Efeito do tipo de traumatismo e da contenção dental na dentadura mista e permanente - avaliação biomecânica pelo método de elementos finitos

Abstract

Traumatic dental injuries (TDI) are a public health problem, due to its high prevalence and recurrence rate, mainly in young patients. TDI's treatment also involves high cost, complex treatment and it needs long-term follow-up. However, there are still a lack of evidence of the biomechanical behavior of splinting after TDI in mixed and permanent dentures and consequences during splinting removal on enamel. In severe dental trauma injuries, it is extremely important the reposition and splinting of the injured tooth, but the stiffness, stability and the extension of the splint on the different ages still induces uncertainty and generates a diversity and non-unified protocols. Besides that, the removal procedures of the dental splints are still based in empirical decisions. This thesis was structure in three specific aims. First Aim: Evaluate the effect of different types of semi-rigid splint in patient specific three-dimensional model, generated from a cone-beam tomography, simulating a permanent avulsed incisor on strain and stress distribution on traumatized tooth and at adjacent teeth and dentoalveolar structures. Second Aim: To evaluate the effect on mobility of splint materials and extensions for an avulsed central incisor, stabilized with and without the adjacent incisor under intrusive and extrusive loading under different periodontal ligament (PDL) conditions. Third Aim: To evaluate in an experimental in vitro the preventive effect of iatrogenic damage caused to the enamel in the removal of dental containment varying the violet light illumination and the type of rotating instrument. These objectives are significantly crucial for the possible generation and simplification of protocols in the choice and removal of the splint for dental trauma cases, in order to facilitate the treatment and clinical management of these patients.