{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T23:09:56Z","timestamp":1780441796364,"version":"3.54.1"},"reference-count":84,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006141","name":"Military University of Technology","doi-asserted-by":"publisher","award":["UGB 502-000013-W100-22"],"award-info":[{"award-number":["UGB 502-000013-W100-22"]}],"id":[{"id":"10.13039\/501100006141","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Materials"],"abstract":"<jats:p>Introduction: The aim of this study was to evaluate the effect of corticotomy incision depth on tooth movement and stress distribution in the periodontal ligament (PDL) during orthodontic expansion using finite element analysis (FEA). The demand for accelerated and biologically safe orthodontic techniques has highlighted the importance of understanding biomechanical responses to surgical adjuncts like corticotomy. Objective: The aim of this study is to assess the effect of corticotomy depth on tooth movement and periodontal ligament stress distribution during orthodontic treatment using finite element analysis. Materials and methods: A 3D FEM model was developed based on CBCT and intraoral scans to replicate anatomical structures and simulate clinical orthodontic scenarios. Four conditions were analyzed: no corticotomy and corticotomy incisions of 1 mm, 2 mm, and 3 mm depths, applied between roots and above the apex region. Different cortical bone densities were tested using Young\u2019s modulus values (12,500 MPa\u201327,500 MPa). Stress and displacement values were measured in both the crown and root regions. Results: The 3 mm corticotomy, penetrating through the cortical plate into the cancellous bone, significantly increased crown displacement (up to 26% in low-density bone) and altered root tipping patterns, reducing root movement relative to the crown. Shallower incisions (1\u20132 mm) had minimal effects. Despite increased movement, stress concentration in the cervical PDL region remained high across all scenarios, particularly in the premolar area, exceeding the 4.7 kPa threshold associated with tissue ischemia. Conclusions: Corticotomy depth is a critical factor for optimizing orthodontic tooth movement. Penetration into cancellous bone (3 mm) appears necessary to induce both: not only the Regional Acceleratory Phenomenon (RAP) but also to enhance displacement. However, this approach does not significantly reduce cervical PDL stress and offers limited periodontal protection. Individual planning based on bone density, morphology, and anatomical limitations is essential for balancing treatment efficiency and periodontal safety.<\/jats:p>","DOI":"10.3390\/ma18235290","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T13:09:25Z","timestamp":1763989765000},"page":"5290","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Corticotomy Depth as a Modulator of Orthodontic Tooth Movement and PDL Stress\u2014A Finite Element Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5281-0940","authenticated-orcid":false,"given":"Anna Ewa","family":"Kuc","sequence":"first","affiliation":[{"name":"Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3362-216X","authenticated-orcid":false,"given":"Kamil","family":"Sybilski","sequence":"additional","affiliation":[{"name":"Faculty of Mechanical Engineering, Military University of Technology, ul. gen. Sylwestra Kaliskiego 2, 00-908 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5781-6540","authenticated-orcid":false,"given":"Jacek","family":"Kotu\u0142a","sequence":"additional","affiliation":[{"name":"Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Hajduk","sequence":"additional","affiliation":[{"name":"Chair and Department of Oral Surgery, Medical University of Lublin, Doktora Witolda Chod\u017aki 6 Street, 20-093 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4326-8907","authenticated-orcid":false,"given":"Magdalena","family":"Sulewska","sequence":"additional","affiliation":[{"name":"Department of Periodontal and Oral Mucosa Diseases, Medical University of Bia\u0142ystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2021-3743","authenticated-orcid":false,"given":"Szymon","family":"Saternus","sequence":"additional","affiliation":[{"name":"Faculty of Mechanical Engineering, Military University of Technology, ul. gen. Sylwestra Kaliskiego 2, 00-908 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6934-9014","authenticated-orcid":false,"given":"Justyna Ewa","family":"Kulikowska-Kulesza","sequence":"additional","affiliation":[{"name":"Faculty of Law, University of Bialystok, Mickiewicza 1, 15-213 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Kotarska","sequence":"additional","affiliation":[{"name":"Department of Integrated Dentistry, Wroclaw Medical University, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3284-7893","authenticated-orcid":false,"given":"Beata","family":"Kawala","sequence":"additional","affiliation":[{"name":"Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1300-8020","authenticated-orcid":false,"given":"Jerzy","family":"Ma\u0142achowski","sequence":"additional","affiliation":[{"name":"Faculty of Mechanical Engineering, Military University of Technology, ul. gen. Sylwestra Kaliskiego 2, 00-908 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2518-0007","authenticated-orcid":false,"given":"Micha\u0142","family":"Sarul","sequence":"additional","affiliation":[{"name":"Department of Integrated Dentistry, Wroclaw Medical University, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.adaj.2016.09.004","article-title":"Esthetic perception of changes in facial profile resulting from orthodontic treatment with extraction of premolars: A systematic review","volume":"148","author":"Iared","year":"2017","journal-title":"J. Am. Dent. 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