A REVIEW OF FINITE ELEMENT APPLICATIONS IN ORAL AND MAXILLOFACIAL BIOMECHANICS

Evaluation of Treatment Protocols in Surgically Assisted Rapid Maxillary Expansion by Finite Element Analysis

Background and Objectives: Transverse maxillary deficiency is an important maxillary anomaly that is very common in society and remains current in orthodontics. The maxillary expansion has been used in treatment for a long time. While maxillary expansion can be performed with rapid maxillary expansion in young adults, it is performed with surgically assisted rapid maxillary expansion (SARME) in individuals who have reached skeletal maturity. No consensus has been reached on the most successful surgical technique or the ideal appliance for treating transverse maxillary deficiency. Accordingly, we aimed to evaluate various surgical techniques and orthodontic appliances for treating transverse maxillary deficiency using the finite element method (FEM) to identify the treatment protocol that minimizes stress on the maxillary bone and teeth. Materials and Methods: On the virtual models obtained from the cone beam computed tomography of a patient, two different incisions (the pterygomaxillary junction is separated and not separated) were made and combined using three different orthodontic appliances (tooth, bone, and hybrid assisted). Then, stresses over the maxillary bone and maxillary teeth were calculated by FEM. Results: Our results showed that when the pterygomaxillary plates were separated, fewer stresses were observed on the bone and teeth. Although hybrid-supported appliances created less stress on the teeth than tooth-supported appliances and no difference was found between bone-supported appliances, it was found that hybrid-supported appliances created less stress on the bone than the other appliances. Conclusions: The separation of the pterygomaxillary junction in the SARME operation and the use of a bone-supported or hybrid-supported appliance would place less stress on the bone and teeth.

Pain-related analysis on a resorbed ridge with various denture occlusal schemes using finite element method

Resorbed alveolar ridges, particularly in the lower jaw, have a small denture supporting area, which may cause the stress distribution of mastication load to exceed the pressure-pain threshold (PPT) and induce pain in the mucosa or potentially worsen the ridge resorption. Thus, choosing the ideal occlusal scheme among bilateral balanced (BBO), lingualized (LO), and monoplane (MO) for such conditions becomes crucial. The experiment was conducted using the finite element method on a modeling of a resorbed alveolar ridge in the lower jaw with three dentures placed on top, each of which was given different loading points according to the tooth arrangement of BBO, LO, and MO. The axial load was 100 N, and the resultant oblique loads on BBO and LO were 119 N and 106 N, respectively. The von Mises stresses for BBO, LO, and MO were observed in nine denture-supporting areas, and the results showed that the axial load did not produce stresses that exceeded the PPT value (0.64925 MPa) for BBO, LO, and MO with the highest value on area H, 0.43229 MPa, 0.39715 MPa, and 0.31576 MPa, respectively. However, the oblique load direction showed that the BBO had more areas (area E 0.80778 MPa and area H 0.76256 MPa) that exceeded the PPT than LO (area E 0.64394 MPa). The lingualized occlusal scheme is ideal for patients with resorbed alveolar ridge conditions, especially in terms of limiting interferences when the denture is functioning while maintaining comfort but still providing good masticatory performance and satisfactory esthetics.

Stress analysis of horizontal mid-root fracture managed with different intraradicular fixation protocols: A 3D-finite element study

The current study evaluated the stress distribution in a maxillary central incisor with mid-root fracture after splinting with different intra-radicular posts using 3D-finite element analysis (FEA). Five 3D-FEA models were constructed. Model 1 was an intact tooth with no fracture, Model 2: A tooth with a horizontal mid-root fracture, with no treatment. Model 3: Same as model 2, and intraradicular splinting using fiber post. Model 4: Same as model 2 and intra-radicular splinting using Protaper Gold file F3. Model 5: Same as model 2, and with intraradicular splinting with Ribbond. The FEA of all models was done to obtain the maximum Von-Mises stress in the root canal space, the dentin, the periodontal ligament, and the bone. The highest Von Mises stresses for the root canal space and the dentin were found in Model 3, followed by models 4, 5, and 2, and least in Model 1. The Von Mises stress of the periodontal ligament was the least in model 1. The Von Mises stress of bone was higher in all experimental models than in the baseline model. The results suggest that in cases where intra-radicular splinting is indicated, fiber posts and Ribbond are better alternatives to endodontic files due to the lower stresses exerted.

Computational models and their applications in biomechanical analysis of mandibular reconstruction surgery

Advanced head and neck cancers involving the mandible often require surgical removal of the diseased parts and replacement with donor bone or prosthesis to recreate the form and function of the premorbid mandible. The degree to which this reconstruction successfully replicates key geometric features of the original bone critically affects the cosmetic and functional outcomes of speaking, chewing, and breathing. With advancements in computational power, biomechanical modeling has emerged as a prevalent tool for predicting the functional outcomes of the masticatory system and evaluating the effectiveness of reconstruction procedures in patients undergoing mandibular reconstruction surgery. These models offer cost-effective and patient-specific treatment tailored to the needs of individuals. To underscore the significance of biomechanical modeling, we conducted a review of 66 studies that utilized computational models in the biomechanical analysis of mandibular reconstruction surgery. The majority of these studies employed finite element method (FEM) in their approach; therefore, a detailed investigation of FEM has also been provided. Additionally, we categorized these studies based on the main components analyzed, including bone flaps, plates/screws, and prostheses, as well as their design and material composition.

The optimal design and three-dimensional finite element analysis of CAD/CAM integrated roach attachment

Objectives

To investigate the effect of different designs of movable parts and prosthetic materials on the stress distribution of supporting tissues in mandibular free end dentition defects using three-dimensional finite element analysis of digital Roach attachments.

Material and methods

A 3D model of a patient with Kennedy class I mandibular edentulous conditions was generated, and twelve prosthesis models were applied, combining two designs of removable parts and six types of CAD/CAM restorative materials with different elastic modulus (conventional zirconia, ultra-translucent zirconia, Polyetheretherketone (PEEK), Lithium disilicate, Nanoceramic resin, and resin composite (Paradigm MZ100, 3 M ESPE)). The stress distribution of abutment periodontal ligament, edentulousmucosa, and junction of attachment were analyzed using finite element analysis.

Results

The stress value of the buccal neck of the periodontal ligament and the maximum compressive stress of the distal periodontal ligament of the design with clasp arms were higher than those without clasp arms, while the stress on the junction of attachment and the displacement of the mucosa in the edentulous area were smaller. Restorative materials with high elastic modulus, such as conventional zirconia and ultra-translucent zirconia, are recommended to be used as the fixed part of Roach attachment.

Conclusion

CAD/CAM Roach attachments with clasp arms are recommended for the protection of mucosal soft tissue. Restorative materials with high elastic modulus, such as conventional zirconia and ultra-translucent zirconia, are recommended as the fixed part of Roach attachment for patients with free end defect of mandibular dentition.

Clinical significance

This study provides references for the design with clasp arms and the selection of clinical fixed-movable prosthetic materials. Clinicians should consider the design of attachments and selection of appropriate manufacturing materials carefully to avoid negative impacts on patients' periodontal support tissues.

Improving dental implant stability by optimizing thread design: Simultaneous application of finite element method and data mining approach

STATEMENT OF PROBLEM

Lack of knowledge regarding the optimal design of thread configuration in dental implants, which can offer a satisfactory level of stability in the implant-bone construct, is a significant challenge in the field of dental biomechanics.

PURPOSE

The purpose of this finite element analysis study was to identify the optimal thread design by investigating the effects of thread parameters such as thread depth (TD), thread width (TW), and thread pitch (TP), as well as upper (α) and lower (β) thread angles, on the maximum principal stress in cancellous and cortical bone, maximum von Mises stress in the dental implant, and maximum shear stress at the implant-bone interface.

MATERIAL AND METHODS

A finite element model of an alveolar bone segment with a dental implant was developed. The Latin hypercube sampling method was used to generate a dataset of virtual experiments, which were analyzed by using the decision tree method to identify suitable thread designs that minimize mechanical stimuli. Additionally, the effectiveness of thread parameters on stress levels in the bone, implant, and their interface were assessed.

RESULTS

The results of this study, verified by comparison with previous literature, indicated that TD, TW, and upper thread angle were the most effective parameters in promoting implant stability.

CONCLUSIONS

By analyzing the decision trees, optimum ranges for all the thread parameters were determined as follows: 0.25 Collapse

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Affiliation(s)

Masoud Arabbeiki Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
Mohammad Reza Niroomand Department of Mechanical Engineering, Payame Noor University, Tehran, Iran.
Gholamreza Rouhi Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran

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Performance of Graphene-Based and Polyether-Ether-Ketone Polymers as Removable Partial Denture Esthetic Clasp Materials after Cyclic Fatigue

The esthetic clasp material is a clinical demand for a satisfactory removable partial denture. The purpose of this study is to assess the mechanical performance of graphene-based polymer (GBP) and polyether-ether-ketone (PEEK) materials as clasp materials. Thirty-two clasps were fabricated by CAD-CAM from two materials, GBP and PEEK. All clasps were tested for retention force after 10,000 cycles of insertion and removal and thermocycling. The clasp arms’ deformation was measured, and areas of stress−strain concentration were explored. The Mann−Whitney U test was used to compare the retentive force of the studied groups, while the independent sample t-test was applied to check the difference in clasp arm deformation at α = 0.5. The results showed a significantly higher retentive force (2.248 ± 0.315 N) in PEEK clasps, at p < 0.001. The deformation of the clasp arm of the GBP clasps was significantly higher than PEEK clasps. Areas of stress−strain concentration were seen at the junction of the retentive arm to the minor connector and at the retentive arm terminal. It could be concluded that PEEK polymer had a better mechanical performance as an esthetic clasp material than the GBP. An optimization study for GBP might be required to check the validity of such an application.

FINITE ELEMENT SPINE MODELS AND SPINAL INSTRUMENTS: A REVIEW

There is considerable biomechanics literature on finite element modeling and analysis of the spine. To accurately mimic the biomechanical behavior of the vertebral column, a generated computational model has to include anatomical structures that are consistent with physiological reality. In this review article, we focused on the finite element spine models that have been developed by various approaches in the literature. Firstly, the anatomical features of the spine and the spinal components have been briefly explained. We then focused on the modeling stages of vertebrae, ligaments, facet joints, intervertebral discs, and spinal instruments. With this paper, we expect to provide a comprehensive resource regarding the modeling preferences used in spine modeling.

Effect of Model Parameters on the Biomechanical Behavior of the Finite Element Cervical Spine Model

Finite element (FE) models have frequently been used to analyze spine biomechanics. Material parameters assigned to FE spine models are generally uncertain, and their effect on the characterization of the spinal components is not clear. In this study, we aimed to analyze the effect of model parameters on the range of motion, stress, and strain responses of a FE cervical spine model. To do so, we created a computed tomography-based FE model that consisted of C2-C3 vertebrae, intervertebral disc, facet joints, and ligaments. A total of 32 FE analyses were carried out for two different elastic modulus equations and four different bone layer numbers under four different loading conditions. We evaluated the effects of elastic modulus equations and layer number on the biomechanical behavior of the FE spine model by taking the range of angular motion, stress, and strain responses into account. We found that the angular motions of the one- and two-layer models had a greater variation than those in the models with four and eight layers. The angular motions obtained for the four- and eight-layer models were almost the same, indicating that the use of a four-layer model would be sufficient to achieve a stress value converging to a certain level as the number of layers increases. We also observed that the equation proposed by Gupta and Dan (2004) agreed well with the experimental angular motion data. The outcomes of this study are expected to contribute to the determination of the model parameters used in FE spine models.

Bone Density Micro-CT Assessment during Embedding of the Innovative Multi-Spiked Connecting Scaffold in Periarticular Bone to Elaborate a Validated Numerical Model for Designing Biomimetic Fixation of Resurfacing Endoprostheses

Our team has been working for some time on designing a new kind of biomimetic fixation of resurfacing endoprostheses, in which the innovative multi-spiked connecting scaffold (MSC-Scaffold) that mimics the natural interface between articular cartilage and periarticular trabecular bone in human joints is the crucial element. This work aimed to develop a numerical model enabling the design of the considered joint replacement implant that would reflect the mechanics of interacting biomaterials. Thus, quantitative micro-CT analysis of density distribution in bone material during the embedding of MSC-Scaffold in periarticular bone was applied. The performed numerical studies and corresponding mechanical tests revealed, under the embedded MSC-Scaffold, the bone material densification affecting its mechanical properties. On the basis of these findings, the built numerical model was modified by applying a simulated insert of densified bone material. This modification led to a strong correlation between the re-simulation and experimental results (FVU = 0.02). The biomimetism of the MSC-Scaffold prototype that provided physiological load transfer from implant to bone was confirmed based on the Huber–von Mises–Hencky (HMH) stress maps obtained with the validated finite element (FE) model of the problem. The micro-CT bone density assessment performed during the embedding of the MSC-Scaffold prototype in periarticular bone provides insight into the mechanical behaviour of the investigated implant-bone system and validates the numerical model that can be used for the design of material and geometric features of a new kind of resurfacing endoprostheses fixation.

Evaluation of Bone-Implant Interface Stress and Strain Using Heterogeneous Mandibular Bone Properties Based on Different Empirical Correlations

Objectives  The purpose of this study was to compare methods used for calculating heterogeneous patient-specific bone properties used in finite element analysis (FEA), in the field of implant dentistry, with the method based on homogenous bone properties.

Materials and Methods  In this study, three-dimensional (3D) computed tomography data of an edentulous patient were processed to create a finite element model, and five identical 3D implant models were created and distributed throughout the dental arch. Based on the calculation methods used for bone material assignment, four groups—groups I to IV—were defined. Groups I to III relied on heterogeneous bone property assignment based on different equations, whereas group IV relied on homogenous bone properties. Finally, 150 N vertical and 60-degree-inclined forces were applied at the top of the implant abutments to calculate the von Mises stress and strain.

Results  Groups I and II presented the highest stress and strain values, respectively. Based on the implant location, differences were observed between the stress values of group I, II, and III compared with group IV; however, no clear order was noted. Accordingly, variable von Mises stress and strain reactions at the bone–implant interface were observed among the heterogeneous bone property groups when compared with the homogenous property group results at the same implant positions.

Conclusion  Although the use of heterogeneous bone properties as material assignments in FEA studies seem promising for patient-specific analysis, the variations between their results raise doubts about their reliability. The results were influenced by implants’ locations leading to misleading clinical simulations.

BIOMECHANICAL EVALUATION OF RECONSTRUCTED EXTENSIVE MANDIBULAR DEFECTS BY DIFFERENT MODELS USING FINITE ELEMENT METHOD

Rehabilitation of major mandibular defects after tumor resection has become a serious challenge for surgeons. In this research, four various models were designed to repair a critical mandibular lateral defect. Biomechanical behavior of the models was assessed by Finite Element Method. These models are including Fibular-Free Flap (FFF), Customized Prosthesis (CP), Tray Implant without Bone Graft (TI-wo-BG), and Tray Implant with Bone Graft (TI-w-BG). FFF is a subset of microvascular free flap technique in which some segments of patient’s fibula bone are used to restore mandibular defects. CP is a hollow and light prosthesis which is fabricated using Additive Manufacturing technology from Ti alloy powder. TI-wo-BG is similar to a crib which is designed according to the geometry of the patient’s mandible. TI-w-BG, in fact, is a TI-wo-BG which is filled with small cortico-cancellous chips in order to benefit potential profit of bone grafting. The chewing operation and loading on the mandible was simulated considering the three mandibular muscular forces including masseter, medial pterygoid, and temporalis.

The result of FEM analysis of TI-wo-BG and TI-w-BG showed that in both models, screw number 6 endured a strain of 5684 and 2852[Formula: see text][Formula: see text]m/m which exceeded pathological and mild overload risk, respectively. This may increase the probability of screw loosening and system failure. The results proved the stability of the FFF and CP models. In addition, it can be concluded that stress and strain on the screw’s interfaces can decrease by improving the plate and increasing the friction at the interface of plate, bone and screw.

Biomechanical comparison of implantation approaches for the treatment of mandibular total edentulism

Applying four anterior implants placed vertically or tilted in the mandible is considered to provide clinically reasonable results in the treatment of mandibular posterior edentulism. It is also reported that a combination of four anterior and two short posterior implants can be an alternative approach for the rehabilitation of severe atrophy cases. In this study, we aimed to evaluate the biomechanical responses of three different implant placement configurations, which represent the clinical options for the treatment of mandibular edentulism. Three-dimensional models of the mandible, prosthetic bar, dental implant, abutment, and screw were created. Finite element models of the three implant configurations (Protocol 1: Four anterior implants, Protocol 2: Four anterior and two short posterior implants, Protocol 3: Two anterior and two tilted posterior implants: All-on-4™ concept) were generated for 10 patients and analyzed under different loading conditions including chewing, biting, and impact forces. Protocol 2 led to the lowest stress concentrations over the mandible among the three protocols (p < 0.016). Protocol 2 resulted in significantly lower stresses than Protocol 3 and Protocol 1 over prosthetic bars under chewing forces (p < 0.016). None of the implant placement protocols consistently exhibited the lowest stress distribution over abutments. The lowest stresses over dental implants under the chewing, biting, and impact forces were obtained in Protocol 1, Protocol 2, and Protocol 3, respectively (p < 0.016). Protocol 3 was the best option to obtain the lowest stress values over the screws under all types of loading conditions (p < 0.016). In conclusion, Protocol 2 was biomechanically more ideal than Protocol 1 and Protocol 3 to manage the posterior edentulism.

A three-dimensional finite element analysis of mechanical function for 4 removable partial denture designs with 3 framework materials: CoCr, Ti-6Al-4V alloy and PEEK

Polyetheretherketone (PEEK) is a new material used for the frameworks of removable partial dentures (RPD). The questions whether the PEEK framework has similar stress distribution on oral tissue and displacement under masticatory forces as titanium alloy (Ti-6Al-4V) or cobalt-chromium alloy (CoCr) remain unclear and worth exploring. A patient's intraoral data were obtained via CBCT and master model scan. Four RPDs were designed by 3Shape dental system, and the models were processed by three-dimensional finite element analysis. Among three materials tested, PEEK has the lowest maximum von Mises stress (VMS) on periodontal ligament (PDL), the greatest maximum VMS on mucosa, the maximum displacement on free-end of framework, and the lowest maximum VMS on framework. Results suggested that PEEK framework has a good protective effect on PDL, suggesting applications for patients with poor periodontal conditions. However, the maximum displacement of the free-end under masticatory force is not conducive for denture stability, along with large stress on the mucosa indicate that PEEK is unsuitable for patients with more loss of posterior teeth with free-end edentulism.

Variation of 3D outer and inner crown morphology in modern human mandibular premolars

Objectives

This study explores the outer and inner crown of lower third and fourth premolars (P₃, P₄) by analyzing the morphological variation among diverse modern human groups.

Materials and Methods

We studied three‐dimensional models of the outer enamel surface and the enamel–dentine junction (EDJ) from μCT datasets of 77 recent humans using both an assessment of seven nonmetric traits and a standard geometric morphometric (GM) analysis. For the latter, the dental crown was represented by four landmarks (dentine horns and fossae), 20 semilandmarks along the EDJ marginal ridge, and pseudolandmarks along the crown and cervical outlines.

Results

Certain discrete traits showed significantly different regional frequencies and sexual dimorphism. The GM analyses of both P₃s and P₄s showed extensive overlap in shape variation of the various populations (classification accuracy 15–69%). The first principal components explained about 40% of shape variance with a correlation between 0.59 and 0.87 of the features of P₃s and P₄s. Shape covariation between P₃s and P₄s expressed concordance of high and narrow or low and broad crowns.

Conclusions

Due to marked intragroup and intergroup variation in GM analyses of lower premolars, discrete traits such as the number of lingual cusps and mesiolingual groove expression provide better geographic separation of modern human populations. The greater variability of the lingual region suggests a dominance of functional constraints over geographic provenience or sex. Additional information about functionally relevant aspects of the crown surface and odontogenetic data are needed to unravel the factors underlying dental morphology in modern humans.