Mechanical strain on the human skull in a humanoid robotic model

Mandibular autorotation revisited: A retrospective study of accuracy and stability of maxillary impaction in retrognathic patients with condylar osteoarthritis

The aim of this retrospective study was to evaluate the accuracy of maxillary positioning with mandibular autorotation using the straight locking miniplate (SLM) technique and computer-aided design/computer-aided manufacturing (CAD/CAM) wafers on postoperative stability in patients with skeletal class II malocclusion and condylar osteoarthritis. Cephalometric analysis of the maxillary position and MA center (ARC) before (T0), 3 days (T1), 3 months (T2), and 1 year (T3) after surgery was performed. Analysis of 21 patients revealed a mean movement of -2.0 ± 2.2 mm (x-axis) and 5.4 ± 2.4 mm (y-axis) at U1 and of -1.5 ± 2.4 mm (x-axis) and 4.9 ± 1.6 mm (y-axis) at U7. The SNA, SNB, ANB, and SN-MP angles and ramus inclination at T0 were significantly different from those at T1, T2, and T3. The distance from the ARC to the Co of T2 and T3 was significantly smaller than that of T1 on the x-axis, indicating that the ARC converged horizontally to Co. There was no significant difference in the amount of rotation at any time point. Accurate maxillary positioning with mandibular autorotation using SLM and CAD/CAM wafers may correct the unstable rotation axis of the mandible and prevent early postoperative relapse.

Three-point bending test simulation on implant fpds with a bio-faithful model

AIM OF THE STUDY

It is well known by previous important studies that mandible flexes during different jaw movements. According to this assumption it is very important to know how implant supported fixed partial dentures could restrict mandibular movements and, could lead to excess strain accumulation that could modify the resolution of implant treatment. The aim of our project is to create a bio-faithful model able to recreate mandibular movements, during three point bending test methods of (FIXED -PARTIAL -DENTURES) FPDs, to avoid a not flexible metal base, where models' properties doesn't allow to obtain a bio-faithful simulation during testing phases.

MATERIALS AND METHODS

2 implants (premium Sweden and Martina®) were embedded in mandible resin section to mimic osteointegrated implants in premolar and molar areas, in order to recreate a Kennedy Class II configuration. Our mandible test simulator was creating according to the measurement obtained according to the study of Schwartz-Dabney and Dechow (2002). Sample so created is tested with testing machine (Instron 5566^®, UK) adopting the three point bending mechanical tests configuration.

DISCUSSION AND CONCLUSION

We can admit that oral cavity is a bio-dynamic system, where different variables incurr, so it's very important that experimental conditions simulate clinical environment. Experimentation should be based on the correlation between the failure mechanisms exhibited for in vitro samples and those observed in fractured clinical prostheses made of the same composition and processing conditions. A bio-faithful model could reduce this wide range between in vitro and in vivo study experimentation.

Introduction of a robot patient into dental education

In recent years, with the increasing social awareness of safety in medical practice, improving clinical skills has become very important, especially for recently graduated dentists. Traditionally, mannequins have been used for clinical skill training, but a mannequin is quite different from a real patient because they have no autonomous movement or conversational ability. This indicates that pre-clinical simulation education is inadequate. We have, therefore, developed a robot patient that can reproduce an authentic clinical situation for dental clinical training. The robot patient, designed as a full-body model with a height of 157 cm, has eight degrees of freedom in the head and the ability to perform various autonomous movements. Moreover, saliva secretion and conversation with the trainee can be reproduced. We have introduced the robot patient into an objective structured clinical examination targeted at fifth-grade students in our dental school to evaluate their skills in cavity preparation, whilst considering the safety of the treatment. As a result, many of the students were able to deal appropriately with a patient's unexpected movement. Moreover, results of a questionnaire survey showed that almost all the students recognised the educational value of the robot patient especially for 'risk management', and they preferred the robot patient to traditional mannequins. Practical application of the robot patient in dental clinical education was evaluated through the experiences of the fifth-grade students, which showed the effectiveness of the robot patient in the dental field.

Cross-sectional human mandibular morphology as assessed in vivo by cone-beam computed tomography in patients with different vertical facial dimensions

INTRODUCTION

The goal of this study was to look at mandibular cortical bone in live patients using cone-beam computed tomography (CBCT) to determine differences in cortical plate thicknesses and mandibular cross-sectional height and width in patients with different vertical facial dimensions.

METHODS

A total of 111 scanned patients were used. Of these subjects, 43 were included in the average vertical facial dimension group (average face), 34 in the high vertical facial group (long face), and 34 in the low vertical facial group (square short face). Cross-sectional slices of the mandible were developed with the cone-beam scans to evaluate the cortical bone between the dentition at 13 locations. Each section was then measured at 8 sites, which included 1 height and 2 width measures of the cross-sectional area and 5 cortical plate thicknesses. An analysis of variance (ANOVA) with a posthoc Bonferroni statistical analysis was used with a significance level of P  ≤0.0167.

RESULTS

The long-face group had slightly more narrow cortical bone than the other 2 facial groups at a few selected sites of the mandible. The height of the cross-sectional area of the mandible in the long-face group was shorter posteriorly than in the other 2 groups and became greater toward the symphysis.

CONCLUSIONS

Mandibular height and width differed more than cortical bone thickness among the 3 types of subjects with different vertical facial dimensions, but statistically significant differences were evident is some sites for cortical bone thickness.

Influence of abutment material on the fracture strength and failure modes of abutment-fixture assemblies when loaded in a bio-faithful simulation

OBJECTIVES

The aim of the present study was to evaluate differences in the ultimate fracture resistance of titanium and zirconia abutments.

MATERIAL AND METHODS

Twenty titanium fixtures were embedded in 20 resin mandible section simulators to mimic osseointegrated implants in the premolar area. The embedded implants were then randomly divided into two groups. Afterwards, specimens in group A (n=10) were connected to titanium abutments (TiDesign™ 3.5/4.0, 5.5, 1.5 mm), while specimens in group B (n=10) were connected to zirconia abutments (ZirDesign ™ 3.5/4.0, 5.5, 1.5 mm). Both groups were loaded to failure in a dynamometric testing machine. Fractured samples were then analyzed by scanning electron microscopy (SEM).

RESULTS

Group A showed a significantly higher fracture strength than that observed in group B. Group A failures were observed at the screw that connects the abutment with the implant while the abutment connection hexagons were plastically bent by the applied load. Group B failures were a result of abutment fractures. SEM analysis showed that in group A the screw failure was driven by crack nucleation, coalescence and propagation, while in group B, the SEM analysis of failed surfaces showed the conchoidal fracture profile characteristic of brittle materials.

CONCLUSIONS

The strength of both tested systems is adequate to resist physiologic chewing forces in the premolar area. Conversely, the titanium and zirconia failure modes evaluated here occurred at unphysiological loads. In addition, because the abutments were tested without crowns, the presented data have limited direct transfer to the clinical situation.

Current computational modelling trends in craniomandibular biomechanics and their clinical implications

Computational models of interactions in the craniomandibular apparatus are used with increasing frequency to study biomechanics in normal and abnormal masticatory systems. Methods and assumptions in these models can be difficult to assess by those unfamiliar with current practices in this field; health professionals are often faced with evaluating the appropriateness, validity and significance of models which are perhaps more familiar to the engineering community. This selective review offers a foundation for assessing the strength and implications of a craniomandibular modelling study. It explores different models used in general science and engineering and focuses on current best practices in biomechanics. The problem of validation is considered at some length, because this is not always fully realisable in living subjects. Rigid-body, finite element and combined approaches are discussed, with examples of their application to basic and clinically relevant problems. Some advanced software platforms currently available for modelling craniomandibular systems are mentioned. Recent studies of the face, masticatory muscles, tongue, craniomandibular skeleton, temporomandibular joint, dentition and dental implants are reviewed, and the significance of non-linear and non-isotropic material properties is emphasised. The unique challenges in clinical application are discussed, and the review concludes by posing some questions which one might reasonably expect to find answered in plausible modelling studies of the masticatory apparatus.

The importance of cortical bone orthotropicity, maximum stiffness direction and thickness on the reliability of mandible numerical models

AIM

To identify mechanical and geometrical variables affecting the biofidelity of numerical models of human mandible. Computed results sensibility to cortical bone orthotropy and thicknesses is investigated.

METHODS

Two mandible numerical models of different bone complexities are setup. In the low-complexity model, cortical bone is coupled with isotropic materials properties; constant thickness for cortical bone is adopted along the mandible structure. In the higher complexity model, the cortical bone is considered as an orthotropic material according to an independent mechanical characterization performed on fresh human dentate mandibles. Cortical thickness distribution, the values of the principal elastic moduli and principal directions of orthotropy are considered as piecewise heterogeneous. Forces for masseter (10 N), medial pterigoid (6 N), anterior (4 N) and posterior (4 N) temporalis muscles are applied to the models. Computed strains fields are compared with those experimentally measured in an independent test performed on a real human mandible in the same loading conditions.

RESULTS

Under closure muscles forces both models shows similar strain distribution. On the contrary, strain fields values are significantly different between the presented models.

CONCLUSIONS

The mandible structure is sensible to compact bone orthotropy and thickness at the facial side of condylar neck, retro molar area and at the lingual side of middle portion of the corpus in molars area, anterior margin of the ramus. In these areas, it is advisable to use orthotropic properties for cortical bone to accurately describe the strain state.