Numerical simulations on periprosthetic bone remodeling: a systematic review

BACKGROUND AND OBJECTIVE

The aim of the present study was to review the literature concerning the analysis of periprosthetic bone remodeling through finite element (FE) simulation.

METHODS

A systematic review was conducted on 9 databases, taking into account a ten-year time period (from 2009 until 2020). The inclusion criteria were: articles published in English, publication date after 2009, full text articles, articles containing the keywords both in the abstract and in the title. The articles were classified through the following parameters: dimensionality of the simulation, modelling of the bone-prosthesis interface, output parameters, type of simulated prosthesis, bone remodeling algorithm.

RESULTS

Sixty-seven articles were included in the study. Femur and tooth were the most evaluated bone segment (respectively 41.8% and 29.9%). The 55.2% of the evaluated articles used a bonded bone-prosthesis interface, 73% used 3D simulations, 67.2% of the articles (45 articles) evaluate the bone remodeling by the bone density variation. At last, 59.7% of the articles employed algorithms based on a specific remodeling function.

CONCLUSIONS

Increasing interest in the bone remodeling FE analysis in different bone segments emerged from the review, and heterogeneous solutions were adopted. An optimal balance between computational cost and accuracy is needed to accurately simulate the bone remodeling phenomenon in the post-operative period.

The remodeling of alveolar bone supporting the mandibular first molar with different levels of periodontal attachment

The objective of this study was to investigate alveolar bone remodeling of the mandibular first molar with differing levels of periodontal attachment under mastication loading. Three-dimensional finite element models of the mandibular first molar with differing levels of periodontal attachment were established. The stress distributions and bone density changes were analyzed under mastication loading to simulate the remodeling process of mandibular bone based on the theory of strain energy density. The results showed that the alveolar buccal, lingual ridges and root apex areas experienced higher stresses. The stresses and densities of the alveolar bone increased proportionally to increased mastication loading. Decrease in alveolar bone density under extreme loading indicated bone resorption. The remodeling rate was continual with gradual loading. Periodontal ligament support marginally decreased with an increased remodeling rate under extreme loading. Changes in alveolar bone density can reflect the remodeling process of periodontal tissue under mastication loading. The relationship between the change in density and mastication loading during remodeling can provide useful indicators into clinical treatment and diagnosis of the periodontal disease.