Numerical investigation of the biomechanical effects of orthodontic intermaxillary elastics on the temporomandibular joint

Temporomandibular joint disorder (TMD) often coincides with malocclusion, and in some cases TMDs are reported after orthodontic treatment. Intermaxillary elastics (also known as orthodontic elastics, OE) are a common way to apply force during orthodontic treatment, and they might cause mechanical effects on the temporomandibular joint (TMJ), thereby lead to joint remodeling. It is still a controversial topic whether the adapted remodeling of the TMJ or of the alveolar bone is the main cause for the alteration of occlusion after treatment with OEs. It was the aim of this study to analyze whether variations of OEs would develop harmful effects on the healthy TMJ. A TMJ model with a masticatory system based on Hill-type muscle actuators was established. Mouth opening and closure with and without OEs were simulated, and maximum principal stresses in the disc and condylar cartilage as well as the displacement of the mandible were analyzed. We found no considerably difference in the mandibular movement without and with symmetrical OEs during mouth opening and closing. At full mouth opening, stresses in the disc and condylar cartilage of some models with OEs were much smaller than without OEs, but we did not find consistency in the results from the left and right sides of the same model (e.g. the lowest compressive stress on the left side of disc from the model with Class II OEs is much smaller than without OEs, −17.3 MPa compared with −28.2, while on the right side, there was no obvious difference). Hence, we could not conclude that OEs would develop deleterious effects on the healthy TMJ.