vera gel versus a 0. 12% chlorhexidine gel in preventing traumatic ulcers in patients with fixed orthodontic appliances: a double-blind randomized clinical trial. Odontology, 2020, 108(3): 470-478.

Journal of Biomedical Engineering

Study on quantitative analysis of bracket-induced nonlinear response of labio-cheek soft tissue during the orthodontic process

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