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Chancharoen W, Pansai J, Boonchuay T, Saeya S, Das R, Chobpenthai T, Aimmanee S. Performance parametric formulation of carbon fiber-reinforced composite locking bone implant plates based on finite-element analysis. Comput Methods Biomech Biomed Engin 2024:1-17. [PMID: 38808689 DOI: 10.1080/10255842.2024.2358362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 05/17/2024] [Indexed: 05/30/2024]
Abstract
The treatment of Giant Cell Tumor (GCT) in the distal radius poses challenges due to the intricate anatomical features of the bone. It often necessitates the use of long implant plates or the interconnection of multiple short plates after tumor excision. However, the deployment of metal plates may increase the risk of screw loosening and various complications. To address these challenges, this study proposes the adoption of carbon fiber-reinforced PEEK (CFRP) as the base material. As a unique strategy, performance parameters (PP) were developed to compare CFRP implant plates with a Ti-6Al-4V plate using the Finite-element Method. The focus was on four elements: the screw axial force, bone growth, callus formation, and bone resorption. The investigation into the screw axial force involved analyzing the internal force of the screw. The remaining parameters were evaluated using the stress, strain, or elastic energy induced in the bones. The findings showed that the second screw endured the largest screw axial force, measuring 10.16 N under a 90-degree 10-N loading at the translocated bone. The model without a callus exerted a significantly greater force on the screw than the model with a callus, leading to screw loosening in the early stage of treatment. The maximum PP, reached 1.62, was achieved with an angle-ply [456/-456] laminate, featuring a weighting fraction of 0.7 for bone growth and 0.1 for the other parameters. This study provides a generalized methodology for assessing the performances of CFRP implants and offers guidelines for future development in composite implant plate technology.
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Affiliation(s)
- Wares Chancharoen
- Laboratory of Artificial Intelligence and Innovation in Medicine (AIIM), Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, LakSi, Thailand
| | - Jirapong Pansai
- Advanced Materials and Structures Laboratory (AMASS), Center for Lightweight Materials Design and Manufacturing, Department of Mechanical Engineering, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Thung Khru, Thailand
| | - Teeravut Boonchuay
- Advanced Materials and Structures Laboratory (AMASS), Center for Lightweight Materials Design and Manufacturing, Department of Mechanical Engineering, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Thung Khru, Thailand
| | - Somchart Saeya
- Advanced Materials and Structures Laboratory (AMASS), Center for Lightweight Materials Design and Manufacturing, Department of Mechanical Engineering, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Thung Khru, Thailand
| | - Raj Das
- School of Engineering, RMIT University, Melbourne, Australia
| | - Thanapon Chobpenthai
- Laboratory of Artificial Intelligence and Innovation in Medicine (AIIM), Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, LakSi, Thailand
| | - Sontipee Aimmanee
- Advanced Materials and Structures Laboratory (AMASS), Center for Lightweight Materials Design and Manufacturing, Department of Mechanical Engineering, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Thung Khru, Thailand
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Roy D, Das MC, Dhason R, Roy S, Datta S. Effect of matrix material property on the composite tibia fracture plate: a biomechanical study. Biomed Phys Eng Express 2024; 10:035026. [PMID: 38547526 DOI: 10.1088/2057-1976/ad38c4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
For the purpose of fixing tibia fractures, composite bone plates are suggested. Metal plates cause stress shielding, lessen the compression force at the fracture site, and have an impact on the healing process because they are significantly more rigid than bone. To prevent excessive shear strain and consequent instability at the fracture site, it is imperative to reduce stiffness in the axial direction without lowering stiffness in the transverse direction. Only a carefully crafted fiber reinforced composite with anisotropic properties will suffice to accomplish this. The purpose of the current study is to examine the impact of axial and shear movements at the fracture site on the fixing of metal and composite bone plates. After modeling the tibia with a 1 mm fracture gap, titanium plates, carbon/epoxy, carbon/PEEK, and carbon/UHMWPE composite bone plates were used to fix it. There are 6 holes on each of the 103 mm long plates. To determine the stresses and axial movement in the fracture site, anatomical 3D Finite Element (FE) models of the tibia with composite bone plates are built. The simulations that were run for various composite plate layouts and types give suggestions for selecting the best composite bone plate. Although the matrix material causes some variations in behaviors, most of the plates perform as well as or even better than metal plates. Thus, the appropriate composite combinations are recommended for a given fracture structure.
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Affiliation(s)
- Drupad Roy
- Department of Mechanical Engineering, MCKV Institute of Engineering, Liluah, Howrah 711204, West Bengal, India
| | - Manik Chandra Das
- Department of Industrial Engineering and Management, Maulana Abul Kalam Azad University of Technology, Haringhata, Nadia 741249, West Bengal, India
| | - Raja Dhason
- Departement of Mechanical Engineering, SRM Institute of Science and Technology, Kattakulathur, Chengalpattu Dist. 603203, Tamil Nadu, India
| | - Sandipan Roy
- Departement of Mechanical Engineering, SRM Institute of Science and Technology, Kattakulathur, Chengalpattu Dist. 603203, Tamil Nadu, India
| | - Shubhabrata Datta
- Departement of Mechanical Engineering, SRM Institute of Science and Technology, Kattakulathur, Chengalpattu Dist. 603203, Tamil Nadu, India
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Mischler D, Gueorguiev B, Windolf M, Varga P. On the importance of accurate elasto-plastic material properties in simulating plate osteosynthesis failure. Front Bioeng Biotechnol 2023; 11:1268787. [PMID: 38107614 PMCID: PMC10725216 DOI: 10.3389/fbioe.2023.1268787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
Background: Plate osteosynthesis is a widely used technique for bone fracture fixation; however, complications such as plate bending remain a significant clinical concern. A better understanding of the failure mechanisms behind plate osteosynthesis is crucial for improving treatment outcomes. This study aimed to develop finite element (FE) models to predict plate bending failure and validate these against in vitro experiments using literature-based and experimentally determined implant material properties. Methods: Plate fixations of seven cadaveric tibia shaft fractures were tested to failure in a biomechanical setup with various implant configurations. FE models of the bone-implant constructs were developed from computed tomography (CT) scans. Elasto-plastic implant material properties were assigned using either literature data or the experimentally derived data. The predictive capability of these two FE modelling approaches was assessed based on the experimental ground truth. Results: The FE simulations provided quantitatively correct prediction of the in vitro cadaveric experiments in terms of construct stiffness [concordance correlation coefficient (CCC) = 0.97, standard error of estimate (SEE) = 23.66, relative standard error (RSE) = 10.3%], yield load (CCC = 0.97, SEE = 41.21N, RSE = 7.7%), and maximum force (CCC = 0.96, SEE = 35.04, RSE = 9.3%), when including the experimentally determined material properties. Literature-based properties led to inferior accuracies for both stiffness (CCC = 0.92, SEE = 27.62, RSE = 19.6%), yield load (CCC = 0.83, SEE = 46.53N, RSE = 21.4%), and maximum force (CCC = 0.86, SEE = 57.71, RSE = 14.4%). Conclusion: The validated FE model allows for accurate prediction of plate osteosynthesis construct behaviour beyond the elastic regime but only when using experimentally determined implant material properties. Literature-based material properties led to inferior predictability. These validated models have the potential to be utilized for assessing the loads leading to plastic deformation in vivo, as well as aiding in preoperative planning and postoperative rehabilitation protocols.
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Affiliation(s)
- Dominic Mischler
- AO Research Institute Davos, Davos, Switzerland
- Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland
| | | | | | - Peter Varga
- AO Research Institute Davos, Davos, Switzerland
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Adamović P, Matoc L, Knežević P, Sabalić S, Kodvanj J. Biomechanical analysis of a novel screw system with a variable locking angle in mandible angle fractures. Med Biol Eng Comput 2023; 61:2951-2961. [PMID: 37535297 DOI: 10.1007/s11517-023-02895-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023]
Abstract
Locking plates nowadays represent an important treatment in bone trauma and bone healing due to its strong biomechanical properties. The purpose of this study was to both computationally and experimentally validate a novel screw locking system by comparing it to another locking system from state-of-the-art and to apply it in an environment of a fractured mandible. FEA was used to test both systems prior to experimental tests. The systems were locked in the plate holes at 0°, 10°, 15°, and 20°. Cyclic bending tests and push-out tests were performed in order to determine the stiffness and push-out forces of both locking systems. Finally, newly designed locking system was implemented in mandibular angle fracture. Control locking system was biomechanically superior in push-out test, but with no greater significance. In contrast, the new locking system showed greater stiffness by 17.3% at the deflection angle of 20° in cyclic tests, with lower values for other deflection angles. Similar values were displayed in fractured mandible angle environment. Greater stiffness of the new locking system in cyclic loading tests, together with polyaxiallity of the new locking screw, could lead to easier application and improved biomechanical stability of the mandible angle fractures.
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Affiliation(s)
- Petra Adamović
- Experimental Mechanics Laboratory, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Ivana Lučića 5, 10000, Zagreb, Croatia
| | - Lovro Matoc
- Department of Maxillofacial Surgery, University Hospital Centre Zagreb, Kišpatićeva Ulica 12, 10000, Zagreb, Croatia.
| | - Predrag Knežević
- Department of Maxillofacial and Oral Surgery, Dubrava University Hospital, Avenija Gojka Šuška 6, 10000, Zagreb, Croatia
| | - Srećko Sabalić
- Department of Traumatology, Sestre Milosrdnice University Hospital Center, Draškovićeva 19, 10000, Zagreb, Croatia
- School of Medicine, University of Split, Šoltanska 2, 21000, Split, Croatia
| | - Janoš Kodvanj
- Experimental Mechanics Laboratory, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Ivana Lučića 5, 10000, Zagreb, Croatia
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Coelho DDC, Zille DR, Lima J, Grillo R. Nasal spine implant to correct nasal asymetry and to enable nose correction accompanying orthognathic surgery. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:491-493. [PMID: 35248755 DOI: 10.1016/j.jormas.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Orthognathic surgery is gaining importance as an aesthetic procedure. The aim of this work is the first case report of a simultaneous rhinoplasty and orthognathic surgery, using a nasal spine implant. CASE REPORT This is a retrospective study based on the CARE guideline. A nasal spine implant was virtually planned and printed in polyetheretherketone (PEEK) to correct a nasal deviation and enable a rhinoplasty in the same surgical time. Both the surgeon and the patient were very satisfied with the clinical result. CONCLUSIONS Virtually planned and printed nasal spine implant is feasible. A helpful method to support rhinoplasty in orthognathic surgery to avoid deviations in the tip of the nose or asymmetries in the nostrils.
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Affiliation(s)
- Diego de Carvalho Coelho
- Department of Oral & Maxillofacial Surgery, Faculdade Patos de Minas, School of Dentistry, Rua Major Gote, 1408 Centro, Patos de Minas/Minas Gerais, 38700-001, Brazil
| | | | | | - Ricardo Grillo
- Department of Oral & Maxillofacial Surgery, Faculdade Patos de Minas, School of Dentistry, Rua Major Gote, 1408 Centro, Patos de Minas/Minas Gerais, 38700-001, Brazil; Department of Oral & Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil.
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Ganse B, Orth M, Roland M, Diebels S, Motzki P, Seelecke S, Kirsch SM, Welsch F, Andres A, Wickert K, Braun BJ, Pohlemann T. Concepts and clinical aspects of active implants for the treatment of bone fractures. Acta Biomater 2022; 146:1-9. [PMID: 35537678 DOI: 10.1016/j.actbio.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/24/2022] [Accepted: 05/02/2022] [Indexed: 12/17/2022]
Abstract
Nonunion is a complication of long bone fractures that leads to disability, morbidity and high costs. Early detection is difficult and treatment through external stimulation and revision surgery is often a lengthy process. Therefore, alternative diagnostic and therapeutic options are currently being explored, including the use of external and internal sensors. Apart from monitoring fracture stiffness and displacement directly at the fracture site, it would be desirable if an implant could also vary its stiffness and apply an intervention to promote healing, if needed. This could be achieved either by a predetermined protocol, by remote control, or even by processing data and triggering the intervention itself (self-regulated 'intelligent' or 'smart' implant). So-called active or smart materials like shape memory alloys (SMA) have opened up opportunities to build active implants. For example, implants could stimulate fracture healing by active shortening and lengthening via SMA actuator wires; by emitting pulses, waves, or electromagnetic fields. However, it remains undefined which modes of application, forces, frequencies, force directions, time durations and periods, or other stimuli such implants should ideally deliver for the best result. The present paper reviews the literature on active implants and interventions for nonunion, discusses possible mechanisms of active implants and points out where further research and development are needed to build an active implant that applies the most ideal intervention. STATEMENT OF SIGNIFICANCE: Early detection of delays during fracture healing and timely intervention are difficult due to limitations of the current diagnostic strategies. New diagnostic options are under evaluation, including the use of external and internal sensors. In addition, it would be desirable if an implant could actively facilitate healing ('Intelligent' or 'smart' implant). Implants could stimulate fracture healing via active shortening and lengthening; by emitting pulses, waves, or electromagnetic fields. No such implants exist to date, but new composite materials and alloys have opened up opportunities to build such active implants, and several groups across the globe are currently working on their development. The present paper is the first review on this topic to date.
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Effect of Joint Use of External Minifixator and Titanium Lockplate on Total Active Motion Range and Hand Function Recovery in Comminuted Metacarpal and Phalanx Fracture Patients. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:3566364. [PMID: 35126920 PMCID: PMC8808207 DOI: 10.1155/2022/3566364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 12/31/2022]
Abstract
Objective To explore the effect of joint use of external minifixator and titanium lockplate on total active motion (TAM) range and hand function recovery in comminuted metacarpal and phalanx fracture patients. Methods The medical data of 70 patients with comminuted metacarpal and phalanx fracture treated in our hospital from June 2017 to June 2020 were screened for the retrospective study, and the patients were divided into the control group (Kirschner wire internal fixation) and the study group (an external minifixator with titanium lockplate) according to the treatment modalities, with 35 cases each. After treatment, the clinical efficacy of patients was compared between the two groups. Results No between-group differences in patients' general data were observed (P > 0.05); the time for hospital stay and fracture healing was obviously shorter in the study group than that in the control group (P < 0.05); after treatment, the study group obtained significantly higher TAM range good rate (P < 0.05), significantly higher Carroll hand function test pass rate (P < 0.05), and obviously better grip strength of both hands and score on digital opposition of thumb than those in the control group (P < 0.05); and after surgery, the study group had significantly lower incidence rates of complications such as infection, local inflammation, displacement of bone, and adhesion of tendon that those in the control group (P < 0.05). Conclusion Joint use of an external minifixator and titanium lockplate can effectively promote the TAM range and accelerate hand function recovery for comminuted metacarpal and phalanx fracture patients and is conducive to reducing the incidence of postoperative complications, which is safe and has significant efficacy.
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Souza JCM, Pinho SS, Braz MP, Silva FS, Henriques B. Carbon fiber-reinforced PEEK in implant dentistry: A scoping review on the finite element method. Comput Methods Biomech Biomed Engin 2021; 24:1355-1367. [PMID: 33616450 DOI: 10.1080/10255842.2021.1888939] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: The aim of the present study was to perform an integrative systematic review on the stress distribution assessed by finite element analysis on dental implants or abutments composed of carbon fiber-reinforced PEEK composites.Method: An electronic search was performed on PUBMED and ScienceDirect using a combination of the following search terms: PEEK, Polyetheretherketone, FEA, FEM, Finite element, Stress, Dental implant and Dental abutment.Results: The findings reported mechanical properties and the stress distribution through implant and abutment composed of PEEK and its fiber-reinforced composites. Unfilled PEEK revealed low values of elastic modulus and strength that negatively affected the stress distribution through the abutment and implant towards to the bone tisues. The incorporation of 30% carbon fibers increased the elastic modulus and strength of the PEEK-matrix composites although some studies reported no statistic differences in stress magnitude when compared to unfilled PEEK. However, an increase in short carbon fibers up to 60% revealed an enhancement on the stress distribution through abutment and implants towards to the bone tissues. PEEK veneering onto titanium core structures can also be a strategy to control the stress distribution at the implant-to-bone interface.Conclusions: The stiffness and strength of PEEK-matrix composites can be increased by the improvement of the carbon fibers' network. Thus, the content, shape, dimensions, and chemical composition of fibers are key factors to improve the stress distribution through abutment and implants composed of PEEK-matrix composites.
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Affiliation(s)
- Júlio C M Souza
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, 4800-058 Guimarães, Braga, Portugal.,Dept. of Dental Sciences, School of Dentistry, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra PRD, Portugal
| | - Sofia S Pinho
- Dept. of Dental Sciences, School of Dentistry, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra PRD, Portugal
| | - Maria Pranto Braz
- Dept. of Dental Sciences, School of Dentistry, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra PRD, Portugal
| | - Filipe S Silva
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, 4800-058 Guimarães, Braga, Portugal
| | - Bruno Henriques
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, 4800-058 Guimarães, Braga, Portugal.,Ceramic and Composite Materials Research Group (CERMAT), Departmenf of Mechanical Engineering (EMC), Federal University of Santa Catarina (UFSC), 88040-900 Florianópolis/SC, Brazil
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