Variations in cortical material properties throughout the human dentate mandible

Bone stress and interfacial sliding analysis of implant designs on an immediately loaded maxillary implant: a non-linear finite element study

OBJECTIVES

This study investigated the surrounding bone stress and the implant-bone interfacial sliding of implant designs and implant sizes of immediately loaded implant with maxillary sinus augmentation by using three-dimensional (3D) non-linear finite element (FE) analysis.

METHODS

Twenty-four FE models including four implant designs (cylindrical, threaded, stepped and step-thread implants) and three implant dimensions (standard, long and wide threaded implants) with a bonded and three levels of frictional contact of implant-bone interfaces were analyzed. The maxillary model was constructed from computer tomography (CT) images of a human skull and all 3D implant models were created via the computer-aided design (CAD) software.

RESULTS

The use of threaded implants decreased the bone stress and sliding distance obviously about 30% as compared with non-threaded (cylindrical and stepped) implants. Increasing the implant's length or diameter reduced the bone stress by 13-26%. Employing a immediately loaded implant with smooth machine surface (mu=0.3, mu represents frictional coefficient) increased the bone stress by 28-63% as compared with the osseointegrated (bonded interfaces) implants. Roughening the implant surface (mu>0.3) did not reduced the bone stress, however it did decrease the interfacial sliding between implant and bone.

CONCLUSIONS

For an immediately loaded implant placed with sinus augmentation, using threaded implant could decrease both the bone stress and implant-bone sliding distance which may improve the implant initial stability and long-term survival. Rough surface of implants shows no benefit to reduce the bone stress but they could lower the interfacial sliding. On the contrary, employing long or wide implants decrease the bone stress but they cannot diminish the interfacial sliding.

Recombinant human BMP-2 enhances the effects of materials used for reconstruction of large cranial defects

PURPOSE

Cranial defect reconstruction presents 2 challenges: induction of new bone formation, and providing structural support during the healing process. This study compares quantity and quality of new bone formation based on various materials and support frameworks.

MATERIALS AND METHODS

Eighteen dogs underwent surgical removal of a significant portion of their cranial vault. Demineralized bone matrix was used to fill the defect in all animals. In 9 dogs, recombinant human bone morphogenetic protein-2 (rhBMP-2) was added, while the other 9 served as the non-rhBMP-2 group. In each group, 3 animals were fixed with cobalt chrome plates, 3 with adding platelet-rich plasma, and 3 fixed with a Lactosorb (Walter Lorenz Surgical, Inc, Jacksonville, FL) resorbable mesh. Necropsy was done at 12 weeks postoperative. Histomorphometry, density, and mechanical properties of the regenerate were analyzed.

RESULTS

The non-rhBMP-2 groups showed minimal substitution of demineralized bone matrix with new bone, while only sporadic remnants of demineralized bone matrix were present in the rhBMP-2 groups. The defect showed more new bone formation (P < .001) and density (P < .001) in the rhBMP-2 groups by Kruskal-Wallis test. The area of new bone was not significantly different among the rhBMP-2 subgroups. The resorbable mesh struts showed no sign of bone invasion or substitution. In the non-rhBMP-2 resorbable mesh group, demineralized bone matrix almost totally disintegrated without replacement by new bone.

CONCLUSIONS

The addition of rhBMP-2 to demineralized bone matrix accelerated new bone formation in large cranial defects, regardless of the supporting framework or the addition of platelet-rich plasma. The use of a resorbable mesh in such defects is advisable only if rhBMP-2 is added.

Elastic modulus variation in mandibular bone: a microindentation study of Macaca fascicularis

We characterized the heterogeneous anisotropic elastic properties of mandibular bone in an adult female specimen of Macaca fascicularis using the technique of microindentation. This approach used an indenter of known mass and geometry to sample bone hardness at a spatial resolution in the order of 100 mum. Hardness values were converted to elastic modulus using empirically derived regression. We determined properties in alveolar, midcorpus, and basal regions of coronal and transverse sections taken from multiple locations along the corpus and ramus. Within sections, we determined properties from endosteal, midcortical, and periosteal regions. We found regional variations in bone structure, including bands of orthotropic circumferential lamellar bone at the endosteal and periosteal corpus base, angular region, and ramus. Transversely isotropic osteonal bone characterizes the midcortices of alveolar and basal regions, with many resorption spaces in alveolar regions restricting sampling opportunities. Regional variations in elasticity include relatively compliant bone in the anterior corpus and ramus. Basal cortical bone is stiffer longitudinally than transversely or superoinferiorly, while the evidence for directional dependence in alveolar bone is equivocal. Alveolar bone appears to be relatively compliant with respect to bone found in midcorpus or basal regions. Considerable variation exists in structure and material properties on a highly localized scale, more so than is discernible through conventional approaches for determining material property variation.

Anisotropic finite element modeling for patient-specific mandible

This paper presents an ad hoc modular software tool to quasi-automatically generate patient-specific three-dimensional (3D) finite element (FE) model of the human mandible. The main task is taking into account the complex geometry of the individual mandible, as well as the inherent highly anisotropic material law. At first, by computed tomography data (CT), the individual geometry of the complete range of mandible was well reproduced, also the separation between cortical and cancellous bone. Then, taking advantage of the inherent shape nature as 'curve' long bone, the algorithm employed a pair of B-spline curves running along the entire upper and lower mandible borders as auxiliary baselines, whose directions are also compatible with that of the trajectory of maximum material stiffness throughout the cortical bone of the mandible. And under the guidance of this pair of auxiliary baselines, a sequence of B-spline surfaces were interpolated adaptively as curve cross-sections to cut the original geometry. Following, based on the produced curve contours and the corresponding curve cross-section surfaces, quite well structured FE volume meshes were constructed, as well as the inherent trajectory vector fields of the anisotropic material (orthotropic for cortical bone and transversely isotropic for cancellous bone). Finally, a sensitivity analysis comprising various 3D FE simulations was carried out to reveal the relevance of elastic anisotropy for the load carrying behavior of the mandible.

Probabilistic analysis of peri-implant strain predictions as influenced by uncertainties in bone properties and occlusal forces

OBJECTIVES

The purpose of this study was to examine the influence of variability in bone properties and loading on peri-implant crestal and cancellous bone strains using a probabilistic approach, in combination with finite element (FE) analysis.

MATERIAL AND METHODS

Oblique occlusal loading was applied to a single endosseous implant embedded in a two-dimensional (2-D) FE model of a premolar section of a mandible. Perfect bonding was assumed at all interfaces. Five independent parameters (cortical bone thickness (T), cortical (ECORT) and cancellous (ECANC) bone Young's moduli, and vertical (FVERT) and horizontal (FHOR) occlusal forces) were assigned statistical distributions based on data in the literature. Two cancellous bone distribution models were examined, one with a lower mean and range (LM) and the second with a higher mean and range (HM) of cancellous bone Young's modulus values. Sets of randomly chosen values for the five parameters were selected from the distributions and FE analyses were performed for all randomly selected sets.

RESULTS

In the LM model, 50% of the cases experienced hyper-physiologic peri-implant crestal strains in the region of commonly reported saucerization, compared with about 25% of the cases in the HM model. Relative probabilistic sensitivities (%) of bone strains to the independent input parameters (T, ECORT, ECANC, FVERT and FHOR) were as follows: 29, 11, 30, 13, and 17 for the LM model, and 17, 11, 35, 21, and 15 for the HM model, respectively.

CONCLUSION

Probabilistic analyses of FE models suggest that up to twice as many cases in the LM distribution may be at risk of saucerization as compared with the HM distribution model. Although based on hypothetical distribution values and the limitations inherent to a 2-D analysis, this probabilistic study demonstrated that FE models are very sensitive to the often arbitrarily assigned values for cancellous bone Young's modulus, and also to values used for cortical bone thickness, when the cancellous bone modulus is low.

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

Mandibular symphyseal distraction osteogenesis is a common clinical procedure to modify the geometrical shape of the mandible for correcting problems of dental overcrowding and arch shrinkage. In spite of consolidated clinical use, questions remain concerning the optimal latency period and the influence of mastication loading on osteogenesis within the callus prior to the first distraction of the mandible. This work utilized a mechano-regulation model to assess bone regeneration within the callus of an osteotomized mandible. A 3D model of the mandible was reconstructed from CT scan data and meshed using poroelastic finite elements (FE). The stimulus regulating tissue differentiation within the callus was hypothesized to be a function of the strain and fluid flow computed by the FE model. This model was then used to analyse tissue differentiation during a 15-day latency period, defined as the time between the day of the osteotomy and the day when the first distraction is given to the device. The following predictions are made: (1) the mastication forces generated during the latency period support osteogenesis in certain regions of the callus, and that during the latency period the percentage of progenitor cells differentiating into osteoblasts increases; (2) reducing the mastication load by 70% during the latency period increases the number of progenitor cells differentiating into osteoblasts; (3) the stiffness of new tissue increases at a slower rate on the side of bone callus next to the occlusion of the mandibular ramus which could cause asymmetries in the bone tissue formation with respect to the middle sagittal plane. Although the model predicts that the mastication loading generates such asymmetries, their effects on the spatial distribution of callus mechanical properties are insignificant for typical latency periods used clinically. It is also predicted that a latency period of longer than a week will increase the risk of premature bone union across the callus.

The Influence of Expansion Rates on Mandibular Distraction Osteogenesis: A Computational Analysis

Mandibular distraction osteogenesis is a clinical procedure used for modifying the mandibular geometry when problems of dental overcrowding and arch shrinkage occur. The objective of this study is to use a computational model of tissue differentiation to examine the influence of the rate of distraction on bone re-growth within the fracture callus of a human mandible submitted to symphyseal distraction osteogenesis. A 3D model of the mandible is reconstructed from CT scan data and meshed into finite elements. Two different mastication loadings have been investigated: a 'full' mastication load and a 'reduced' mastication load where the action of each muscle was reduced by 70%. Four different distraction rates were analyzed: 0.6, 1.2, 2, and 3 mm/day, allowing a total displacement of 6 mm. In the early stages of the distraction process it is predicted that there is a decrease in the amount of bone tissue forming within the center of the fracture gap for all distraction rates. After the initial phases of expansion, the bone tissue within the callus increases for the slower rate of distraction or continues to decrease at the faster rates of distraction. At the end of the simulated maturation period, 47% of the distracted callus was predicted to consist of bone tissue for a distraction rate of 0.6 mm/day, decreasing to 22% for a distraction rate of 3 mm/day. Significantly higher amounts of bone formation were predicted for all distraction rates for the case of reduced mastication loading. Disparities between the model predictions and what is observed in vivo were found. For instance, during the latency period, the distraction period and beyond, the model is predicting larger than expected amounts of cartilage tissue formation within the callus. This and other limitations of the proposed model are discussed and possible specific explanations for these disparities are provided in the paper. The model predicts a distraction rate of around 1.2 mm/day to be optimal as higher rates produce less bone tissue while the risk of a premature bone union is greater at slower rates of distraction because in the latter stages of the distraction process bone tissue is predicted to form between the left and right side of the bone callus.

Functional morphology of the mangabey mandibular corpus: Relationship to dental specializations and feeding behavior

Recent molecular and morphological surveys suggest that mangabeys do not represent a monophyletic group. Specifically, Cercocebus is the sister taxon of Mandrillus, whereas Lophocebus forms an unresolved trichotomy with Papio and Theropithecus. The Cercocebus-Mandrillus clade is characterized by skeletal and dental adaptations related to acquisition and processing of hard-object foods that resist decomposition for months on the forest floor. Although species of both mangabey genera can be described as frugivorous seed predators with a strong reliance on hard-object foods, a growing body of evidence indicates that Cercocebus (terrestrial) and Lophocebus (arboreal) mangabeys differ in the hardness of the seeds they consume and the manner in which seeds are processed. The taxa are also distinguished on the basis of dental morphology. Given the purported differences in feeding behaviors of the two mangabey genera, we consider whether there are predictable biomechanical consequences of these behaviors that are reflected in mandibular corpus dimensions. In addition, we present metric data summarizing functional aspects of mangabey mandibular corpus morphology. Mangabey genera are generally not distinguished by differences in relative corpus size, either in postcanine or symphyseal regions. Distinct symphyseal scaling patterns characterize the Papio-Lophocebus clade and the Mandrillus-Cercocebus clade, while the postcanine corpus scales similarly between them. The hypothesis that preferential use of the incisors vs. premolars to initially process these foods results in distinct stress environments is weakly supported, given circumstantial evidence that the relative importance of bending vs. torsion may differ between Cercocebus and Lophocebus.

Tissue Engineering the Mandibular Condyle

Tissue engineering provides the revolutionary possibility for curing temporomandibular joint (TMJ) disorders. Although characterization of the mandibular condyle has been extensively studied, tissue engineering of the mandibular condyle is still in an inchoate stage. The purpose of this review is to provide a summary of advances relevant to tissue engineering of mandibular cartilage and bone, and to serve as a reference for future research in this field. A concise anatomical overview of the mandibular condyle is provided, and the structure and function of the mandibular condyle are reviewed, including the cell types, extracellular matrix (ECM) composition, and biomechanical properties. Collagens and proteoglycans are distributed heterogeneously (topographically and zonally). The complexity of collagen types (including types I, II, III, and X) and cell types (including fibroblast-like cells, mesenchymal cells, and differentiated chondrocytes) indicates that mandibular cartilage is an intermediate between fibrocartilage and hyaline cartilage. The fibrocartilaginous fibrous zone at the surface is separated from hyaline-like mature and hypertrophic zones below by a thin and highly cellular proliferative zone. Mechanically, the mandibular condylar cartilage is anisotropic under tension (stiffer anteroposteriorly) and heterogeneous under compression (anterior region stiffer than posterior). Tissue engineering of mandibular condylar cartilage and bone is reviewed, consisting of cell culture, growth factors, scaffolds, and bioreactors. Ideal engineered constructs for mandibular condyle regeneration must involve two distinct yet integrated stratified layers in a single osteochondral construct to meet the different demands for the regeneration of cartilage and bone tissues. We conclude this review with a brief discussion of tissue engineering strategies, along with future directions for tissue engineering the mandibular condyle.

Assessing mechanical function of the zygomatic region in macaques: validation and sensitivity testing of finite element models

Crucial to the interpretation of the results of any finite element analysis of a skeletal system is a test of the validity of the results and an assessment of the sensitivity of the model parameters. We have therefore developed finite element models of two crania of Macaca fascicularis and investigated their sensitivity to variations in bone material properties, the zygomatico-temporal suture and the loading regimen applied to the zygomatic arch. Maximum principal strains were validated against data derived from ex vivo strain gauge experiments using non-physiological loads applied to the macaque zygomatic arch. Elastic properties of the zygomatic arch bone and the zygomatico-temporal suture obtained by nanoindentation resulted in a high degree of congruence between experimental and simulated strains. The findings also indicated that the presence of a zygomatico-temporal suture in the model produced strains more similar to experimental values than a completely separated or fused arch. Strains were distinctly higher when the load was applied through the modelled superficial masseter compared with loading an array of nodes on the arch. This study demonstrates the importance of the accurate selection of the material properties involved in predicting strains in a finite element model. Furthermore, our findings strongly highlight the influence of the presence of craniofacial sutures on strains experienced in the face. This has implications when investigating craniofacial growth and masticatory function but should generally be taken into account in functional analyses of the craniofacial system of both extant and extinct species.

Mechanical behavior of an osteotomized mandible with distraction orthodontic devices

This work analyzes the mechanical behavior of a human mandible when distraction orthodontic devices are used for correcting problems of dental overcrowding and/or arch shrinkage. The mandible 3D model is reconstructed from CT scan data and meshed into finite elements. The distractor is also modeled. FEM analysis included geometric non-linearity. Displacement field of healthy and osteotomized mandibles are compared. Progressive expansion of the distractor and effects of mastication are also analyzed. Finally, we compare two distraction protocols PROT1 and PROT2 where device is, respectively, expanded by 0.6 or 1.2mm/day. The global displacement is 6mm according to clinical recommendations. It came out that mastication forces generate displacements compatible with bone remodeling. However, parasitic rotations of the mandible arms due to mastication may counteract arch expansion induced by the device. Stress concentrations occurred where the device is fixed: stress peaks stay however below yield limit. Finally, PROT2 reduced by about 10% stresses in mandible and reproduces better than PROT1 the displacement field imposed by the device.

Morphometric estimation of torsional stiffness and strength in primate mandibles

In comparative studies of masticatory function and mandibular biomechanics, the mediolateral dimension of the postcanine corpus (corpus breadth) is commonly utilized as a measure of torsional stiffness from which relative torsional strength is inferred. The use of this dimension entails certain assumptions about corpus shape and cortical bone distribution that are invalid. When corpus breadth is related to an appropriate, empirically supported measure of torsional strength, it is revealed that this dimension has limited utility for inference of biomechanical competence under torsion. The use of linear dimensions to infer structural adaptations to specific loading regimes is problematic given that bone tissue is not optimally deployed to minimize strain levels arising from isolated loads. For the inference of the masticatory biomechanical environment, the more reasonable approach is to consider overall size of the corpus (i.e., cross-sectional area) for inference of intra- and inter-specific differences in masticatory forces.

Functional significance of strain distribution in the human mandible under masticatory load: numerical predictions

A common feature of studies of mandibular morphology is the assumption that there is some functional relation between the form of the lower jaw and masticatory stress. It was noted that the local variation in cortical bone thickness in the mandibular corpus appears to be stereotypical among anthropoids. This occurs at sections under the molars, where the lingual cortical plate is thinner than buccal one. In this study we investigate and contrast the strain pattern along buccal and lingual surfaces of the mandibular corpus during mastication using a numerical model of a human mandible. We show that strain distribution differs in alveolar and mid-corpus segments of the mandible and that the latter develops an alternate pattern between the buccal and lingual aspects of the working and balancing sides of the jaw. We then relate the magnitude of these strains to Frost's mechanostat. Our results suggest that the cortical asymmetry of the human mandible is in fact not related to strain patterns generated during mastication.

A comparison of cortical elastic properties in the craniofacial skeletons of three primate species and its relevance to the study of human evolution

When a force is applied to an object, the resulting pattern of strain is a function of both the object's geometry and its elastic properties. Thus, knowledge of elastic properties in craniofacial cortical bone is indispensable for exploring the biomechanics and adaptation of primate skulls. However, elastic properties, such as density and stiffness, cannot be measured in all species, particularly extinct species known only from fossils. In order for advanced engineering techniques such as finite element analysis (FEA) to be applied to questions of primate and hominid craniofacial functional morphology, it is important to understand interspecific patterns of variation in elastic properties. We hypothesized that closely related species would have similar patterns of bone elastic properties, and that similarities with extant species should allow reasonable predictions of elastic properties in the skeletons of extinct primate species. In this study, we tested this hypothesis by measuring elastic properties in five areas of the external cortex of the baboon craniofacial skeleton using an ultrasonic technique, and by comparing the results to existing data from macaque and human crania. Results showed that cortical density, thickness, elastic and shear moduli, and anisotropy varied among areas in the baboon cranium. Similar variation had previously been found in rhesus and human crania, suggesting area-specific elastic patterns in the skulls of each species. Comparison among species showed differences, suggesting species-specific patterns. These patterns were more similar between macaques and baboons for density, maximum elastic and shear stiffness, and anisotropy than between either of these and humans. This finding demonstrates that patterns of cortical elastic properties are generally similar in closely related primate species with similar craniofacial morphology. Thus, reasonable estimates of cortical bone elastic properties should be possible for extinct species through the study of phylogenetically related and functionally similar modern forms. For example, reasonable elastic property estimates of cortical bone from fossil hominid skulls should be possible once adequate information about such properties in extant great apes is added to our current data from humans, macaques, and baboons. Such data should eventually allow FEA of craniofacial function in fossil hominids.

Comparison of Plate-Screw Systems Used in Mandibular Fracture Reduction: Finite Element Analysis

A finite element model of the human dentate mandible has been developed to provide a comparison of fixation systems used currently for fracture reduction. Volume domains for cortical bone, cancellous bone, and teeth were created and meshed in ANSYS 8.0 based on IGES curves created from computerized tomography data. A unilateral molar clench was loaded on the model with a fracture gap simulated along the symphysis. Results based on Von Mises stress in cortical and cancellous bone surrounding the screws, and on fracture surface spatial fixation, show some relative differences between different screw-plate systems, yet all were judged to be appropriate in their reduction potential.

Application of an image-based weighted measure of skeletal bending stiffness to great ape mandibles

Traditional measures of structural stiffness in the primate skeleton do not consider the heterogeneous material stiffness distribution of bone. This assumption of homogeneity introduces an unknown degree of error in estimating stiffness in skeletal elements. Measures of weighted stiffness can be developed by including heterogeneous grayscale variations evident in computed tomographic (CT) images. Since gray scale correlates with material stiffness, the distribution of bone quality and quantity can be simultaneously considered. We developed weighted measures of bending resistance and applied these to CT images at three locations along the mandibular corpus in the hominoids Gorilla, Pongo, and Pan. We calculated the traditional (unweighted) moment of inertia for comparison to our weighted measure, which weighs each pixel by its gray-scale value. This weighing results in assignment of reduced moment of inertia values to sections of reduced density. Our weighted and unweighted moments differ by up to 22%. These differences are not consistent among sections, however, such that they cannot be calculated by simple correction of unweighted moments. The effect of this result is that the rank ordering of individual sections within species changes if weighted moments are considered. These results suggest that the use of weighted moments may spur different interpretations of comparative data sets that rely on stiffness measures as estimates of biomechanical competence.

Elastic properties of external cortical bone in the craniofacial skeleton of the rhesus monkey

Knowledge of elastic properties and of their variation in the cortical bone of the craniofacial skeleton is indispensable for creating accurate finite-element models to explore the biomechanics and adaptation of the skull in primates. In this study, we measured elastic properties of the external cortex of the rhesus monkey craniofacial skeleton, using an ultrasonic technique. Twenty-eight cylindrical cortical specimens were removed from each of six craniofacial skeletons of adult Macaca mulatta. Thickness, density, and a set of longitudinal and transverse ultrasonic velocities were measured on each specimen to allow calculation of the elastic properties in three dimensions, according to equations derived from Newton's second law and Hooke's law. The axes of maximum stiffness were determined by fitting longitudinal velocities measured along the perimeter of each cortical specimen to a sinusoidal function. Results showed significant differences in elastic properties between different functional areas of the rhesus cranium, and that many sites have a consistent orientation of maximum stiffness among specimens. Overall, the cortical bones of the rhesus monkey skull can be modeled as orthotropic in many regions, and as transversely isotropic in some regions, e.g., the supraorbital region. There are differences from human crania, suggesting that structural differences in skeletal form relate to differences in cortical material properties across species. These differences also suggest that we require more comparative data on elastic properties in primate craniofacial skeletons to explore effectively the functional significance of these differences, especially when these differences are elucidated through modeling approaches, such as finite-element modeling.

Material properties of the dentate maxilla

The aim of this study was to determine regional variability of material properties in the dentate maxilla. Cortical samples were removed from 15 sites of 15 adult dentate fresh-frozen maxillas. Cortical thickness, density, elastic properties, and the direction of greatest stiffness were obtained. Results showed that cortical bone in the alveolar region tended to be thicker, less dense, and less stiff. Cortical bone from the body of the maxilla was thinner, denser, and stiffer. Palatal cortical bone was intermediate in some features but overall was more similar to cortical bone from the alveolar region. The principal axes of stiffness varied regionally. The regions with the greatest consistency were the alveolar area and the frontomaxillary pillar, where the grain of the cortical bone was aligned vertically from the incisors to the medial external aspect of the orbit. Elastic properties in the human maxilla, especially the orientation of the principal axes of stiffness, were more variable than in the mandible. Incorporation of these properties into finite-element models should improve their accuracy and reliability.

Engineering craniofacial scaffolds

OBJECTIVE

To develop an integrated approach for engineering craniofacial scaffolds and to demonstrate that these engineered scaffolds would have mechanical properties in the range of craniofacial tissue and support bone regeneration for craniofacial reconstruction.

EXPERIMENTAL VARIABLE

Scaffold architecture designed to achieve desired elasticity and permeability. Scaffold external shape designed to match craniofacial anatomy.

OUTCOME MEASURE

Final fabricated biomaterial scaffolds. Compressive mechanical modulus and strength. Bone regeneration as measured by micro-CT scanning, mechanical testing and histology.

SETTING

Departments of Biomedical Engineering, Oral/Maxillofacial Surgery, and Oral Medicine, Pathology and Oncology at the University of Michigan.

RESULTS

Results showed that the design/fabrication approach could create scaffolds with designed porous architecture to match craniofacial anatomy. These scaffolds could be fabricated from a wide range of biomaterials, including titanium, degradable polymers, and degradable calcium phosphate ceramics. Mechanical tests showed that fabricated scaffolds had compressive modulus ranging 50 to 2900 MPa and compressive strength ranging from 2 to over 56 MPa, within the range of human craniofacial trabecular bone. In vivo testing of designed scaffolds showed that they could support bone regeneration via delivery of BMP-7 transduced human gingival fibroblasts in a mouse model. Designed hydroxyapatite scaffolds with pore diameters ranging from 400 to 1200 microns were implanted in minipig mandibular defects for 6 and 18 weeks. Results showed substantial bone ingrowth (between 40 and 50% at 6 weeks, between 70 and 80% at 18 weeks) for all scaffolds, with no significant difference based on pore diameter.

CONCLUSION

Integrated image-based design and solid free-form fabrication can create scaffolds that attain desired elasticity and permeability while fitting any 3D craniofacial defect. The scaffolds could be manufactured from degradable polymers, calcium phosphate ceramics and titanium. The designed scaffolds supported significant bone regeneration for all pore sizes ranging from 300 to 1200 microns. These results suggest that designed scaffolds are clinically applicable for complex craniofacial reconstruction.

Mandibular stiffness in humans: numerical predictions

The chin is a feature unique to humans. This study evaluates the effect of mandibular symphyseal design on biomechanical masticatory effectiveness as determined by structural stiffness and stress developed under flexural and torsional loading. A simple model of three symphyseal shapes (chin, flat symphysis and lingual buttress), was built to represent human, Neanderthal and higher primate symphyses and these were subjected to wishboning and torsional forces. Additionally, an anatomically detailed reconstruction was made of the CT scan of an actual human mandible, which was then also morphed into a chinless model. The results of a 3-D finite element analysis show firstly, that none of the three different symphyseal shapes is biomechanically more advantageous than the others for the given loading condition. Secondly, we show in a CT-derived model, that the presence of a chin does not confer significantly improved stiffness to torsional or flexural loading. These results indicate that the acquisition of a chin in modern humans is not related to the functional demands placed upon the mandible during mastication, but suggest that it may have developed in response to other biomechanical demands.

Analysis of bone-implant interaction phenomena by using a numerical approach

OBJECTIVES

The purpose of the present work is to investigate the interaction phenomena occurring between endosseus dental implants and peri-implant bone tissue.

MATERIAL AND METHODS

Detailed finite element models are adopted in order to analyze the actual behavior of bone-implant system depending on implant and anatomical site configuration and loading conditions. Different types of titanium dental implants are considered. Implant finite element models are obtained through a reverse engineering procedure and adopting specific software for the reconstruction of geometrical configuration. Anatomical sites are modeled starting from computerized tomography data, according to specific image processing procedures.

RESULTS

Occlusal static forces are applied to the implants and their effects on the bone-implant interface region are evaluated. The influence of several parameters, such as morphometry of anatomical site or loading condition, on the biomechanical response of bone-implant system is considered.

CONCLUSIONS

The evaluation of the biomechanical response of implant-bone compound necessarily requires the adoption of accurate numerical models, accounting for the complex geometry of threaded implants, as well as of the anatomy of the patients to be able to provide for reliable results pertaining to stress/strain path on peri-implant bone tissue.

Finite element analysis in functional morphology

This article reviews the fundamental principles of the finite element method and the three basic steps (model creation, solution, and validation and interpretation) involved in using it to examine structural mechanics. Validation is a critical step in the analysis, without which researchers cannot evaluate the extent to which the model represents or is relevant to the real biological condition. We discuss the method's considerable potential as a tool to test biomechanical hypotheses, and major hurdles involved in doing so reliably, from the perspective of researchers interested in functional morphology and paleontology. We conclude with a case study to illustrate how researchers deal with many of the factors and assumptions involved in finite element analysis.

Material properties of the human cranial vault and zygoma

The material properties of cortical bone from the diaphyses of long bones (e.g., the femur and tibia) vary by direction, such that bone is stiffer and stronger along its long axis. This configuration improves the abilities of these structures to resist axial compressive loads coupled with bending. As in long bones, cortical bone from the cranial vault is subject to mechanical loads from various orofacial functions and the contraction of attached muscles. However, experimental studies suggest that the resulting bone strains are at least an order of magnitude smaller than those found in the midshafts of the femur or tibia. The characteristics of the three-dimensional elastic properties of cortical bone are largely unexplored in regions of low bone strain, including the cranial vault, in which little is known regarding cortical structure and function. In the present study we examined variations in the cortical microstructure and material properties of the bone of the human cranial vault, including the parietal, frontal, temporal, and occipital bones. A facial bone, the zygoma, was also included to contrast the properties of the cranial vault with another craniofacial intramembranous bone that experiences larger strains. Cortical specimens from the outer cortical plate of the cranial vault were removed from 15 frozen human crania. We measured cortical thicknesses and densities, and determined the primary direction of stiffness within the bone specimens prior to ultrasonic testing to determine their elastic properties. There were statistically significant differences in elastic properties between bones and, in some cases, sites within bones, which for most variables were clustered by bone or region. In striking contrast to this pattern, elastic moduli in the direction of primary stiffness were larger in cortical regions underlying muscle attachments than in regions without muscle attachments. Few sites in the cranial vault or zygoma showed a consistent orientation of the material axes among individuals, although specimens from many regions had directional differences similar to those in cortical bone from the mandible, femur, or tibia.

Accuracy of elastic property measurement in mandibular cortical bone is improved by using cylindrical specimens

Ultrasonic determination of elastic properties in human craniofacial cortical bone is problematic because of a lack of information about the principal material axes, and because the cortex is often thinner than in long bones. This study investigated solutions that permit reasonable determination of elastic properties in the human mandible. We tested whether ultrasonic velocities could be reliably measured in cylindrical samples of aluminum and mandibular bone, and the effects of reduced specimen thickness. Results indicted that (1) varying shape had minimal effects on ultrasonic velocities or derived elastic properties, and (2) ultrasonic velocities have relatively increased measurement error as propagation distances decreased. The increased error in velocity measurements of mandibular cortical specimens of less than 1.2 mm in thickness should be considered when assessing the reliability of single measurements.