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Han M, Li SH, Yao Y, Zhao Y, You LP, Zheng Q, Xu XM. Risk factors for gingival invagination: A retrospective study. J Clin Periodontol 2024; 51:1199-1209. [PMID: 38783632 DOI: 10.1111/jcpe.14005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/07/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
AIM This study aimed to identify the risk factors for gingival invagination during orthodontic treatment after premolar extraction. MATERIALS AND METHODS The medical records of 135 patients who had undergone interdental space closure after premolar extraction were collected, and cone beam computed tomography was performed to determine the presence of gingival invagination. The risk factors were examined using mixed-effects models and generalized propensity score weighting (GPSW) to develop a predictive model. RESULTS Univariate analysis revealed that the extraction site, buccal bone thickness 4 mm apical to the cemento-enamel junction (MB1), mid-root buccal bone thickness (MB2) and vertical skeletal relationships were related to gingival invagination (p < .05). Furthermore, a subsequent multivariable mixed-effects model analysis indicated a significantly increased risk of gingival invagination at MB1 < 1 mm (p < .001; odds ratio [ORMB1≤0.5mm] = 29.304; 95% confidence interval [CI]: 8.986-93.807; OR0.5 CONCLUSIONS The risk of gingival invagination is higher in patients with MB1 < 1 mm and in normodivergent or hyperdivergent patients.
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Affiliation(s)
- M Han
- Department of Orthodontics, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, China
| | - S H Li
- Department of Orthodontics, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, China
| | - Y Yao
- Department of Orthodontics, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, China
| | - Yijiao Zhao
- The Center of Digital Dentistry, Faculty of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - L P You
- Department of Orthodontics, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, China
| | - Q Zheng
- Department of Orthodontics, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, China
| | - X M Xu
- Department of Orthodontics, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, China
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Zhong J, Huang W, Ahmad R, Chen J, Wu C, Hu J, Zheng K, Swain MV, Li Q. A Soft-Tissue Driven Bone Remodeling Algorithm for Mandibular Residual Ridge Resorption Based on Patient CT Image Data. Adv Healthc Mater 2024; 13:e2400091. [PMID: 38722148 DOI: 10.1002/adhm.202400091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/04/2024] [Indexed: 09/03/2024]
Abstract
The role of the biomechanical stimulation generated from soft tissue has not been well quantified or separated from the self-regulated hard tissue remodeling governed by Wolff's Law. Prosthodontic overdentures, commonly used to restore masticatory functions, can cause localized ischemia and inflammation as they often compress patients' oral mucosa and impede local circulation. This biomechanical stimulus in mucosa is found to accelerate the self-regulated residual ridge resorption (RRR), posing ongoing clinical challenges. Based on the dedicated long-term clinical datasets, this work develops an in-silico framework with a combination of techniques, including advanced image post-processing, patient-specific finite element models and unsupervised machine learning Self-Organizing map algorithm, to identify the soft tissue induced RRR and quantitatively elucidate the governing relationship between the RRR and hydrostatic pressure in mucosa. The proposed governing equation has not only enabled a predictive simulation for RRR as showcased in this study, providing a biomechanical basis for optimizing prosthodontic treatments, but also extended the understanding of the mechanobiological responses in the soft-hard tissue interfaces and the role in bone remodeling.
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Affiliation(s)
- Jingxiao Zhong
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
| | - Wenwei Huang
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
| | - Rohana Ahmad
- Faculty of Dentistry and Integrative Pharmacogenomics Institute, Universiti Teknologi MARA, Selangor, 40450, Malaysia
| | - Junning Chen
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, EX4 4QJ, UK
| | - Chi Wu
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
| | - Jingrui Hu
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, EX4 4QJ, UK
| | - Keke Zheng
- Institute for Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot Watt University, Edinburgh, EH14 4AS, UK
| | - Michael V Swain
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
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Lai K, Yu Q, Huang T, Dai W, Yu Z, Wang Y, Xi Y, Chen Y, Yang G. Bone alteration and esthetics associated with implant-supported prostheses in the anterior maxilla under different implant placement timing: A retrospective clinical study of 1 to 3 years. J Prosthet Dent 2024:S0022-3913(24)00353-6. [PMID: 38806340 DOI: 10.1016/j.prosdent.2024.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 05/30/2024]
Abstract
STATEMENT OF PROBLEM Different factors influence alterations in facial bone thickness and esthetic outcomes after implant placement. Whether the timing of implant placement influences alterations in the bone dimensional and esthetic outcomes is unclear. PURPOSE The purpose of this retrospective clinical study was to assess the influence of the timing of implant placement on alveolar bone alterations and esthetic outcome. MATERIAL AND METHODS Data were collected from 40 patients who had received guided bone regeneration (GBR) performed simultaneously with immediate, early, or delayed single-tooth implant placement in the anterior maxilla. Facial and palatal horizontal bone thicknesses (FHBT, PHBT) and vertical bone level (FVBL, PVBL) immediately after surgery (T0), at 6 months after implant placement (T1), and at 1 to 3 years follow-up (T2) were measured, and the changes calculated. The pink esthetic score (PES) and white esthetic score (WES) were evaluated at the 1- to 3-year follow-up. The Kruskal-Wallis followed by the Dunn t test was applied to evaluate bone alteration among groups, and the Bonferroni method was used for adjusting multiple comparisons. The 1-way ANOVA test was used to determine any significance in the esthetic outcome in the 3 groups (α=.05). RESULTS The reduction in the FHBT0 of the immediate, early, and delayed implant placement group (T2-T0) was -1.17 (-1.70, -0.61) mm, -1.53 (-1.69, -0.49) mm, and -1.47 (-2.30, -0.20) mm, respectively. The FHBT around the implant apices remained basically stable. No obvious changes in the PHBT around the implants of the immediate and delayed implant placement group were noted. The FVBL significantly decreased in each group during the follow-up period (-1.34 (01.88, -0.56) mm, immediate; -2.88 (-3.79, -1.07) mm, early; -1.26 (-2.52, -0.48) mm, delayed). The PVBL change in the early implant placement group (-2.18 (-3.26, -0.86) mm) was more significant than that in the immediate (-0.55 (-2.10, -0.17) mm) and delayed (-0.51 (-1.29, 0.02) mm) implantation groups (P =.013). The mean ±standard deviation PES/WES score of the immediate (15.6 ±1.84) and early (15.00 ±1.13) implant placement groups was higher than that of the delayed implant placement group (13.92 ±2.10) without significant difference. CONCLUSIONS Similar bone changes and esthetic outcomes were found around implants of the immediate, early, and delayed implant placement groups.
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Affiliation(s)
- Kaichen Lai
- Attending Physician, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Qiong Yu
- Resident Physician, Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Tingben Huang
- Attending Physician, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Wei Dai
- Graduate student, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Zhou Yu
- Postgraduate student, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Yuchen Wang
- Postgraduate student, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Yue Xi
- Resident Physician, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Yitong Chen
- Postgraduate student, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Guoli Yang
- Professor, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China.
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Ichikawa H, Yoda N, Ogawa T, Iwamoto M, Kawata T, Egusa H, Sasaki K. Impact of implant location on load distribution of implant-assisted removable partial dentures: a review of in vitro model and finite-element analysis studies. Int J Implant Dent 2023; 9:31. [PMID: 37725286 PMCID: PMC10509086 DOI: 10.1186/s40729-023-00500-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Appropriate load distribution among the supporting elements is essential for the long-term success of implant-assisted removable partial dentures; however, there is little information available on load distribution. PURPOSE This study aimed to evaluate the effect of implant location on load distribution in implant-assisted removable partial dentures by reviewing in vitro models and finite-element analysis studies. MATERIALS AND METHODS English-language studies which examined the load distribution of implant-assisted removable partial dentures and were published between January 2001 and October 2022 were extracted from PubMed, ScienceDirect, and Scopus online databases, and manual searching. Two reviewers selected the articles based on the predetermined inclusion and exclusion criteria, followed by data extraction and analysis. RESULTS Forty-seven studies were selected after evaluating the titles and abstracts of 264 articles; two were identified manually. After screening the text, 12 studies were included: six in vitro model experiments and six finite-element analysis studies. All included studies used a mandibular free-end missing model (Kennedy Class I or II). The influence of implant location on load distribution to the abutment tooth, implant, and mucosa under the denture base was summarized in three cases: implant at the premolar, first molar, and second molar region. Due to differences in the measurement method of load distribution and loading condition to the denture, the results differed among the studies. CONCLUSIONS The implant location in implant-assisted removable partial dentures can affect load distribution to the supporting elements, such as the abutment tooth, implant, and mucosa under the denture base.
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Affiliation(s)
- Hiromi Ichikawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
- Dental Technical Training School attached to Nihon University School of Dentistry, Tokyo, Japan
| | - Nobuhiro Yoda
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan.
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia.
| | - Toru Ogawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
| | - Maya Iwamoto
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
| | - Tetsuo Kawata
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
| | - Hiroshi Egusa
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
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Irandoust S, Müftü S. On computational predictions of fluid flow and its effects on bone healing in dental implant treatments: an investigation of spatiotemporal fluid flow in cyclic loading. Biomech Model Mechanobiol 2023; 22:85-104. [PMID: 36329356 DOI: 10.1007/s10237-022-01633-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/05/2022] [Indexed: 11/06/2022]
Abstract
Fluid flow in (porous) bone plays an important role in its maintenance, adaptation, and healing after an injury. Experimental and computational studies apply mechanical loading on bone to predict fluid flow development and/or to find its material properties. In most cases, mechanical loading is applied as a linear function in time. Multiple loading functions-with identical peak load and loading frequency-were used to investigate load-induced fluid flow and predict bone healing surrounding a dental implant. Implementing an instantaneous healing stimulus led to major differences in healing predictions for slightly different loading functions. Load-induced fluid flow was found to be displacement-rate dependent with complex spatial-temporal variations and not necessarily symmetrical during loading and unloading phases. Haversine loading resulted in more numerical stability compared to ramped/triangular loading, providing the opportunity for further investigation of the effects of various physiological masticatory loadings. It was concluded that using the average healing stimulus during cyclic loading gives the most robust bone healing predictions.
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Affiliation(s)
- Soroush Irandoust
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, 02115, USA.
| | - Sinan Müftü
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, 02115, USA
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6
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Wan B, Yoda N, Zheng K, Zhang Z, Wu C, Clark J, Sasaki K, Swain M, Li Q. On interaction between fatigue of reconstruction plate and time-dependent bone remodeling. J Mech Behav Biomed Mater 2022; 136:105483. [PMID: 36302272 DOI: 10.1016/j.jmbbm.2022.105483] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE The fibula free flap (FFF) has been extensively used to repair large segmental bone defects in the maxillofacial region. The reconstruction plate plays a key role in maintaining stability and load-sharing while the fibula unites with adjacent bone in the course of healing and remodeling. However, not all fibula flaps would fully unite, and fatigue of prosthetic devices has been recognized as one major concern for long-term load-bearing applications. This study aims to develop a numerical approach for predicting the fatigue life of the reconstruction plate by taking into account the effect of ongoing bone remodeling. METHODS The patient-specific mandible reconstruction with a prosthetic system is studied in this work. The 3D finite element model with heterogeneous material properties obtained from clinical computerized tomography (CT) data is developed for bone, and eXtended Finite Element Method (XFEM) is adopted for the fatigue analysis of the plate. During the remodeling process, the changing apparent density and Young's modulus of bone are simulated in a step-wise fashion on the basis of Wolff's law, which is correlated with the specific clinical follow-up. The maximum biting forces were considered as the driving force on the bone remodeling, which are measured clinically at different time points (4, 16 and 28 months) after reconstruction surgery. RESULTS Under various occlusal loadings, the interaction between fatigue crack growth and bone remodeling is investigated to gain new insights for the future design of prosthetic devices. The simulation results reveal that appropriate remodeling of grafted bone could extend the fatigue life of fixation plates in a positive way. On the other hand, the rising occlusal load associated with healing and remodeling could lead to fatigue fracture of fixation plate and potentially cause severe bone resorption. CONCLUSION This study proposes an effective approach for more realistically predicting fatigue life of prosthetic devices subject to a tissue remodeling condition in-silico. It is anticipated to provide a guideline for deriving an optimal design of patient-specific prosthetic devices to better ensure longevity.
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Affiliation(s)
- Boyang Wan
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, NSW, 2006, Australia.
| | - Nobuhiro Yoda
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 9808575, Japan.
| | - Keke Zheng
- College of Engineering, Mathematics, and Physical Sciences, University of Exeter, EX4 4QF, United Kingdom.
| | - Zhongpu Zhang
- School of Computing, Engineering and Mathematics, Western Sydney University, Penrith, NSW, 2751, Australia.
| | - Chi Wu
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, NSW, 2006, Australia.
| | - Jonathan Clark
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, NSW, 15, Australia.
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 9808575, Japan.
| | - Michael Swain
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, NSW, 2006, Australia.
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, NSW, 2006, Australia.
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Assoratgoon I, Yoda N, Iwamoto M, Sato T, Kawata T, Egusa H, Sasaki K. In vivo measurement of three-dimensional load exerted on dental implants: a literature review. Int J Implant Dent 2022; 8:52. [DOI: 10.1186/s40729-022-00454-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/17/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
For biomechanical consideration of dental implants, an understanding of the three-dimensional (3D) load exerted on the implant is essential, but little information is available on the in vivo load, including the measuring devices.
Purpose
This review aimed to evaluate studies that used specific load-measuring devices that could be mounted on an implant to measure the functional load in vivo.
Materials and methods
An electronic search utilizing the internet research databases PubMed, Google Scholar, and Scopus was performed. The articles were chosen by two authors based on the inclusion and exclusion criteria.
Results
In all, 132 studies were selected from the database search, and 16 were selected from a manual search. Twenty-three studies were finally included in this review after a complete full-text evaluation. Eleven studies were related to the force measurements using the strain gauges, and 12 were related to the piezoelectric force transducer. The principles of the two types of devices were completely different, but the devices produced comparable outcomes. The dynamics of the load magnitude and direction on the implant during function were clarified, although the number of participants in each study was small.
Conclusions
The load exerted on the implant during function was precisely measured in vivo using specific measuring devices, such as strain gauges or piezoelectric force transducers. The in vivo load data enable us to determine the actual biomechanical status in more detail, which might be useful for optimization of the implant prosthetic design and development of related materials. Due to the limited data and difficulty of in vivo measurements, the development of a new, simpler force measurement device and method might be necessary.
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Onone Gialain I, Folmer Rodrigues da Silva L, Kasumi Gantier Takano M, Yagüe Ballester R, Guimarães Roscoe M, Barbosa Cruz Meira J. Peri-implant bone resorption risk of anterior maxilla narrow single implants: a finite-element analysis. Biomater Investig Dent 2022; 9:92-100. [PMID: 36325029 PMCID: PMC9621276 DOI: 10.1080/26415275.2022.2135516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Statement of the problem: Narrow implants have been recommended in high esthetic demand regions to ensure greater buccal bone thickness (BBT) and minimize soft-tissue recession due to insufficient bone support. However, a limited area of bone-implant interface can increase the risk of peri-implant bone resorption due to occlusal forces. Purpose: This article encourages the use of evidence-based finite element analysis to optimize the aesthetic outcomes in maxillary lateral incisor single-supported implant crown by accurate biomechanical planning. This study aimed to analyze the best implant dimensions that would preserve the maximum BBT and avoid peri-implant bone resorption due to occlusal forces. Materials and methods: A maxilla segment was constructed based on anthropological measurements. Four implant diameters (Ø = 3.25; 3.50; 3.75 or 4.00 mm) and two lengths (L = 10 or 13 mm) were simulated. The occlusal force parameters were defined to simulate clinical conditions. The bone resorption risk analysis was based on Frost's mechanostat theory altering the strain output to strain energy density (SED). The peri-implant bone resorption risk indexes (PIBRri) were calculated by dividing the average of the top ten SED elements of the cortical and trabecular buccal wall by the pathologic resorption limit for each bone. Results: For trabecular bone, only the model Ø4.00L13 exhibited a low PIBRri. For cortical bone, all models presented a low PIBRri, except for models Ø3.25. Conclusion: The selection of a 3.25 mm dental implant to preserve a 2 mm BBT should be avoided since it generates a high peri-implant bone resorption risk induced by occlusal overload.
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Affiliation(s)
- Ivan Onone Gialain
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | | | - Marlene Kasumi Gantier Takano
- “Finite element analysis in Dentistry” Course, School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Rafael Yagüe Ballester
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Marina Guimarães Roscoe
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Josete Barbosa Cruz Meira
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil,CONTACT Josete Barbosa Cruz Meira Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
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9
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Liu B, Lv Y, Li X, Liu Z, Zheng Y, Wen P, Liu N, Huo Y, Zhou F, Tian Y. Influence of different fixation modes on biomechanical conduction of 3D printed prostheses for treating critical diaphyseal defects of lower limbs: A finite element study. Front Surg 2022; 9:959306. [PMID: 36090321 PMCID: PMC9448880 DOI: 10.3389/fsurg.2022.959306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/04/2022] [Indexed: 11/15/2022] Open
Abstract
Background Applying 3D printed prostheses to repair diaphyseal defects of lower limbs has been clinically conducted in orthopedics. However, there is still no unified reference standard for which the prosthesis design and fixation mode are more conducive to appropriate biomechanical conduction. Methods We built five different types of prosthesis designs and fixation modes, from Mode I to Mode V. Finite element analysis (FEA) was used to study and compare the mechanical environments of overall bone-prosthesis structure, and the maximum stress concentration were recorded. Additionally, by comparing the maximum von Mises stress of bone, intramedullary (IM) nail, screw, and prosthesis with their intrinsic yield strength, the risk of fixation failure was further clarified. Results In the modes in which the prosthesis was fixed by an interlocking IM nail (Mode I and Mode IV), the stress mainly concentrated at the distal bone-prosthesis interface and the middle-distal region of nail. When a prosthesis with integrally printed IM nail and lateral wings was implanted (Mode II), the stress mainly concentrated at the bone-prosthesis junctional region. For cases with partially lateral defects, the prosthesis with integrally printed wings mainly played a role in reconstructing the structural integrity of bone, but had a weak role in sharing the stress conduction (Mode V). The maximum von Mises stress of both the proximal and distal tibia appeared in Mode III, which were 18.5 and 47.1 MPa. The maximum peak stress shared by the prosthesis, screws and IM nails appeared in Mode II, III and I, which were 51.8, 87.2, and 101.8 MPa, respectively. These peak stresses were all lower than the yield strength of the materials themselves. Thus, the bending and breakage of both bone and implants were unlikely to happen. Conclusion For the application of 3D printed prostheses to repair diaphyseal defects, different fixation modes will lead to the change of biomechanical environment. Interlocking IM nail fixation is beneficial to uniform stress conduction, and conducive to new bone regeneration in the view of biomechanical point. All five modes we established have reliable biomechanical safety.
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Affiliation(s)
- Bingchuan Liu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Yang Lv
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Xingcai Li
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
| | - Zhongjun Liu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Yufeng Zheng
- School of Materials Science and Engineering, Peking University, Beijing, China
| | - Peng Wen
- Department of Mechanical Engineering, Tsinghua University, Beijing, China
| | - Ning Liu
- R&D Center, AK Medical Co., Ltd., Beijing, China
| | - Yaping Huo
- R&D Center, AK Medical Co., Ltd., Beijing, China
| | - Fang Zhou
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
- Correspondence: Fang Zhou Yun Tian
| | - Yun Tian
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
- Correspondence: Fang Zhou Yun Tian
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10
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Liao M, Wang C, Wang C, Xu Y. Influence of bone morphology on the mechanobiological stimuli distribution of maxillary anterior labial bone: A biomechanical study. J ESTHET RESTOR DENT 2022; 34:1085-1095. [PMID: 35674468 DOI: 10.1111/jerd.12935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/14/2022] [Accepted: 05/23/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study intended to ascertain the dimensional effects of labial bone thickness and height on the mechanobiological stimuli distribution of maxillary anterior labial bone through biomechanical analysis. MATERIAL AND METHODS Twelve 3D finite element models of an anterior maxillary region with an implant were computer-simulated, including four levels of labial bone thicknesses (2, 1.5, 1.0, and 0.5 mm) and three levels of labial bone heights (normal, reduced by 1/3, reduced by 1/2). A 45° buccolingual oblique load of 100 N was applied to the implant restoration. RESULTS Equivalent stress and principal strain mainly concentrated on crestal bone around the implant neck. The maximum equivalent stress in bone decreased as labial bone mass decreased, while the maximum principal strain and the displacement of dental implant increased as labial bone mass decreased. No significant difference of these three indicators was observed, when the labial bone thickness changed in the range of 2.0-1.0 mm with sufficient labial bone height. CONCLUSIONS In terms of biomechanics, the thickness of labial bone plate was recommended ≥1 mm. Sufficient labial bone height was warranted to prevent the stability of the implants from being seriously affected. The labial bone heights were more effective than thicknesses on the mechanobiological stimuli response of the dental implant-bone system. CLINICAL SIGNIFICANCE For this 3D finite element study, the biomechanical responses under different bone mass conditions were explored, in order to predict the process of bone remodeling and provide valid clinical recommendations for the decision-making process regarding the choices of tissue augmentation for some specific esthetic implantation cases for future clinical applications.
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Affiliation(s)
- Menglin Liao
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Chunjuan Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Chao Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China.,Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, China.,School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Yamei Xu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
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Yu W, Chen S, Ma L, Ma X, Xu X. Biomechanical Analysis of Different Framework Design, Framework Material and Bone Density in the Edentulous Mandible With Fixed Implant-Supported Prostheses: A Three-Dimensional Finite Element Study. J Prosthodont 2022; 32:309-317. [PMID: 35546271 DOI: 10.1111/jopr.13532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 04/24/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The objective of this finite element study was to investigate the effect of different framework designs, framework materials, and bone densities on the stress distribution of fixed implant-supported prostheses for edentulous mandibles. MATERIALS AND METHODS Under the condition of 2-mm cortical bone, 16 models were created in the edentulous mandible to simulate different framework designs (1-piece or 3-piece frameworks) with different framework material (pure titanium, zirconia, polyetheretherketone, or carbon fiber-reinforced polyetheretherketone) in-high or low-density trabecular bone. Then, vertical loading and oblique loading at 75° were applied to the anterior and posterior regions. The stress distribution and stress concentration region of implant and peri-implant bone with different combinations were compared by finite element analysis. RESULTS The use of the 1-piece zirconia framework in high-density trabecular bone improved stress distribution on implants and peri-implant bone. The region of stress concentration is located in the buccal cervix of the distal implants and the distobuccal portion of the cortical bone in all models. To improve the stress distribution on fixed implant-supported dentures for edentulous mandibles, the 1-piece framework and zirconia represent the better combinations. CONCLUSION Under the condition of 2-mm cortical bone thickness, the full-arch zirconia framework had minimum von Mises stress on implants and peri-implant bone in all models, and high trabecular bone density greatly decreased the stress on cortical bone. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Wenqian Yu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Siyi Chen
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Li Ma
- Department of Vip center, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xiaoni Ma
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xin Xu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
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Lin C, Hu H, Zhu J, Rong Q, Tang Z. Influence of different diameter reductions in the labial neck region on the stress distribution around custom-made root-analogue implants. Eur J Oral Sci 2022; 130:e12833. [PMID: 35014088 DOI: 10.1111/eos.12833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/28/2021] [Indexed: 01/16/2023]
Abstract
This study was designed to investigate the influence of diameter reductions on the stress distribution around root-analogue implants via 3D finite element analysis. Four root-analogue implant models with different diameter reductions (0, 1, 2, or 3 mm), a traditional threaded implant and congruent bone models were created through reverse engineering. A 100-N force was applied parallel with and in a 45° angle to the implant axis, respectively. The stress concentration in the labial neck area around implants with 1-2 mm diameter reduction was lower than seen with no reduction. When the implant diameter was reduced by 3 mm, there were obvious stress concentrations in both implant and bone (the maximum stress was 206 and 111 MPa, respectively). In other groups, the maximum stress was 65.1 MPa in the bone and 108 MPa in the implant. Additionally, the stress concentration in the bone around the root-analogue implant when the implant diameter was reduced by 0-2 mm (maximum stress of 65.1 MPa) was obviously smaller than that around the traditional implant (maximum stress 130.4 MPa). Reducing the diameter of maxillary central incisor root-analogue implants by up to 2 mm next to the labial cortical bone could help disperse stress.
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Affiliation(s)
- Chunping Lin
- Department of Stomatology, Fujian Provincial Hospital, Fujian, China.,Second Dental Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hongcheng Hu
- Second Dental Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Junxin Zhu
- Second Dental Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Zhihui Tang
- Second Dental Center, Peking University School and Hospital of Stomatology, Beijing, China
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Ghaziani AO, Soheilifard R, Kowsar S. The effect of functionally graded materials on bone remodeling around osseointegrated trans-femoral prostheses. J Mech Behav Biomed Mater 2021; 118:104426. [PMID: 33740685 DOI: 10.1016/j.jmbbm.2021.104426] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 10/21/2022]
Abstract
Osseointegrated trans-femoral fixations have been used as alternatives for conventional sockets in recent years. Despite numerous advantages, the dissimilarity of the mechanical properties between bone and implant has led to issues in periprosthetic bone adaptation. This study aims to address these issues by proposing fixations made of functionally graded materials (FGMs). The computational study of bone remodeling was performed by linking a bone remodeling algorithm to the finite element analysis. The 3D model of the femur was created by computerized tomography (CT) scan images, and a Titanium fixture, along with nine Titanium/Hydroxyapatite FGM fixtures, were modeled. The analyses revealed evident advantages for the FGM fixtures over the conventionally used Titanium fixtures. Furthermore, it was shown that the gradation direction considerably affects the bone adaptation procedure. The results showed that using a radial FGM with low-stiffness material in the outer layer and less metal composition significantly improves the bone remodeling behavior.
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Affiliation(s)
| | - Reza Soheilifard
- Department of Mechanical Engineering, Hakim Sabzevari University, Sabzevar, Iran.
| | - Sara Kowsar
- Department of Mechanical Engineering, Hakim Sabzevari University, Sabzevar, Iran
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