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ORIGINAL RESEARCH article

Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 12 - 2024 | doi: 10.3389/fbioe.2024.1479751
This article is part of the Research Topic Applications of Digital Twin Technology in Dentistry View all 4 articles

Clinical insights into tooth extraction via torsion method: a biomechanical analysis of the tooth-periodontal ligament complex

Provisionally accepted
Jiawei Xing Jiawei Xing 1Guangzeng Zhang Guangzeng Zhang 2Mingliang Sun Mingliang Sun 2Hao Pan Hao Pan 2Congdi Zhang Congdi Zhang 2Yao Liu Yao Liu 1Kehan Li Kehan Li 1Ze He Ze He 1Kailiang Zhang Kailiang Zhang 2Jizeng Wang Jizeng Wang 3En Luo En Luo 1*Baoping Zhang Baoping Zhang 2*
  • 1 West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
  • 2 School (Hospital) of Stomatology Lanzhou University, Lanzhou 730000, China, Lanzhou, Gansu Province, China
  • 3 College of Civil Engineering and Mechanics, Lanzhou University, Lanzhou, Gansu Province, China

The final, formatted version of the article will be published soon.

    Traditionally, extracting single, flat-or curved-rooted teeth through twisting is unfeasible. However, our clinical practice suggests that such teeth can be extracted efficiently through moderate twisting in a minimally invasive manner. Given the lack of studies on biomechanics of the tooth-periodontal ligament (PDL) complex during torsion, which has further constrained its application, we assessed the feasibility of the torsion method for extracting single-rooted teeth and evaluated its minimally invasive potential. Using three-dimensional finite element analysis, we examined the stress distribution of the tooth and PDL during torsion. Then, we examined changes in the optimal torsion angle (OTA) and stress distribution across various anatomical scenarios.During torsion loading, stress concentration was primarily observed on the sing-rooted tooth surface near the alveolar crest, whereas molars at the root furcation. The OTA was found to increase under conditions such as narrowing of root width, decrease in the root apical curvature, change from type I to IV bone, alveolar bone loss, and shortening of root length. Moreover, the clinically validated model demonstrated that 74% of outcomes fell within the standard OTA range.In conclusion, the decrease in PDL area necessitated a larger angle for complete PDL tearing.Single-rooted teeth with root width-to-thickness ratios of ≥0.42 and apical curvatures of ≤30°a re suitable for extraction using the torsion method. This study confirms the feasibility of the torsion method for minimally invasive tooth extraction and expands its indications, laying the theoretical foundation and essential insights for its clinical application.

    Keywords: Biomechanics, Periodontal Ligament, Minimally invasive dentistry, Finite Element Analysis, Oral surgery

    Received: 30 Aug 2024; Accepted: 26 Sep 2024.

    Copyright: © 2024 Xing, Zhang, Sun, Pan, Zhang, Liu, Li, He, Zhang, Wang, Luo and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    En Luo, West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, China
    Baoping Zhang, School (Hospital) of Stomatology Lanzhou University, Lanzhou 730000, China, Lanzhou, Gansu Province, China

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