Finite Element Analysis of TMJ Disks Stress Level due to Orthodontic Eruption Guidance Appliances

In the present work, the effect of Eruption Guidance Appliances (EGAs) on TemporoMandibular Joint (TMJ) disks stress level is studied. EGAs are orthodontic appliances used for early orthodontic treatments in order to prevent malocclusion problems. Commercially available EGAs are usually produced by using standard sizes. For this reason, they are not able to meet all the specific needs of each patient. In particular, EGAs are symmetric devices, while patient arches generally present asymmetric conditions. Thus, uneven stress levels may occur in TMJ disks, causing comfort reduction and potential damage to the most solicited disk. On the other hand, a customized EGA could overcome these issues, improving the treatment effectiveness. In this preliminary study, a Finite Element (FE) model was developed to investigate the effects of a symmetric EGA when applied to an asymmetric mouth. Different misalignment conditions were studied to compare the TMJ disks stress levels and to analyze the limitations of a symmetric EGA. The developed FE model can be used to design patient-specific EGAs, which could be manufactured by exploiting non-conventional techniques such as 3D printing.