Occlusal load modelling significantly impacts the predicted tooth stress response during biting: a simulation study

Comparison of Two Types of Patient Specific Implants (PSI) and Quad Zygoma Implant (QZI) for Rehabilitation of Post-COVID Maxillary Mucormycosis Defect (PCMMD): Finite Element Analysis

Introduction

The residual post-COVID maxillary mucormycosis defect (PCMMD) were extensive, due to unilateral or bilateral maxillectomies. The Goal of rehabilitation of PCMMD is to deliver a prosthetically driven reconstruction. FEA was to evaluate the biomechanical response of PSI struts (PSI 1), PSI Screw retained (PSI 2) and QZI to masticatory load on virtual simulation to improve accuracy and enhance the design.

Aim

To validate and compare the Biomechanical benefit of the PSI struts, PSI Screw retained, QZI in a case of rehabilitation of post-COVID maxillary mucormycosis defect (PCMMD) by FEA study.

Methodology

The result of stress to masticatory load on virtual simulation for (1) Maximum and minimum stress (Von Mises stress); (2) the Displacement (in three positions) and (3) the Deformation (Plastic strain) was compared on virtual simulation for PSI 1 and PSI 2 and QZI.

Conclusion

The FEA and comparative evaluation of PSI 1, PSI 2 and QZI showed a good resistance to displacement. The stress and strain values are low and acceptable. In comparison QZI shows more stress in the anterior region.

Modelling motor units in 3D: influence on muscle contraction and joint force via a proof of concept simulation

Functional heterogeneity is a skeletal muscle’s ability to generate diverse force vectors through localised motor unit (MU) recruitment. Existing 3D macroscopic continuum-mechanical finite element (FE) muscle models neglect MU anatomy and recruit muscle volume simultaneously, making them unsuitable for studying functional heterogeneity. Here, we develop a method to incorporate MU anatomy and information in 3D models. Virtual fibres in the muscle are grouped into MUs via a novel “virtual innervation” technique, which can control the units’ size, shape, position, and overlap. The discrete MU anatomy is then mapped to the FE mesh via statistical averaging, resulting in a volumetric MU distribution. Mesh dependency is investigated using a 2D idealised model and revealed that the amount of MU overlap is inversely proportional to mesh dependency. Simultaneous recruitment of a MU’s volume implies that action potentials (AP) propagate instantaneously. A 3D idealised model is used to verify this assumption, revealing that neglecting AP propagation results in a slightly less-steady force, advanced in time by approximately 20 ms, at the tendons. Lastly, the method is applied to a 3D, anatomically realistic model of the masticatory system to demonstrate the functional heterogeneity of masseter muscles in producing bite force. We found that the MU anatomy significantly affected bite force direction compared to bite force magnitude. MU position was much more efficacious in bringing about bite force changes than MU overlap. These results highlight the relevance of MU anatomy to muscle function and joint force, particularly for muscles with complex neuromuscular architecture.

A biophysically guided constitutive law of the musculotendon-complex: modelling and numerical implementation in Abaqus

BACKGROUND AND OBJECTIVE

Many biomedical, clinical, and industrial applications may benefit from musculoskeletal simulations. Three-dimensional macroscopic muscle models (3D models) can more accurately represent muscle architecture than their 1D (line-segment) counterparts. Nevertheless, 3D models remain underutilised in academic, clinical, and commercial environments. Among the reasons for this is a lack of modelling and simulation standardisation, verification, and validation. Here, we strive towards a solution by providing an open-access, characterised, constitutive relation (CR) for 3D musculotendon models.

METHODS

The musculotendon complex is modelled following the state-of-the-art active stress approach and is treated as hyperelastic, transversely isotropic, and nearly incompressible. Furthermore, force-length and -velocity relationships are incorporated, and muscle activation is derived from motor-unit information. The CR was implemented within the commercial finite-element software package Abaqus as a user-subroutine. A masticatory system model with left and right masseters was used to demonstrate active and passive movement.

RESULTS

The CR was characterised by various experimental data sets and was able to capture a wide variety of passive and active behaviours. Furthermore, the masticatory simulations revealed that joint movement was sensitive to the muscle's in-fibre passive response.

CONCLUSIONS

This user-material provides a "plug and play" template for 3D neuro-musculoskeletal finite element modelling. We hope that this reduces modelling effort, fosters exchange, and contributes to the standardisation of such models.

Application of Food Mechanics and Oral Processing in Modelling First Bite of Grilled Meat

This study analyzed the potential of modelling meat mastication by using pork and poultry meat as food with different physical properties under different grilling temperatures. For the purpose of modelling oral processing, temporal dominance of sensations and finite element methods were employed. A panel with ten subjects was trained and used for oral processing analysis and temporal dominance of sensations revealing in-mouth sensations and mastication characteristics. In parallel, the second aim was to evaluate the mechanical properties of the samples and explore the potential of simulating the first bite using the finite element method. Based on the textural parameters, a 3D model of grilled meat was created and a first-bite simulation was performed. A higher level of differences was observed comparing the number of chews for pork meat compared to poultry meat. The chewing rate showed a statistical difference with values in the range of 1.31 chews/s to 1.46 chews/s for pork meat and between 1.36 chews/s and 1.42 chews/s for poultry meat. Firmness was the predominant sensory attribute recognized by panelists at the beginning of mastication, which confirmed our approach used for first-bite modelling. Simulation results show the growth of internal stress following the jaw’s path. Presented models demonstrate that the highest values are around teeth pressure and lead to a conclusion that upon biting, the meat structure will suffer irreversible damage dividing the grilled meat into two pieces, as it happens during the first bite. The main conclusion of this study is that by combining results from oral processing and testing of mechanical properties of the grilled products, it is possible to simulate the first bite.

FINITE ELEMENT EVALUATION OF THE EFFECT OF ADHESIVE CREAMS ON THE STRESS STATE OF DENTURES AND ABUTMENT TEETH

The appropriate fit of removable partial dentures (RPDs) is hypothesized to lead to lower tooth mobility. An adhesive layer between the denture and oral mucosa can facilitate better denture retention and therefore increased stability. Study objectives were to model and compare the response of abutment structures with and without the application of a denture adhesive and to observe the stress response of abutment periodontal ligaments (PDLs) during the application of occlusal force on the RPD. A 3D finite element (FE) model was developed from computer tomography datasets of the mandibular region and the RPD. An adhesive layer was developed by extending the denture surface and using the Prony series approximation of rheological data to implement a viscoelastic material model. FE simulations were performed by applying a bite force on one of the denture segments, with the resulting deformation in PDL compared between the model with the adhesive layer and the base model without. The maximum deformation of 15[Formula: see text][Formula: see text]m was observed in the 2nd molar abutment PDL with the implementation of the adhesive, as compared to 42[Formula: see text][Formula: see text]m for the model without. The lower impact of RPDs on the supporting abutment teeth could potentially reduce the discomfort of denture wearers.

Probing combinational influence of design variables on bone biomechanical response around dental implant-supported fixed prosthesis

This study aimed to understand the effect of physiological and dental implant-related parameter variations on the osseointegration for an implant-supported fixed prosthesis. Eight design factors were considered (implant shape, diameter, and length; thread pitch, depth, and profile; cantilever [CL] length and implant-loading protocol). Total 36 implantation scenarios were simulated using finite element method based on Taguchi L₃₆ orthogonal array. Three patient-specific bone conditions were also simulated by scaling the density and Young's modulus of a mandible sample to mimic weak, normal, and strong bones. Taguchi method was employed to determine the significance of each design factor in controlling the peri-implant cortical bone microstrain. For normal bone condition, CL length had the maximum contribution (28%) followed by implant diameter (18%), thread pitch (14%), implant length (8%), and thread profile (5%). For strong bone condition, CL and implant diameter had equal contribution (32%) followed by thread pitch (7%) and implant length (5%). For weak bone condition, implant diameter had the highest contribution (31%) followed by CL length (30%), thread pitch (11%) and implant length (8%). The presence of distal CL in dental framework was found to be the most influential design factor, which can cause high strain in the cervical cortical bone. It was seen that implant diameter had more effect compared to implant length toward peri-implant bone biomechanical response. Implant-loading time had no significant effect towards peri-implant bone biomechanical response, signifying immediate loading is possible with sufficient mechanical retention.

Development of a biomechanical model for dynamic occlusal stress analysis

The use of traditional finite element method (FEM) in occlusal stress analysis is limited due to the complexity of musculature simulation. The present purpose was to develop a displacement boundary condition (DBC)-FEM, which evaded the muscle factor, to predict the dynamic occlusal stress. The geometry of the DBC-FEM was developed based on the scanned plastic casts obtained from a volunteer. The electrognathographic and video recorded jaw positional messages were adopted to analyze the dynamic occlusal stress. The volunteer exhibited asymmetrical lateral movements, so that the occlusal stress was further analyzed by using the parameters obtained from the right-side eccentric movement, which was 6.9 mm long, in the stress task of the left-side eccentric movement, which was 4.1 mm long. Further, virtual occlusion modification was performed by using the carving tool software aiming to improve the occlusal morphology at the loading sites. T-Scan Occlusal System was used as a control of the in vivo detection for the location and strength of the occlusal contacts. Data obtained from the calculation using the present developed DBC-FEM indicated that the stress distribution on the dental surface changed dynamically with the occlusal contacts. Consistent with the T-Scan recordings, the right-side molars always showed contacts and higher levels of stress. Replacing the left-side eccentric movement trace by the right-side one enhanced the simulated stress on the right-side molars while modification of the right-side molars reduced the simulated stress. The present DBC-FEM offers a creative approach for pragmatic occlusion stress prediction.

Comparative Analysis of Stress and Deformation between One-Fenced and Three-Fenced Dental Implants Using Finite Element Analysis

Finite element analysis (FEA) has always been an important tool in studying the influences of stress and deformation due to various loads on implants to the surrounding jaws. This study assessed the influence of two different types of dental implant model on stress dissipation in adjoining jaws and on the implant itself by utilizing FEA. This analysis aimed to examine the effects of increasing the number of fences along the implant and to compare the resulting stress distribution and deformation with surrounding bones. When a vertical force of 100 N was applied, the largest displacements found in the three-fenced and single-fenced models were 1.7469 and 2.5267, respectively, showing a drop of 30.8623%. The maximum stress found in the three-fenced and one-fenced models was 13.518 and 22.365 MPa, respectively, showing a drop of 39.557%. Moreover, when an oblique force at 35° was applied, a significant increase in deformation and stress was observed. However, the three-fenced model still had less stress and deformation compared with the single-fenced model. The FEA results suggested that as the number of fences increases, the stress dissipation increases, whereas deformation decreases considerably.

Improvement of an additively manufactured subperiosteal implant structure design by finite elements based topological optimization

To design a new subperiosteal implant structure for patients suffering from severe Maxillary Atrophy that lowers manufacturing cost, shortens surgical time and reduces patient trauma with regard to current implant structures. A 2-phase finite-element-based topology optimization process was employed with implants made from biocompatible materials via additive manufacturing. Five bite loading cases related to standard chewing, critical chewing force, and worst conditions of fastening were considered along with each specific result to establish the areas that needed to be subjected to fatigue strength optimization. The 2-phase topological optimization tested in this study performed better than the reference implant geometry in terms of both the structural integrity of the implant under tensile-compressive and fatigue strength conditions and the material constraints related to implant manufacturing conditions. It returns a nearly 28% lower volumetric geometry and avoids the need to use two upper fastening screws that are required with complex surgical procedures. The combination of topological optimization methods with the flexibility afforded by additively manufactured biocompatible materials, provides promising results in terms of cost reduction, minimizing the surgical trauma and implant installation impact on edentulous patients.

Finite Element Evaluation of the Effect of Adhesive Creams on the Stress State of Dentures and Oral Mucosa

The base fit between a removable partial denture (RPD) and the underlying soft tissue plays a significant role in its performance. The application of a denture adhesive is hypothesized to result in better retention of RPDs and, as a result, contribute to lower stress on the oral mucosa. The objectives of this study were to observe and compare the distribution of simulated bite forces applied to the RPD through the abutments and soft tissue for models with and without the use of a denture adhesive. Furthermore, we evaluated the possible benefit of using a denture adhesive in lowering stresses on the oral mucosa. The RPD, mandible, oral mucosa, abutment teeth supporting the RPD, and the corresponding abutment periodontal ligaments (PDLs) were modelled as 3D volumes based on computer tomography (CT) datasets. A viscoelastic adhesive layer between the RPD and oral mucosa was incorporated into this base model using Prony series approximation. The layer was developed as a volume extract using the denture surface. Finite element (FE) simulations were performed for the bite force on one of the RPD segments, with the resulting force and moments experienced by the dental structures and oral mucosa compared between the model with the adhesive layer and the base model without. As a result, the contact pressure on the oral mucosa for the model with the denture adhesive decreased to 0.15 MPa as compared to 0.25 MPa for the model without the adhesive. The potential role of denture adhesives in leading to a better fit between the RPD and oral mucosa as well as lowering contact pressures could be used to improve comfort in patients wearing RPDs.

Direct resin composite restoration of endodontically-treated permanent molars in adolescents: bite force and patient-specific finite element analysis

Objective To evaluate the influence of three levels of dental structure loss on stress distribution and bite load in root canal-treated young molar teeth that were filled with bulk-fill resin composite, using finite element analysis (FEA) to predict clinical failure. Methodology Three first mandibular molars with extensive caries lesions were selected in teenager patients. The habitual occlusion bite force was measured using gnathodynamometer before and after endodontic/restoration procedures. The recorded bite forces were used as input for patient-specific FEA models, generated from cone-beam computed tomographic (CT) scans of the teeth before and after treatment. Loads were simulated using the contact loading of the antagonist molars selected based on the CT scans and clinical evaluation. Pre and post treatment bite forces (N) in the 3 patients were 30.1/136.6, 34.3/133.4, and 47.9/124.1. Results Bite force increased 260% (from 36.7±11.6 to 131.9±17.8 N) after endodontic and direct restoration. Before endodontic intervention, the stress concentration was located in coronal tooth structure; after rehabilitation, the stresses were located in root dentin, regardless of the level of tooth structure loss. The bite force used on molar teeth after pulp removal during endodontic treatment resulted in high stress concentrations in weakened tooth areas and at the furcation. Conclusion Extensive caries negatively affected the bite force. After pulp removal and endodontic treatment, stress and strain concentrations were higher in the weakened dental structure. Root canal treatment associated with direct resin composite restorative procedure could restore the stress-strain conditions in permanent young molar teeth.