Finite element analysis of the human mandible to assess the effect of removing an impacted third molar.
OBJECTIVE
Finite element analysis (FEA) was used to generate 3-dimensional models of a human mandible with impacted third molars. The aim was to analyze the effects of removing various amounts of bone around an impacted mandibular third molar and to predict the possibility of iatrogenic fracture.


METHODS
Data were acquired from cone beam computed tomography (CBCT) scans of a patient using numerically calculated mechanical parameters. Virtual surgery was then performed on the mandibular models, and standardized chewing forces were applied to the resulting simulations.


RESULTS
The modelling showed that the highest stress during normal clenching occurred if the surgical procedure involved the external oblique ridge. The peak stress occurred at the site of removal of the third molar, during contralateral loading of the mandible.


CONCLUSIONS
Use of CBCT allowed production of high-quality models of an individual patient and simulation of various surgical scenarios. FEA identified the accumulation of stress and strain at specific parts of the mandible and predicted the responses of bone to mechanical activity. FEA could prove useful to dental practitioners in the future to predict the likelihood of iatrogenic fracture of the jaws after surgical removal of mandibular bone, such as occurs when the third molar is removed. This may allow dentists to change their approach to tooth removal in certain cases.
Szucs
Attila
A
Department of oral and maxillofacial surgery and dentistry, faculty of dentistry, Semmelweis University, Budapest, Hungary.
Bujtár
Péter
P
Sándor
George K B
GK
Barabás
József
J
D001696:Biomechanical Phenomena; D001732:Bite Force; D015519:Bone Density / Q000502:physiology; D003198:Computer Simulation; D054893:Cone-Beam Computed Tomography / Q000379:methods; D055119:Elastic Modulus; D005260:Female; D020342:Finite Element Analysis; D005544:Forecasting; D006801:Humans; D007049:Iatrogenic Disease; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008337:Mandibular Fractures / Q000209:etiology; D008953:Models, Anatomic; D008954:Models, Biological; D008964:Molar, Third / Q000473:pathology / Q000601:surgery*; D010027:Osteotomy; D010347:Patient Care Planning; D011862:Radiography, Panoramic / Q000379:methods; D013314:Stress, Mechanical; D014095:Tooth, Impacted / Q000473:pathology / Q000601:surgery*; D014584:User-Computer Interface; D055815:Young Adult