Bone remodeling induced by dental implants of functionally graded materials

A Parametric Study on a Dental Implant Geometry Influence on Bone Remodelling through a Numerical Algorithm

To ensure the long-term success of a dental implant, it is imperative to understand how chewing loads are transferred through the implant prosthetic components to the surrounding bone tissue. The stress distribution depends on several factors, such as load type, bone–implant interface, shape and materials of the fixture and quality and quantity of the bone. These aspects are of fundamental importance to ensure implant stability and to evaluate the remodelling capacity of the bone tissue to adapt to its biomechanical environment. A bone remodelling algorithm was formulated by the authors and implemented by means of finite element simulations on four different implants with several design characteristics. Internal bone microstructure and density, apposition/resorption of tissue and implant stability were evaluated over a period of 12 months, showing the influence of the geometry on bone tissue evolution over time. Bone remodelling algorithms may be a useful aid for clinicians to prevent possible implant failures and define an adequate implant prosthetic rehabilitation for each patient. In this work, for the first time, external bone remodelling was numerically predicted over time.

Functional Gradient Metallic Biomaterials: Techniques, Current Scenery, and Future Prospects in the Biomedical Field

Functional gradient materials (FGMs), as a modern group of materials, can provide multiple functions and are able to well mimic the hierarchical and gradient structure of natural systems. Because biomedical implants usually substitute the bone tissues and bone is an organic, natural FGM material, it seems quite reasonable to use the FGM concept in these applications. These FGMs have numerous advantages, including the ability to tailor the desired mechanical and biological response by producing various gradations, such as composition, porosity, and size; mitigating some limitations, such as stress-shielding effects; improving osseointegration; and enhancing electrochemical behavior and wear resistance. Although these are beneficial aspects, there is still a notable lack of comprehensive guidelines and standards. This paper aims to comprehensively review the current scenery of FGM metallic materials in the biomedical field, specifically its dental and orthopedic applications. It also introduces various processing methods, especially additive manufacturing methods that have a substantial impact on FGM production, mentioning its prospects and how FGMs can change the direction of both industry and biomedicine. Any improvement in FGM knowledge and technology can lead to big steps toward its industrialization and most notably for much better implant designs with more biocompatibility and similarity to natural tissues that enhance the quality of life for human beings.

A Hybrid Model for Predicting Bone Healing around Dental Implants

BACKGROUND

The effect of the short-term bone healing process is typically neglected in numerical models of bone remodeling for dental implants. In this study, a hybrid two-step algorithm was proposed to enable a more accurate prediction for the performance of dental implants.

METHODS

A mechano-regulation algorithm was firstly used to simulate the tissue differentiation around a dental implant during the short-term bone healing. Then, the result was used as the initial state of the bone remodeling model to simulate the long-term healing of the bones. The algorithm was implemented by a 3D finite element model.

RESULTS

The current hybrid model reproduced several features which were discovered in the experiments, such as stress shielding effect, high strength bone connective tissue bands, and marginal bone loss. A reasonable location of bone resorptions and the stability of the dental implant is predicted, compared with those predicted by the conventional bone remodeling model.

CONCLUSIONS

The hybrid model developed here predicted bone healing processes around dental implants more accurately. It can be used to study bone healing before implantation surgery and assist in the customization of dental implants.

Kriging Surrogate Model for Resonance Frequency Analysis of Dental Implants by a Latin Hypercube-Based Finite Element Method

The dental implantation in clinical operations often encounters difficulties and challenges of failure in osseointegration, bone formulation, and remodeling. The resonance frequency (RF) can effectively describe the stability of the implant in physical experiments or numerical simulations. However, the exact relationship between the design variables of dental implants and RF of the system is correlated, complicated, and dependent. In this study, an appropriate mathematical model is proposed to evaluate and predict the implant stability and performance. The model has merits not only in the prediction reliability and accuracy but also in the compatibility and flexibility, in both experimental data and numerical simulation results. The Kriging surrogate model is proposed to present the numerical relationship between RF and material parameters of dental implants. The Latin Hypercube (LH) sampling method as a competent and sophisticated method is applied and combined with the finite element method (FEM). The methods developed in this paper provide helpful guidance for designers and researchers in the implantation design and surgical plans.

Micro-CT based modelling for characterising injection-moulded porous titanium implants

Design of prosthetic implants to ensure rapid and stable osseointegration remains a significant challenge, and continuous efforts have been directed to new implant materials, structures and morphology. This paper aims to develop and characterise a porous titanium dental implant fabricated by metallic powder injection-moulding. The surface morphology of the specimens was first examined with a scanning electron microscope (SEM), followed by microscopic computerised tomography (μ-CT) scanning to capture its 3D microscopic features non-destructively. The nature of porosity and pore sizes were determined statistically. A homogenisation technique based on the Hills-energy theorem was adopted to evaluate its directional elastic moduli, and the conservation of mass theorem was employed to quantify the oxygen diffusivity for bio-transportation feature. This porous medium was found to have pore sizes varying from 50 to 400 µm and the average porosity of 46.90 ± 1.83%. The anisotropic principal elastic moduli were found fairly close to the upper range of cortical bone, and the directional diffusivities could potentially enable radial osseous tissue ingrowth and vascularisation. This porous titanium successfully reduces the elastic modulus mismatch between implant and bone for dental and orthopaedic applications, and provides improved capacity for transporting oxygen, nutrient and waste for pre-vascular network formation. Copyright © 2016 John Wiley & Sons, Ltd.

Comparison of various functionally graded femoral prostheses by finite element analysis

This study is focused on finite element analysis of a model comprising femur into which a femoral component of a total hip replacement was implanted. The considered prosthesis is fabricated from a functionally graded material (FGM) comprising a layer of a titanium alloy bonded to a layer of hydroxyapatite. The elastic modulus of the FGM was adjusted in the radial, longitudinal, and longitudinal-radial directions by altering the volume fraction gradient exponent. Four cases were studied, involving two different methods of anchoring the prosthesis to the spongy bone and two cases of applied loading. The results revealed that the FG prostheses provoked more SED to the bone. The FG prostheses carried less stress, while more stress was induced to the bone and cement. Meanwhile, less shear interface stress was stimulated to the prosthesis-bone interface in the noncemented FG prostheses. The cement-bone interface carried more stress compared to the prosthesis-cement interface. Stair climbing induced more harmful effects to the implanted femur components compared to the normal walking by causing more stress. Therefore, stress shielding, developed stresses, and interface stresses in the THR components could be adjusted through the controlling stiffness of the FG prosthesis by managing volume fraction gradient exponent.

Simulation on the internal structure of three-dimensional proximal tibia under different mechanical environments

Background

Bone can adjust its morphological structure to adapt to the changes of mechanical environment, i.e. the bone structure change is related to mechanical loading. This implies that osteoarthritis may be closely associated with knee joint deformity. The purposes of this paper were to simulate the internal bone mineral density (BMD) change in three-dimensional (3D) proximal tibia under different mechanical environments, as well as to explore the relationship between mechanical environment and bone morphological abnormity.

Methods

The right proximal tibia was scanned with CT to reconstruct a 3D proximal tibia model in MIMICS, then it was imported to finite element software ANSYS to establish 3D finite element model. The internal structure of 3D proximal tibia of young normal people was simulated using quantitative bone remodeling theory in combination with finite element method, then based on the changing pattern of joint contact force on the tibial plateau in valgus knees, the mechanical loading was changed, and the simulated normal tibia structure was used as initial structure to simulate the internal structure of 3D proximal tibia for old people with 6° valgus deformity. Four regions of interest (ROIs) were selected in the proximal tibia to quantitatively analyze BMD and compare with the clinical measurements.

Results

The simulation results showed that the BMD distribution in 3D proximal tibia was consistent with clinical measurements in normal knees and that in valgus knees was consistent with the measurement of patients with osteoarthritis in clinics.

Conclusions

It is shown that the change of mechanical environment is the main cause for the change of subchondral bone structure, and being under abnormal mechanical environment for a long time may lead to osteoarthritis. Besides, the simulation method adopted in this paper can more accurately simulate the internal structure of 3D proximal tibia under different mechanical environments. It helps to better understand the mechanism of osteoarthritis and provides theoretical basis and computational method for the prevention and treatment of osteoarthritis. It can also serve as basis for further study on periprosthetic BMD changes after total knee arthroplasty, and provide a theoretical basis for optimization design of prosthesis.