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Zhong J, Huang W, Ahmad R, Chen J, Wu C, Hu J, Zheng K, Swain MV, Li Q. A Soft-Tissue Driven Bone Remodeling Algorithm for Mandibular Residual Ridge Resorption Based on Patient CT Image Data. Adv Healthc Mater 2024; 13:e2400091. [PMID: 38722148 DOI: 10.1002/adhm.202400091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/04/2024] [Indexed: 09/03/2024]
Abstract
The role of the biomechanical stimulation generated from soft tissue has not been well quantified or separated from the self-regulated hard tissue remodeling governed by Wolff's Law. Prosthodontic overdentures, commonly used to restore masticatory functions, can cause localized ischemia and inflammation as they often compress patients' oral mucosa and impede local circulation. This biomechanical stimulus in mucosa is found to accelerate the self-regulated residual ridge resorption (RRR), posing ongoing clinical challenges. Based on the dedicated long-term clinical datasets, this work develops an in-silico framework with a combination of techniques, including advanced image post-processing, patient-specific finite element models and unsupervised machine learning Self-Organizing map algorithm, to identify the soft tissue induced RRR and quantitatively elucidate the governing relationship between the RRR and hydrostatic pressure in mucosa. The proposed governing equation has not only enabled a predictive simulation for RRR as showcased in this study, providing a biomechanical basis for optimizing prosthodontic treatments, but also extended the understanding of the mechanobiological responses in the soft-hard tissue interfaces and the role in bone remodeling.
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Affiliation(s)
- Jingxiao Zhong
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
| | - Wenwei Huang
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
| | - Rohana Ahmad
- Faculty of Dentistry and Integrative Pharmacogenomics Institute, Universiti Teknologi MARA, Selangor, 40450, Malaysia
| | - Junning Chen
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, EX4 4QJ, UK
| | - Chi Wu
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
| | - Jingrui Hu
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, EX4 4QJ, UK
| | - Keke Zheng
- Institute for Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot Watt University, Edinburgh, EH14 4AS, UK
| | - Michael V Swain
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, Sydney, 2006, Australia
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Moga RA, Olteanu CD, Delean AG. Trabecular Bone Component Assessment under Orthodontic Loads and Movements during Periodontal Breakdown-A Finite Elements Analysis. Dent J (Basel) 2024; 12:190. [PMID: 38920891 PMCID: PMC11202809 DOI: 10.3390/dj12060190] [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: 04/11/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
This numerical analysis, by employing Tresca and Von Mises failure criteria, assessed the biomechanical behavior of a trabecular bone component subjected to 0.6, 1.2, and 2.4 N orthodontic forces under five movements (intrusion, extrusion, tipping, rotation, and translation) and during a gradual horizontal periodontal breakdown (0-8 mm). Additionally, they assessed the changes produced by bone loss, and the ischemic and resorptive risks. The analysis employed eighty-one models of nine patients in 405 simulations. Both failure criteria showed similar qualitative results, with Tresca being quantitatively higher by 1.09-1.21. No qualitative differences were seen between the three orthodontic loads. Quantitatively, a doubling (1.2 N) and quadrupling (2.4 N) were visible when compared to 0.6 N. Rotation and translation followed by tipping are the most stressful, especially for a reduced periodontium, prone to higher ischemic and resorptive risks. In an intact periodontium, 1.2 N can be safely applied but only in a reduced periodontium for extrusion and intrusion. More than 0.6 N is prone to increasing ischemic and resorptive risks for the other three movements. In an intact periodontium, stress spreads in the entire trabecular structure. In a reduced periodontium, stress concentrates (after a 4 mm loss-marker for the stress change distribution) and increases around the cervical third of the remaining alveolar socket.
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Affiliation(s)
- Radu-Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Strada Motilor 33, 400001 Cluj-Napoca, Romania;
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Strada Avram Iancu 31, 400083 Cluj-Napoca, Romania
| | - Ada Gabriela Delean
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Strada Motilor 33, 400001 Cluj-Napoca, Romania;
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Li X, Men X, Ji L, Chen X, He S, Zhang P, Chen S. NLRP3-mediated periodontal ligament cell pyroptosis promotes root resorption. J Clin Periodontol 2024; 51:474-486. [PMID: 38164052 DOI: 10.1111/jcpe.13914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/27/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
AIM To investigate the mechanisms by which periodontal ligament cells (PDLCs) convert biomechanical stimulation into inflammatory microenvironment inducing root resorption (RR). MATERIALS AND METHODS RNA sequencing was employed to explore mechanisms in force-inflammatory signal transduction. Then resorption volume, odontoclastic activity, PDLC pyroptotic ratio and NOD-like receptor protein 3 (NLRP3)-mediated pyroptosis pathway activation were analysed under force and pyroptosis inhibition. Further osteoclast formation, macrophage number and transwell polarization demonstrated the effects of PDLC pyroptosis on osteoclastogenesis and M1 polarization. RESULTS RNA sequencing revealed that NLRP3-mediated PDLC pyroptosis induced by Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NFκB)/NLRP3 pathway may be involved in mechano-inflammatory signal transduction. PDLC pyroptosis under force and the expression of NLRP3-mediated pyroptosis pathway in force-enhanced PDLCs were significantly increased, both in vivo and in vitro. MCC950 administration was sufficient to reduce PDLC pyroptosis and alleviate RR, odontoclast formation and M1 polarization in vivo. Further in vitro exploration showed that MCC950 treatment reduced PDLC force-promoted pyroptosis and blocked NLRP3-mediated pyroptosis pathway. Moreover, by treating THP-1 with force-pretreated PDLCs or supernatants, NLRP3-mediated PDLC pyroptotic released products induced osteoclast formation and M1 polarization. CONCLUSIONS NLRP3-mediated PDLC pyroptosis promotes RR. PDLCs transmit excessive force into inflammation signals through TLR4/NFκB/NLRP3 pathway, inducing PDLC pyroptosis, which directly promotes odontoclast formation and subsequent RR or promotes M1 polarization to indirectly trigger odontoclastogenesis and RR.
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Affiliation(s)
- Xinyi Li
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xinrui Men
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ling Ji
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xinyi Chen
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Shushu He
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ping Zhang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Song Chen
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Ardila CM, Arrubla-Escobar DE, Vivares-Builes AM. Efficacy of microchips and 3D sensors for orthodontic force measurement: A systematic review of in vitro studies. Orthod Craniofac Res 2024. [PMID: 38372469 DOI: 10.1111/ocr.12768] [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: 11/10/2023] [Revised: 01/28/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE To evaluate the efficacy of microchips and 3D microsensors in the measurement of orthodontic forces. METHODS Through September 2023, comprehensive searches were conducted on PubMed/MEDLINE, SCOPUS and SCIELO without restrictions. RESULTS After removing duplicate entries and applying the eligibility criteria, 23 studies were included for analysis. All the studies were conducted in vitro, and slightly more than half of them were centred on evaluating orthodontic forces exerted by aligners. Eight utilized microchips as measurement tools, while the remaining studies made use of 3D microsensors for their assessments. In the context of fixed appliances, key findings included a high level of agreement in 3-dimensional orthodontic force detection between simulation results and actual applied forces. Incorporating critical force-moment combinations during smart bracket calibration reduced measurement errors for most components. Translational tooth movement revealed a moment-to-force ratio, aligning with the bracket's centre of resistance. The primary findings in relation to aligners revealed several significant factors affecting the forces exerted by them. Notably, the foil thickness and staging were found to have a considerable impact on these forces, with optimal force transmission occurring at a layer height of 150 μm. Furthermore, the type of material used in 3D-printing aligners influenced the force levels, with attachments proving effective in generating extrusive forces. Deliberate adjustments in aligner thickness were observed to alter the forces and moments generated. CONCLUSIONS Microchips and 3D sensors provide precise and quantitative measurements of orthodontic forces in in vitro studies, enabling accurate monitoring and control of tooth movement.
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Affiliation(s)
- Carlos M Ardila
- School of Dentistry, University of Antioquia, Medellín, Colombia
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Bi S, Shi G. The crucial role of periodontal ligament's Poisson's ratio and tension-compression asymmetric moduli on the evaluation of tooth displacement and stress state of periodontal ligament. J Mech Behav Biomed Mater 2023; 148:106217. [PMID: 37931551 DOI: 10.1016/j.jmbbm.2023.106217] [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: 07/31/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 11/08/2023]
Abstract
The hydrostatic stress in the periodontal ligament (PDL) evaluated by finite element analysis is considered an important indicator for determining an appropriate orthodontic force. The computed result of the hydrostatic stress strongly depends on the PDL material model used in the orthodontic simulation. This study aims to investigate the effects of PDL Poisson's ratio and tension-compression asymmetric moduli on both the simulated tooth displacement and the PDL hydrostatic stress. Three tension-compression symmetric and two asymmetric PDL constitutive models were selected to simulate the tensile and compressive behavior of a PDL specimen under uniaxial loading, and the resulting numerical results were compared with the in-vitro PDL experimental results reported in the literature. Subsequently, a tooth model was established, and the selected constitutive models and parameters were employed to assess the hydrostatic stress state in the PDL under two distinct loading conditions. The simulated results indicate that PDL Poisson's ratio and tension-compression asymmetry exert substantial influences on the simulated PDL hydrostatic stress. Conversely, the elastic modulus exhibits minimal impact on the PDL stress state under the identical loading conditions. Furthermore, the PDL models with tension-compression asymmetric moduli and appropriate Poisson's ratio yield more realistic hydrostatic stress. Hence, it is imperative to employ suitable Poisson's ratio and tension-compression asymmetric moduli for the purpose of characterizing the biomechanical response of the PDL in orthodontic simulations.
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Affiliation(s)
- Shaoyang Bi
- Department of Mechanics, Tianjin University, 135 Yaguan Road, Tianjin, 300354, China.
| | - Guangyu Shi
- Department of Mechanics, Tianjin University, 135 Yaguan Road, Tianjin, 300354, China
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Zhong J, Shibata Y, Wu C, Watanabe C, Chen J, Zheng K, Hu J, Swain MV, Li Q. Functional non-uniformity of periodontal ligaments tunes mechanobiological stimuli across soft- and hard-tissue interfaces. Acta Biomater 2023; 170:240-249. [PMID: 37634832 DOI: 10.1016/j.actbio.2023.08.047] [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: 04/10/2023] [Revised: 08/09/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Abstract
The bone-periodontal ligament-tooth (BPT) complex is a unique mechanosensing soft-/hard-tissue interface, which governs the most rapid bony homeostasis in the body responding to external loadings. While the correlation between such loading and alveolar bone remodelling has been widely recognised, it has remained challenging to investigate the transmitted mechanobiological stimuli across such embedded soft-/hard-tissue interfaces of the BPT complex. Here, we propose a framework combining three distinct bioengineering techniques (i, ii, and iii below) to elucidate the innate functional non-uniformity of the PDL in tuning mechanical stimuli to the surrounding alveolar bone. The biphasic PDL mechanical properties measured via nanoindentation, namely the elastic moduli of fibres and ground substance at the sub-tissue level (i), were used as the input parameters in an image-based constitutive modelling framework for finite element simulation (ii). In tandem with U-net deep learning, the Gaussian mixture method enabled the comparison of 5195 possible pseudo-microstructures versus the innate non-uniformity of the PDL (iii). We found that the balance between hydrostatic pressure in PDL and the strain energy in the alveolar bone was maintained within a specific physiological range. The innate PDL microstructure ensures the transduction of favourable mechanobiological stimuli, thereby governing alveolar bone homeostasis. Our outcomes expand current knowledge of the PDL's mechanobiological roles and the proposed framework can be adopted to a broad range of similar soft-/hard- tissue interfaces, which may impact future tissue engineering, regenerative medicine, and evaluating therapeutic strategies. STATEMENT OF SIGNIFICANCE: A combination of cutting-edge technologies, including dynamic nanomechanical testing, high-resolution image-based modelling and machine learning facilitated computing, was used to elucidate the association between the microstructural non-uniformity and biomechanical competence of periodontal ligaments (PDLs). The innate PDL fibre network regulates mechanobiological stimuli, which govern alveolar bone remodelling, in different tissues across the bone-PDL-tooth (BPT) interfaces. These mechanobiological stimuli within the BPT are tuned within a physiological range by the non-uniform microstructure of PDLs, ensuring functional tissue homeostasis. The proposed framework in this study is also applicable for investigating the structure-function relationship in broader types of fibrous soft-/hard- tissue interfaces.
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Affiliation(s)
- Jingxiao Zhong
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW 2006, Australia
| | - Yo Shibata
- Department of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo, Japan
| | - Chi Wu
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW 2006, Australia
| | - Chie Watanabe
- Department of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo, Japan
| | - Junning Chen
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - Keke Zheng
- Institute for Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot Watt University, Edinburgh, UK
| | - Jingrui Hu
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - Michael V Swain
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW 2006, Australia
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW 2006, Australia.
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Moga RA, Delean AG, Buru SM, Botez MD, Olteanu CD. Orthodontic Internal Resorption Assessment in Periodontal Breakdown-A Finite Elements Analysis (Part II). Healthcare (Basel) 2023; 11:2622. [PMID: 37830659 PMCID: PMC10572129 DOI: 10.3390/healthcare11192622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/14/2023] Open
Abstract
This finite elements analysis (FEA) assessed the accuracy of maximum shear stress criteria (Tresca) in the study of orthodontic internal surface resorption and the absorption-dissipation ability of dental tissues. The present study was conducted over eighty-one models totaling 324 simulations with various bone loss levels (0-8 mm), where 0.6 N and 1.2 N were applied in the intrusion, extrusion, rotation, tipping, and translation movements. Tresca criteria displayed localized high-stress areas prone to resorption for all situations, better visible in the dentine component. The internal resorptive risks are less than external ones, seeming to increase with the progression of the periodontal breakdown, especially after 4 mm. The internal and external surface high-stress areas are strictly correlated. The qualitative stress display for both forces was almost similar. The rotation and tipping displayed the highest resorptive risks for the pulp chamber, decreasing with bone loss. The resorptive risks seem to increase along with the progression of periodontal breakdown if the same applied force is kept. The dentine resemblance to ductile based on its high absorption-dissipation ability seems correct. Tresca seems to supply a better predictability of the prone-to-resorption areas than the other failure criteria.
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Affiliation(s)
- Radu Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Ada Gabriela Delean
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Stefan Marius Buru
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania; (S.M.B.); (M.D.B.)
| | - Mircea Daniel Botez
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania; (S.M.B.); (M.D.B.)
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania;
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Xie Q, Peilun L, Zhitao Z, Guo B, Ke S, Xinxin L, Hu TT, Heng Y, Duohong Z, Chi Y. Fabrication of three-dimensional orthodontic force detecting brackets and preliminary clinical test for tooth movement simulation. Heliyon 2023; 9:e19852. [PMID: 37809553 PMCID: PMC10559236 DOI: 10.1016/j.heliyon.2023.e19852] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 08/26/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
This study aimed to develop an ultraminiature pressure sensor array to measure the force exerted on teeth. Orthodontic force plays an important role in effective, rapid, and safe tooth movement. However, owing to the lack of an adequate tool to measure the orthodontic force in vivo, it remains challenging to determine the best orthodontic loading in clinical and basic research. In this study, a three-dimensional (3D) orthodontic force detection system based on piezoresistive absolute pressure sensors was designed. The 3D force sensing array was constructed using five pressure sensors on a single chip. The size of the sensor array was only 4.1 × 2.6 mm, which can be placed within the bracket base area. Based on the barometric calibration, conversion formulas for the output voltage and pressure of the five channels were constructed. Subsequently, a 3D linear mechanical simulation model of the voltage and stress distribution was established using 312 tests of the applied force in 13 operating modes. Finally, the output voltage was first converted to pressure and then to the resultant force. The 3D force-detection chip was then tested to verify the accuracy of force measurement on the teeth. Based on the test results, the average output force error was only 0.0025 N (0.7169%) (p = 0.958), and the average spatial positioning error was only 0.058 mm (p = 0.872) on the X-axis and 0.050 mm (p = 0.837) on the Y-axis. The simulation results were highly consistent with the actual force applied (intraclass correlation efficient (ICC): 0.997-1.000; p < 0.001). Furthermore, through in vivo measurements and a finite element analysis, the movement trends generated when the measured orthodontic forces that acted on the teeth were simulated. The results revealed that the device can accurately measure the orthodontic force, representing the first clinical test of an orthodontic-force monitoring system. Our study provides a hardware basis for clinical research on efficient, safe, and optimal orthodontic forces, and has considerable potential for application in monitoring the biomechanics of tooth movement.
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Affiliation(s)
- Qianyang Xie
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Li Peilun
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Zhou Zhitao
- Shanghai Institute of Microsystem and Information Technology (SIMIT), Chinese Academy of Sciences, No. 865, Changning Rd., Shanghai, 200050, China
| | - Bai Guo
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Sun Ke
- Shanghai Institute of Microsystem and Information Technology (SIMIT), Chinese Academy of Sciences, No. 865, Changning Rd., Shanghai, 200050, China
| | - Li Xinxin
- Shanghai Institute of Microsystem and Information Technology (SIMIT), Chinese Academy of Sciences, No. 865, Changning Rd., Shanghai, 200050, China
| | - Tao Tiger Hu
- Shanghai Institute of Microsystem and Information Technology (SIMIT), Chinese Academy of Sciences, No. 865, Changning Rd., Shanghai, 200050, China
| | - Yang Heng
- Shanghai Institute of Microsystem and Information Technology (SIMIT), Chinese Academy of Sciences, No. 865, Changning Rd., Shanghai, 200050, China
| | - Zou Duohong
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Yang Chi
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
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Adly MS, Adly AS, Younes R, El Helou M, Panayotov I, Cuisinier F, Carayon D, Estephan E. Prevention and repair of orthodontically induced root resorption using ultrasound: a scoping review. Expert Rev Med Devices 2023. [PMID: 37294872 DOI: 10.1080/17434440.2023.2223965] [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: 02/17/2023] [Accepted: 06/06/2023] [Indexed: 06/11/2023]
Abstract
INTRODUCTION This review summarizes the available recent literature on different mechanisms and parameters of pulsed ultrasound (US) that have been used during orthodontic treatments to prevent and repair root resorption. AREAS COVERED A literature search was conducted between January (2002) and September (2022) in the following databases: PubMed, Google-Scholar, Embase and The-Cochrane-Library. After exclusions, a total of 19 papers were included in the present review. The most used US parameters with positive outcomes were frequency of 1.5 MHz, pulse repetition frequency of 1000 Hz, output intensity of 30 mW/cm2, duration of application of 20 mins and total number sessions were 14 with a repetition interval of 1day. The suggested mechanisms induced by US were alteration of cementoblasts, osteoblasts, osteoclasts, alkaline-phosphatase (ALP), runt-related-gene-2 (Runx2), osteoprotegerin (OPG), type-I-collagen (Col-I), C-telopeptide-type-I-collagen (CTX-I), hepatocyte-growth-factor (HGF), bone morphogenetic protein-2 (BMP-2), cyclooxygenase-2 (Cox-2), calcium (Ca2+), receptor activator of nuclear factor-kappa-B ligand (RANKL), and receptor activator of nuclear factor-kappa-B (RANK). EXPERT OPINION Understanding mechanisms and deciding which parameters of US that can be used during orthodontic treatment to prevent and repair root resorption is a great challenge. This work summarizes all the available data that can aid this process and suggest that US is an effective noninvasive method not only in prevention and repairing of orthodontic induced root resorption but also in accelerating teeth movement.
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Affiliation(s)
| | | | - Richard Younes
- Institute for Neurosciences of Montpellier (INM), Univ Montpellier, Inserm, Montpellier, France
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Marwan El Helou
- LBN, Univ Montpellier, Montpellier, France
- CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
| | - Ivan Panayotov
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
| | - Frederic Cuisinier
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
| | - Delphine Carayon
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
| | - Elias Estephan
- LBN, Univ Montpellier, Montpellier, France
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Moga RA, Olteanu CD, Botez MD, Buru SM. Assessment of the Orthodontic External Resorption in Periodontal Breakdown-A Finite Elements Analysis (Part I). Healthcare (Basel) 2023; 11:healthcare11101447. [PMID: 37239733 DOI: 10.3390/healthcare11101447] [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: 04/11/2023] [Revised: 05/15/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
This Finite Elements Analysis (FEA) assessed the accuracy of Tresca failure criteria (maximum shear stress) for the study of external root resorption. Additionally, the tooth absorption-dissipation ability was assessed. Overall, 81 models of the second mandibular premolar, out of a total of 324 simulations, were involved. Five orthodontic movements (intrusion, extrusion, rotation, translation, and tipping) were simulated under 0.6 N and 1.2 N in a horizontal progressive periodontal breakdown simulation of 0-8 mm. In all simulations, Tresca criteria accurately displayed the localized areas of maximum stress prone to external resorption risks, seeming to be adequate for the study of the resorptive process. The localized areas were better displayed in the radicular dentine-cementum component than in the entire tooth structure. The rotation and translation seem prone to a higher risk of external root resorption after 4 mm of loss. The resorptive risks seem to increase along with the progression of periodontal breakdown if the same amount of applied force is guarded. The localized resorption-prone areas follow the progression of bone loss. The two light forces displayed similar extensions of maximum stress areas. The stress displayed in the coronal dentine decreases along with the progression of bone loss. The absorption-dissipation ability of the tooth is about 87.99-97.99% of the stress.
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Affiliation(s)
- Radu Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania
| | - Mircea Daniel Botez
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
| | - Stefan Marius Buru
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
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Ma H, Teng H, Li A, Zhang Z, Zheng T, Chong DYR, Shao B, Liu Z. The pressure in the temporomandibular joint in the patients with maxillofacial deformities. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101285. [PMID: 36087916 DOI: 10.1016/j.jormas.2022.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Temporomandibular disorder (TMD) symptoms were found to be common in the patients with maxillofacial deformities. The mandibular structure was in relation with the stress within temporomandibular joint (TMJ). However, the current studies on the TMJ stresses in the patients with different maxillofacial deformities are not comprehensive enough. PURPOSE The aim of this study was to investigate the compression and morphology of the TMJ in the patients with different maxillofacial deformities under central occlusion. METHODS 24 patients and 10 asymptomatic individuals were included in this study and divided into patient groups and control group. The 3D models were reconstructed. Muscle forces and boundary conditions corresponding to the central occlusion were applied. Nine morphological parameters of mandible were evaluated. RESULTS The minimum principal stresses in the articular disc and condyle were significantly greater than those of the control group (P<0.05). For the articular disc, the compression on the non-deviation side was greater than those on the deviation side in patients with asymmetrical mandibles. There was difference between both sides in the mandibular prognathism and retrusion groups. The joint space of patients was significantly lower than that of the control group (P<0.05). CONCLUSIONS Maxillofacial deformities might change the condylar position within the articular fossa, which decreased the joint space and increased the compression within TMJ. The patients with asymmetry mandible suffered greater pressure within TMJ on the non-deviation side. The bilaterally over-developed and under-developed mandible in patients might also increase the compression within TMJ.
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Affiliation(s)
- Hedi Ma
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Haidong Teng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Annan Li
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Zhifei Zhang
- Department of Statistics, School of Mathematics, Southwest Jiaotong University,611756, China
| | - Tinghui Zheng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Bingmei Shao
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China; Basic Mechanics Lab, Sichuan University, Chengdu, 610065, China
| | - Zhan Liu
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China.
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Moga RA, Olteanu CD, Botez M, Buru SM. Assessment of the Maximum Amount of Orthodontic Force for PDL in Intact and Reduced Periodontium (Part I). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20031889. [PMID: 36767254 PMCID: PMC9914466 DOI: 10.3390/ijerph20031889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 06/01/2023]
Abstract
This study examines 0.6 N and 1.2 N as the maximum orthodontic force for periodontal ligament (PDL) at multiple levels of periodontal breakdown, and the relationships with the ischemic, necrotic, and resorptive risks. Additionally, this study evaluates if Tresca failure criteria is more adequate for the PDL study. Eighty-one 3D models (from nine patients; nine models/patients) with the 2nd lower premolar and different degrees of bone loss (0-8 mm) where subjected to intrusion, extrusion, rotation, translation, and tipping movements. Tresca shear stress was assessed individually for each movement and bone loss level. Rotation and translation produced the highest PDL stresses, while intrusion and extrusion determined the lowest. Apical and middle third PDL stresses were lower than the cervical stress. In intact periodontium, the amount of shear stress produced by the two investigated forces was lower than the 16 KPa of the maximum physiological hydrostatic pressure (MHP). In reduced periodontium (1-8 mm tissue loss), the apical amount of PDL shear stress was lower than MHP for both applied forces, while cervically for rotation, translation and tipping movements exceeded 16 KPa. Additionally, 1.2 N could be used in intact periodontium (i.e., without risks) and for the reduced periodontium only in the apical and middle third of PDL up to 8 mm of bone loss. However, for avoiding any resorptive risks, in the cervical third of PDL, the rotation, translation, and tipping movements require less than 0.2-0.4 N of force after 4 mm of loss. Tresca seems to be more adequate for the study of PDL than other criteria.
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Affiliation(s)
- Radu Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania
| | - Mircea Botez
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
| | - Stefan Marius Buru
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
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Moga RA, Olteanu CD, Botez M, Buru SM. Assessment of the Maximum Amount of Orthodontic Force for Dental Pulp and Apical Neuro-Vascular Bundle in Intact and Reduced Periodontium on Bicuspids (Part II). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1179. [PMID: 36673936 PMCID: PMC9859427 DOI: 10.3390/ijerph20021179] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/04/2023] [Accepted: 01/07/2023] [Indexed: 06/01/2023]
Abstract
This study examines 0.6 N-4.8 N as the maximum orthodontic force to be applied to dental pulp and apical NVB on intact and 1-8 mm reduced periodontal-ligament (PDL), in connection with movement and ischemic, necrotic and resorptive risk. In addition, it examines whether the Tresca finite-element-analysis (FEA) criterion is more adequate for the examination of dental pulp and its apical NVB. Eighty-one (nine patients, with nine models for each patient) anatomically correct models of the periodontium, with the second lower-premolar reconstructed with its apical NVB and dental pulp were assembled, based on X-ray CBCT (cone-beam-computed-tomography) examinations and subjected to 0.6 N, 1.2 N, 2.4 N and 4.8 N of intrusion, extrusion, translation, rotation, and tipping. The Tresca failure criterion was applied, and the shear stress was assessed. Forces of 0.6 N, 1.2 N, and 2.4 N had negligible effects on apical NVB and dental pulp up to 8 mm of periodontal breakdown. A force of 4.8 N was safely applied to apical NVB on the intact periodontium only. Rotation and tipping seemed to be the most invasive movements for the apical NVB. For the dental pulp, only the translation and rotation movements seemed to display a particular risk of ischemia, necrosis, and internal orthodontic-resorption for both coronal (0-8 mm of loss) and radicular pulp (4-8 mm of loss), despite the amount of stress being lower than the MHP. The Tresca failure criterion seems more suitable than other criteria for apical NVB and dental pulp.
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Affiliation(s)
- Radu Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania
| | - Mircea Botez
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
| | - Stefan Marius Buru
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
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Wang D, Akbari A, Jiang F, Liu Y, Chen J. The effects of different types of periodontal ligament material models on stresses computed using finite element models. Am J Orthod Dentofacial Orthop 2022; 162:e328-e336. [PMID: 36307342 PMCID: PMC9722581 DOI: 10.1016/j.ajodo.2022.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Finite element (FE) method has been used to calculate stress in the periodontal ligament (PDL), which is crucial in orthodontic tooth movement. The stress depends on the PDL material property, which varies significantly in previous studies. This study aimed to determine the effects of different PDL properties on stress in PDL using FE analysis. METHODS A 3-dimensional FE model was created consisting of a maxillary canine, its surrounding PDL, and alveolar bone obtained from cone-beam computed tomography scans. One Newton of intrusion force was applied vertically to the crown. Then, the hydrostatic stress and the von Mises stress in the PDL were computed using different PDL material properties, including linear elastic, viscoelastic, hyperelastic, and fiber matrix. Young's modulus (E), used previously from 0.01 to 1000 MPa, and 3 Poisson's ratios, 0.28, 0.45, and 0.49, were simulated for the linear elastic model. RESULTS The FE analyses showed consistent patterns of stress distribution. The high stresses are mostly concentrated at the apical area, except for the linear elastic models with high E (E >15 MPa). However, the magnitude varied significantly from -14.77 to -127.58 kPa among the analyzed patients. The E-stress relationship was not linear. The Poisson's ratio did not affect the stress distribution but significantly influenced the stress value. The hydrostatic stress varied from -14.61 to -95.48 kPa. CONCLUSIONS Different PDL material properties in the FE modeling of dentition do not alter the stress distributions. However, the magnitudes of the stress significantly differ among the patients with the tested material properties.
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Affiliation(s)
- Dongcai Wang
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China Department of Mechanical and Energy Engineering, Indiana University Purdue University Indianapolis, Indianapolis, Ind; Department of Mechanical and Energy Engineering, Indiana University Purdue University Indianapolis, Indianapolis, Ind
| | - Amin Akbari
- Department of Mechanical and Energy Engineering, Indiana University Purdue University Indianapolis, Indianapolis, Ind
| | - Feifei Jiang
- Soft Robotics Research Center, Shenzhen Institutes of Advanced Technology, Chinese Academy of Science, Shenzhen, China
| | - Yunfeng Liu
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China Department of Mechanical and Energy Engineering, Indiana University Purdue University Indianapolis, Indianapolis, Ind
| | - Jie Chen
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China.
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Moga RA, Buru SM, Olteanu CD. Assessment of the Best FEA Failure Criteria (Part II): Investigation of the Biomechanical Behavior of Dental Pulp and Apical-Neuro-Vascular Bundle in Intact and Reduced Periodontium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315635. [PMID: 36497708 PMCID: PMC9738171 DOI: 10.3390/ijerph192315635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 06/01/2023]
Abstract
The aim of this study was to biomechanically assess the behavior of apical neuro-vascular bundles (NVB) and dental pulp employing Tresca, Von Mises, Pressure, S1 and S3 failure criterions in a gradual periodontal breakdown under orthodontic movements. Additionally, it was to assess the accuracy of failure criteria, correlation with the maximum hydrostatic pressure (MHP), and the amount of force safe for reduced periodontium. Based on cone-beam computed tomography, 81 3D models of the second lower premolar were subjected to 0.5 N of intrusion, extrusion, rotation, tipping, and translation. A Finite Elements Analysis (FEA) was performed. In intact and reduced periodontium apical NVB, stress (predominant in all criteria) was significantly higher than dental pulp stress, but lower than MHP. VM and Tresca displayed identical results, with added pulpal stress in translation and rotation. S1, S3 and Pressure showed stress in the apical NVB area. 0.5 N seems safe up to 8 mm periodontal breakdown. A clear difference between failure criteria for dental pulp and apical NVB cannot be proved based only on the correlation quantitative results-MHP. Tresca and VM (adequate for ductile materials) showed equivalent results with the lowest amounts of stress. The employed failure criteria must be selected based on the type of material to be analyzed.
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Affiliation(s)
- Radu Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Stefan Marius Buru
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania
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Bi S, Guo Z, Zhang X, Shi G. Anchorage effects of ligation and direct occlusion in orthodontics: A finite element analysis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 226:107142. [PMID: 36156441 DOI: 10.1016/j.cmpb.2022.107142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/07/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE During orthodontic treatment, the figure-of-eight ligature and the physiological occlusion play an important role in providing anchorage effects. However, their effects on reaction forces of tooth and stress state in periodontal ligament (PDL) have not been quantitatively evaluated yet. In this study, we presented a finite element analysis process for simulating posterior molar ligature and direct occlusion during orthodontics in order to quantitatively assess their anchorage effects. METHODS A high precision 3D biomechanical model containing upper and lower teeth, PDL, brackets and archwire was generated from the images of computed tomographic scan and sophisticated modelling procedures. The orthodontic treatment of closing the extraction gap was simulated via the finite element method to evaluate the biomechanical response of the molars under the conditions with or without ligation. The simulations were divided into experimental and control groups. In the experimental group, orthodontic force of 1 N was first applied, then direct occlusal forces of 3 and 10 N were applied on each opposite tooth. While in the control group, occlusal forces were applied without orthodontic treatment. The tooth displacement, the stress state in the PDL and the directions of the resultant forces on each tooth were evaluated. RESULTS In the case of molars ligated, the maximum hydrostatic stress in the molars' PDL decreases by 60%. When an initial tooth displacement of several microns occurs in response to an orthodontic force, the direction of the occlusal force changes simultaneously. Even a moderate occlusal force (3 N per tooth) can almost completely offset the mesial forces on the maxillary teeth, thus to provide effective anchorage effect for the orthodontics. CONCLUSIONS The proposed method is effective for simulating ligation and direct occlusion. Figure-of-eight ligature can effectively disperse orthodontic forces on the posterior teeth, while a good original occlusal relationship provides considerable anchorage effects in orthodontics.
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Affiliation(s)
- Shaoyang Bi
- Department of Mechanics, Tianjin University, 135 Yaguan Road, Tianjin 300354, China.
| | - Ziyuan Guo
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China
| | - Xizhong Zhang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China
| | - Guangyu Shi
- Department of Mechanics, Tianjin University, 135 Yaguan Road, Tianjin 300354, China
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Effects of Rigid and Nonrigid Connections between the Miniscrew and Anchorage Tooth on Dynamics, Efficacy, and Adverse Effects of Maxillary Second Molar Protraction: A Finite Element Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4714347. [PMID: 36277899 PMCID: PMC9586811 DOI: 10.1155/2022/4714347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 11/24/2022]
Abstract
Introduction Direct, rigid indirect, and nonrigid indirect absolute anchorages using temporary anchorage devices (TADs, mini-implants/miniscrews) can provide promising opportunities for challenging, yet common, orthodontic tooth movements such as molar protraction. Rigid rectangular wire and ligature wire are the most common methods of attaching a tooth to a miniscrew in indirect anchorages. We aimed to provide a comparison of the rigidity of the connecting wire in terms of stress on the miniscrew, the anchorage loss, and the risk of root resorption using finite element analysis (FEA). Methods The maxillary right second molar was protracted into the proximal space at a 150 g load (1) using direct absolute anchorage with a tapered miniscrew implanted between the premolar roots and using indirect absolute anchorage with the second premolar reinforced by the miniscrew through (2) a rigid stainless steel (SS) wire or (3) a nonrigid SS ligature wire (4) at different elastic moduli. Stresses and displacements of 4 models' elements were measured. The risk of external root resorption was evaluated. Results Connecting the tooth to the miniscrew using rigid full-size wire (model 2) compared to ligature (model 3) can give better control of the anchorage (using the ligature wire, the anchorage loss is 1.5 times larger than the rectangular wire) and may reduce the risk of root resorption of the anchorage unit. However, the risk of miniscrew failure increases with a rigid connection, although it is still lower than with direct anchorage. The miniscrew stress when using a ligature is approximately 30% of the rigid model using the rectangular wire. The miniscrew stress using the rectangular wire is approximately 82.4% of the miniscrew stress in the direct model. Parametric analysis shows that the higher the elastic modulus of the miniscrew-tooth connecting wire in the indirect anchorage, the less the anchorage loss/palatal rotation of the premolars/and the risk of root resorption of the anchorage teeth and instead the stress on the miniscrew increases. Conclusions Direct anchorage (followed by rigid indirect anchorage but not nonrigid) might be recommended when the premolars should not be moved or premolar root resorption is a concern. Miniscrew loosening risk might be the highest in direct anchorage and lowest in nonrigid indirect anchorage (which might be recommended for poor bone densities).
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Moga RA, Buru SM, Olteanu CD. Assessment of the Best FEA Failure Criteria (Part I): Investigation of the Biomechanical Behavior of PDL in Intact and Reduced Periodontium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912424. [PMID: 36231719 PMCID: PMC9564647 DOI: 10.3390/ijerph191912424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 06/01/2023]
Abstract
The accuracy of five failure criterions employed in the study of periodontal ligaments (PDL) during periodontal breakdown under orthodontic movements was assessed. Based on cone-beam computed tomography (CBCT) examinations, nine 3D models of the second lower premolar with intact periodontium were created and individually subjected to various levels of horizontal bone loss. 0.5 N of intrusion, extrusion, rotation, tipping, and translation was applied. A finite Elements Analysis (FEA) was performed, and stresses were quantitatively and qualitatively analyzed. In intact periodontium, Tresca and Von Mises (VM) stresses were lower than maximum physiological hydrostatic pressure (MHP), while maximum principal stress S1, minimum principal stress S3, and pressure were higher. In reduced periodontium, Tresca and VM stresses were lower than MHP for intrusion, extrusion, and the apical third of the periodontal ligament for the other movements. 0.5 N of rotation, translation and tipping induced cervical third stress exceeding MHP. Only Tresca (quantitatively more accurate) and VM are adequate for the study of PDL (resemblance to ductile), being qualitatively similar. A 0.5 N force seems safe in the intact periodontium, and for intrusion and extrusion up to 8 mm bone loss. The amount of force should be reduced to 0.1-0.2 N for rotation, 0.15-0.3 N for translation and 0.2-0.4 N for tipping in 4-8 mm periodontal breakdown. S1, S3, and pressure criteria provided only qualitative results.
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Affiliation(s)
- Radu Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Stefan Marius Buru
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania
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Three-dimensional measurement of periodontal support during surgical orthodontic treatment of high-angle skeletal Class III malocclusion: A retrospective study. Am J Orthod Dentofacial Orthop 2022; 162:839-849. [PMID: 36088148 DOI: 10.1016/j.ajodo.2021.07.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study aimed to quantify the periodontal health of incisors during surgical orthodontic treatment in patients with high-angle Class III malocclusion using a cone-beam computed tomography (CBCT) 3-dimensional (3D) reconstruction technique. METHODS The sample consisted of 30 patients with high-angle Class III malocclusion (mean age, 20.53 ± 2.86 years). CBCT images were taken before treatment (T0), after presurgical orthodontic treatment, and after treatment (T2). In addition, 3D tooth and alveolar bone models were generated. The root surface area, periodontal ligament (PDL)_Area, and vertical bone level (VBL) around the maxillary and mandibular central incisors were measured. RESULTS The root surface area and PDL_Area of maxillary and mandibular central incisors decreased continuously between T0 and T2 (P <0.01). At T2, mandibular central incisors showed 38.64 ± 13.39% PDL_Area loss, and maxillary central incisors exhibited 21.13 ± 16.48% PDL_Area loss. For mandibular central incisors, the PDL_Area loss caused by VBL loss was significantly greater than that for maxillary central incisors (P <0.01) and significantly greater than the PDL_Area loss caused by root resorption (P <0.01). From T0 to T2, the lingual surface of maxillary central incisors exhibited greater VBL loss than the other 3 surfaces (P <0.01), and the labial and lingual surfaces of mandibular central incisors demonstrated greater VBL loss than proximal surfaces (P <0.01). CONCLUSIONS The 3D CBCT reconstruction method provides useful information regarding the periodontal defects of incisors in patients with high-angle skeletal Class III malocclusion. The PDL_Area of maxillary and mandibular central incisors decreased continuously during the treatment. Vertical alveolar bone levels at proximal surfaces appeared to be relatively stable.
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Melendres OU, Cattaneo PM, Roscoe MG, Gialain IO, Dominguez GC, Ballester RY, Meira JBC. Intrusion of overerupted periodontally compromised posterior teeth using orthodontic mini‐implants: a mechanobiological finite element study. Orthod Craniofac Res 2022; 26:239-247. [PMID: 36073609 DOI: 10.1111/ocr.12606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/20/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The intrusion of posterior teeth had been considered challenging up to the development of orthodontic mini implants. In periodontally compromised teeth, the challenge is even greater, because of the root resorption risk due to periodontal ligament over-compression. Still, the precise strategy to determine the force reduction level remains uncertain. OBJECTIVE The objective of the study was to determine, by a finite element analysis (FEA), the force reduction needed to avoid root resorption and maintain the efficiency of orthodontic mechanics of periodontally compromised teeth similar to the sound one. METHODS An anatomical model was constructed representing a premolar inserted into a maxillary bone. Based on the initial model (R0), three bone height loss conditions were simulated (R2 = 2 mm, R4 = 4 mm, and R6 = 6 mm). Two intrusive movements were simulated: pure intrusion (bilateral mini implant) and uncontrolled-tipping intrusion (buccal mini implant). The hydrostatic stress at the periodontal ligament was used to evaluate the risk of root resorption due to over-compression. RESULTS For bilateral mini implant intrusion, the force had to be decreased by 16%, 32% and 48% for R2, R4 and R6, respectively. For buccal mini implant intrusion, the required reductions were higher (20%, 36% and 56%). A linear relationship between the intrusive force reduction and the alveolar bone height loss was observed in both intrusion mechanics. CONCLUSIONS According to the FE results, 8% or 9.3% of force reduction for each millimetre of bone height loss is suggested for intrusion with bilateral or buccal mini implant, respectively. The buccal mini implant anchorage must be associated with a supplemental strategy to avoid buccal crown tipping.
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Affiliation(s)
- Omar Ugarte Melendres
- School of Dentistry, Department of Biomaterials and Oral Biology University of São Paulo São Paulo Brazil
| | - Paolo Maria Cattaneo
- Melbourne Dental School ‐ Faculty of Medicine Dentistry and Health Sciences ‐ University of Melbourne Victoria Australia
| | - Marina Guimarães Roscoe
- School of Dentistry, Department of Biomaterials and Oral Biology University of São Paulo São Paulo Brazil
| | - Ivan Onone Gialain
- School of Dentistry, Department of Biomaterials and Oral Biology University of São Paulo São Paulo Brazil
| | - Gladys Cristina Dominguez
- School of Dentistry, Department of Orthodontics and Pediatric Dentistry University of São Paulo São Paulo Brazil
| | - Rafael Yague Ballester
- School of Dentistry, Department of Biomaterials and Oral Biology University of São Paulo São Paulo Brazil
| | - Josete Barbosa Cruz Meira
- School of Dentistry, Department of Biomaterials and Oral Biology University of São Paulo São Paulo Brazil
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Zhang X, Zhang S, Wang T. How the mechanical microenvironment of stem cell growth affects their differentiation: a review. Stem Cell Res Ther 2022; 13:415. [PMID: 35964140 PMCID: PMC9375355 DOI: 10.1186/s13287-022-03070-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/20/2022] [Indexed: 12/18/2022] Open
Abstract
Stem cell differentiation is of great interest in medical research; however, specifically and effectively regulating stem cell differentiation is still a challenge. In addition to chemical factors, physical signals are an important component of the stem cell ecotone. The mechanical microenvironment of stem cells has a huge role in stem cell differentiation. Herein, we describe the knowledge accumulated to date on the mechanical environment in which stem cells exist, which consists of various factors, including the extracellular matrix and topology, substrate stiffness, shear stress, hydrostatic pressure, tension, and microgravity. We then detail the currently known signalling pathways that stem cells use to perceive the mechanical environment, including those involving nuclear factor-kB, the nicotinic acetylcholine receptor, the piezoelectric mechanosensitive ion channel, and hypoxia-inducible factor 1α. Using this information in clinical settings to treat diseases is the goal of this research, and we describe the progress that has been made. In this review, we examined the effects of mechanical factors in the stem cell growth microenvironment on stem cell differentiation, how mechanical signals are transmitted to and function within the cell, and the influence of mechanical factors on the use of stem cells in clinical applications.
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Affiliation(s)
- Xiaofang Zhang
- Department of Radiotherapy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Sibo Zhang
- China Medical University, Shenyang, China
| | - Tianlu Wang
- Department of Radiotherapy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China.
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Li T, Wang H, Jiang Y, Guan Y, Chen S, Wu Z, Zou S, Bonewald LF, Duan P. Canonical Wnt/β-catenin signaling has positive effects on osteogenesis, but can have negative effects on cementogenesis. J Periodontol 2022; 93:1725-1737. [PMID: 35642884 DOI: 10.1002/jper.21-0599] [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: 10/15/2021] [Revised: 03/21/2022] [Accepted: 05/24/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND To date, therapeutic approaches for cementum regeneration are limited and outcomes remain unpredictable. A significant barrier to improve therapies for cementum regeneration is that the cementocyte and its intracellular signal transduction mechanisms remain poorly understood. This study aims to elucidate the regulatory mechanism of Wnt pathway in cementogenesis. METHODS The effects of canonical Wnt signaling were compared in vitro using immortalized murine cementocyte cell line IDG-CM6 and osteocyte cell line IDG-SW3 by qRT-PCR, Western blot, confocal microscopy, alkaline phosphatase (ALP) assay and Alizarin red S staining. In vivo, histological changes of cementum and bone formation were examined in transgenic mice in which constitutive activation of β-catenin is driven by Dmp1 promoter. RESULTS Expression of components of the Wnt/β-catenin pathway were much greater in the IDG-SW3 cells compared to the IDG-CM6 cells resulting in much lower expression of Sost/sclerostin in the IDG-SW3 cells. In the IDG-CM6 cells, low dose Wnt3a (20 ng/ml) had a modest effect while high dose (200 ng/ml) inhibited runt-related transcription factor 2 (Runx2), osterix (Osx), ALP and osteopontin (OPN) in contrast to the IDG-SW3 cells where high dose Wnt3a dramatically increased mRNA expression of these same markers. However, high Wnt3a significantly increased mRNA for components of Wnt/β-catenin signaling pathway in both IDG-CM6 and IDG-SW3 cells. In vivo, constitutive activation of β-catenin in the Dmp1-lineage cells in mice leads to bone hyperplasia and cementum hypoplasia. CONCLUSION(S) These findings indicate that Wnt signaling has distinct and different effects on the regulation of long bone as compared to cementum. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tiancheng Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Han Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yukun Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yuzhe Guan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Shuo Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zuping Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Shujuan Zou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lynda Faye Bonewald
- Departments of Anatomy, Cell Biology & Physiology and Orthopaedic Surgery, Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Peipei Duan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Wu J, Wang X, Jiang Y, Wu Z, Shen Q, Chen Y, Meng Q, Ye N. Effect of archwire plane and archwire size on anterior teeth movement in sliding mechanics in customized labial orthodontics: a 3D finite element study. BMC Oral Health 2022; 22:33. [PMID: 35144590 PMCID: PMC8832676 DOI: 10.1186/s12903-022-02066-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/31/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate anterior teeth movement with different archwire planes and archwire sizes during space closure with and without miniscrew in sliding mechanics. METHODS A 3D finite element method was applied to simulate anterior teeth retraction with and without miniscrew and power arm. Initial displacements and pressure stresses of periodontal tissue in anterior teeth were calculated after the teeth were applied with retraction forces with different archwire planes and archwire sizes. RESULTS High archwire plane showed better torque control of anterior teeth in both sliding mechanics. With intramaxillary retraction, anterior teeth showed lingual tipping and extrusion movement, whereas larger-size archwires did not reduce it. In miniscrew sliding mechanics, anterior teeth showed labial tipping and intrusion movement. Compared with intramaxillary retraction, the retraction force produced less pressure stress on periodontal tissue in miniscrew sliding mechanics with long power arm. CONCLUSIONS Higher archwire plane is conducive to anterior teeth torque control. In order to achieve the bodily movement of the anterior teeth during space closure, it is more important to choose the appropriate method (miniscrew sliding mechanics with long power arm), instead of increasing the size of the archwire.
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Affiliation(s)
- Jianhua Wu
- Department of Orthodontics, Hefei Stomatological Hospital, Annhui, China
| | - Xiaoting Wang
- Department of Orthodontics, Shanghai Xuhui District Dental Center, Shanghai, China
| | - Yiyang Jiang
- Wake Forest University, Winston-Salem, North Carolina, USA
| | - Zichen Wu
- College of Stomatology, Annhui Medical University, Annhui, China
| | - Qun Shen
- Department of Orthodontics, Hefei Stomatological Hospital, Annhui, China
| | - Yucheng Chen
- Department of Orthodontics, Hefei Stomatological Hospital, Annhui, China
| | - Qianjiao Meng
- Department of Orthodontics, Hefei Stomatological Hospital, Annhui, China
| | - Niansong Ye
- Private Practice, Shanghai Huaguang Dental Clinic, 6C, No.201, Lane 3215, Hongmei Road, Shanghai, China.
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Chawla S, Deshmukh S. FEAr no more! Finite element analysis in orthodontics. JOURNAL OF THE INTERNATIONAL CLINICAL DENTAL RESEARCH ORGANIZATION 2022. [DOI: 10.4103/jicdro.jicdro_79_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Dot G, Licha R, Goussard F, Sansalone V. A new protocol to accurately track long-term orthodontic tooth movement and support patient-specific numerical modeling. J Biomech 2021; 129:110760. [PMID: 34628204 DOI: 10.1016/j.jbiomech.2021.110760] [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: 02/12/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 10/20/2022]
Abstract
Numerical simulation of long-term orthodontic tooth movement based on Finite Element Analysis (FEA) could help clinicians to plan more efficient and mechanically sound treatments. However, most of FEA studies assume idealized loading conditions and lack experimental calibration or validation. The goal of this paper is to propose a novel clinical protocol to accurately track orthodontic tooth displacement in three-dimensions (3D) and provide 3D models that may support FEA. Our protocol uses an initial cone beam computed tomography (CBCT) scan and several intra-oral scans (IOS) to generate 3D models of the maxillary bone and teeth ready for use in FEA. The protocol was applied to monitor the canine retraction of a patient during seven months. A second CBCT scan was performed at the end of the study for validation purposes. In order to ease FEA, a frictionless and statically determinate lingual device for maxillary canine retraction was designed. Numerical simulations were set up using the 3D models provided by our protocol to show the relevance of our proposal. Comparison of numerical and clinical results highlights the suitability of this protocol to support patient-specific FEA.
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Affiliation(s)
- Gauthier Dot
- Univ Paris Est Creteil, CNRS, MSME, F-94010, Creteil, France; Univ Gustave Eiffel, MSME, F-77474, Marne-la-Vallée, France; Service d'Odontologie, Hopital Pitie-Salpetriere, AP-HP, Universite de Paris, Paris, France
| | - Raphael Licha
- Univ Paris Est Creteil, CNRS, MSME, F-94010, Creteil, France; Univ Gustave Eiffel, MSME, F-77474, Marne-la-Vallée, France
| | - Florent Goussard
- CR2P, UMR 7207, Muséum national d'Histoire naturelle, CNRS, Sorbonne Université, 8 rue Buffon, CP38 75005, Paris, France
| | - Vittorio Sansalone
- Univ Paris Est Creteil, CNRS, MSME, F-94010, Creteil, France; Univ Gustave Eiffel, MSME, F-77474, Marne-la-Vallée, France.
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26
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Zhong J, Pierantoni M, Weinkamer R, Brumfeld V, Zheng K, Chen J, Swain MV, Weiner S, Li Q. Microstructural heterogeneity of the collagenous network in the loaded and unloaded periodontal ligament and its biomechanical implications. J Struct Biol 2021; 213:107772. [PMID: 34311076 DOI: 10.1016/j.jsb.2021.107772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 07/02/2021] [Accepted: 07/19/2021] [Indexed: 01/17/2023]
Abstract
The periodontal ligament (PDL) is a highly heterogeneous fibrous connective tissue and plays a critical role in distributing occlusal forces and regulating tissue remodeling. Its mechanical properties are largely determined by the extracellular matrix, comprising a collagenous fiber network interacting with the capillary system as well as interstitial fluid containing proteoglycans. While the phase-contrast micro-CT technique has portrayed the 3D microscopic heterogeneity of PDL, the topological parameters of its network, which is crucial to understanding the multiscale constitutive behavior of this tissue, has not been characterized quantitatively. This study aimed to provide new understanding of such microscopic heterogeneity of the PDL with quantifications at both tissue and collagen network levels in a spatial manner, by combining phase-contrast micro-CT imaging and a purpose-built image processing algorithm for fiber analysis. Both variations within a PDL and among the PDL with different shapes, i.e. round-shaped and kidney-shaped PDLs, are described in terms of tissue thickness, fiber distribution, local fiber densities, and fiber orientation (namely azimuthal and elevation angles). Furthermore, the tissue and collagen fiber network responses to mechanical loading were evaluated in a similar manner. A 3D helical alignment pattern was observed in the fiber network, which appears to regulate and adapt a screw-like tooth motion under occlusion. The microstructural heterogeneity quantified here allows development of sample-specific constitutive models to characterize the PDL's functional and pathological loading responses, thereby providing a new multiscale framework for advancing our knowledge of this complex limited mobility soft-hard tissue interface.
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Affiliation(s)
- Jingxiao Zhong
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, Australia
| | - Maria Pierantoni
- Department of Structural Biology, Weizmann Institute of Science, Rehovot, Israel; Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - Richard Weinkamer
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
| | - Vlad Brumfeld
- Department of Chemical Research Support, Weizmann Institute of Science, Rehovot, Israel
| | - Keke Zheng
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, Australia; College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - Junning Chen
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - Michael V Swain
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, Australia
| | - Steve Weiner
- Department of Structural Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, Australia.
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Orthodontic Treatment of a Patient with Dentin Dysplasia Type I and Bilateral Maxillary Canine Impaction: Case Presentation and a Family-Based Genetic Analysis. CHILDREN-BASEL 2021; 8:children8060519. [PMID: 34207061 PMCID: PMC8234607 DOI: 10.3390/children8060519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/06/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022]
Abstract
Dentin dysplasia is a rare hereditary disorder, transmitted by autosomal dominant mode, affecting both dentin and pulp. In Type I crown morphology is normal, but root dentin organization loss leads to shorter roots. Mutations in the SSUH2, VPS4B and SMOC2 genes have been reported as responsible for this condition. Orthodontic treatment was conducted on an 11-year-old female patient presenting the disorder along with bilaterally impacted permanent maxillary canines, in close proximity to the roots of the lateral and central incisors. Treatment plan included lateral incisors extraction, surgical exposure and traction of the impacted canines. Light forces were applied from a custom-made trans-palatal arch. Comprehensive orthodontic treatment was performed using edgewise appliances. After 3 years and 2 months, group function occlusion was achieved. The canines underwent composite resin restorations. At one year post-retention, the dentition remained stable. Family-based genetic analysis did not reveal any mutations in the aforementioned genes pointing to further genetic heterogeneity of this disorder. As dental medicine becomes more sophisticated and personalized, the association between mutation type/function and orthodontic treatment response may provide useful therapeutic insights. The positive treatment response of the presented case could be attributed to a more “benign” mutation awaiting to be identified.
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Cattaneo PM, Cornelis MA. Orthodontic Tooth Movement Studied by Finite Element Analysis: an Update. What Can We Learn from These Simulations? Curr Osteoporos Rep 2021; 19:175-181. [PMID: 33538966 DOI: 10.1007/s11914-021-00664-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW To produce an updated overview of the use of finite element (FE) analysis for analyzing orthodontic tooth movement (OTM). Different levels of simulation complexity, including material properties and level of morphological representation of the alveolar complex, will be presented and evaluated, and the limitations will be discussed. RECENT FINDINGS Complex formulations of the PDL have been proposed, which might be able to correctly predict the behavior of the PDL both when chewing forces and orthodontic forces are simulated in FE models. The recent findings do not corroborate the simplified view of the classical OTM theories. The use of complex and biologically coherent FE models can help understanding the mechanisms leading to OTM as well as predicting the risk of root resorption related to specific force systems and magnitudes.
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Affiliation(s)
- Paolo M Cattaneo
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 720 Swanston St, Carlton VIC, Melbourne, 3053, Australia.
| | - Marie A Cornelis
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 720 Swanston St, Carlton VIC, Melbourne, 3053, Australia
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Roscoe MG, Cattaneo PM, Dalstra M, Ugarte OM, Meira JBC. Orthodontically induced root resorption: A critical analysis of finite element studies' input and output. Am J Orthod Dentofacial Orthop 2021; 159:779-789. [PMID: 33785230 DOI: 10.1016/j.ajodo.2020.02.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/01/2020] [Accepted: 02/01/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Orthodontically induced inflammatory root resorption (OIIRR) constitutes an undesirable risk connected to orthodontic treatment. Finite element analysis (FEA) is a powerful tool to study the risk of OIIRR. However, its efficiency in predicting OIIRR depends on the insertion of the correct inputs and the selection of an output coherent with the clinical failure mechanism. METHODS By combining a systematic review with a 3-dimensional FEA, this article discusses which are the implications of using certain periodontal ligament (PDL) properties (linear and nonlinear models) and failure criteria. Six orthodontic loading regimes were simulated in a maxillary premolar: pure intrusion, buccal tipping, and their combination applied with either a light (25 cN) or a heavy (225 cN) force. Three stress parameters in the PDL were compared: von Mises stress, minimum principal stress, and hydrostatic stress (σH). RESULTS The comparison between linear and nonlinear models showed notable differences in stress distribution patterns and magnitudes. For the nonlinear PDL, none of the light-force models reached the critical compressive hydrostatic stress of 4.7 kPa, whereas all the heavy-force models reached it. In addition, the regions of critical compressive σH matched with the regions with resorption craters in clinical studies. In linear models, the σH critical value of 4.7 kPa was reached even in the light-force scenario. CONCLUSIONS Only compressive hydrostatic stress in PDL satisfied the requirements to be used as an FEA indicator of OIIRR. However, the requirements were satisfied only when a nonlinear PDL model was considered.
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Affiliation(s)
- Marina Guimarães Roscoe
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | - Paolo M Cattaneo
- Dentistry and Health Sciences, Melbourne Dental School, University of Melbourne, Melbourne, Australia; Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Michel Dalstra
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Omar Melendres Ugarte
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Josete B C Meira
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Nonsurgical treatment of an adult with skeletal Class III malocclusion, anterior crossbite, and an impacted canine. Am J Orthod Dentofacial Orthop 2021; 159:522-535. [PMID: 33485716 DOI: 10.1016/j.ajodo.2020.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/01/2020] [Accepted: 01/01/2020] [Indexed: 10/22/2022]
Abstract
Class III malocclusion presents some complexity in terms of diagnosis and treatment and affects not only the jaws but the whole craniofacial complex. Besides, functional forward displacement of the mandible may be diagnosed in a patient presenting Class III malocclusion, as the 2 entities are not incompatible or mutually exclusive. This case report describes the multidisciplinary, nonsurgical, orthodontic treatment of an adult patient with a skeletal Class III malocclusion, anterior crossbite, and a palatally impacted canine, treated with fixed appliances and skeletal anchorage. To upright the mandibular molars, distalize the whole mandibular arch, and avoid excessive inclination of maxillary incisors to improve dentofacial esthetics, miniscrews were placed in the retromolar area. The treatment results were very satisfactory and remained stable after a reasonable retention period.
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Kuang Y, Wang C, Hu B, Feng G, Wang C, Song J. Biomechanical analysis of reinstating buccally flared maxillary 2nd molars using 3D printing anchorage supports: a 3D finite element study. Comput Methods Biomech Biomed Engin 2021; 24:1085-1096. [PMID: 33393828 DOI: 10.1080/10255842.2020.1867850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The buccally flared maxillary 2nd molar has certain consequences on oral function and health. However, existing methods have some degree of disadvantages, such as invasion, complexity and side effects. The objectives of this study were to design anchorage systems to correct buccally flared maxillary 2nd molars and analyze their biomechanical effects by 3-dimensional (3D) finite element analysis. Finite element (FE) models of the 3D tanspalatal arches (TPAs) and 3D splints with different thicknesses and force points were constructed. The stress distribution on teeth, the hydrostatic pressure on periodontal ligaments and the initial displacement of teeth were analyzed. A total of 18 FE models were constructed and analyzed. The stress concentrated on a single anchorage tooth, and the hydrostatic pressure and initial displacement of the anchorage tooth were greater than those of the malposed 2nd molar in the 3D splint anchorage system. The stress spread on all anchorage teeth and the hydrostatic pressure and initial displacement of the anchorage tooth were less than those of the malposed 2nd molar in the 3D TPA anchorage system. Theoretically, the 3D TPA was better than the 3D splint as an anchorage to correct the buccally flared 2nd molar. A combination of 0.8 mm of thickness and mesial force point provided the optimal conditions for the 3D TPA. Further clinical studies should be conducted to verify the effects of 3D appliances.
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Affiliation(s)
- Yunchun Kuang
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Chunjuan Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Bo Hu
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Ge Feng
- Department of Orthodontics, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Chao Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Jinlin Song
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Adult orthodontic retreatment of severe root resorption by skeletal anchorage: A case report. Int Orthod 2020; 18:863-873. [PMID: 32893148 DOI: 10.1016/j.ortho.2020.08.002] [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: 07/19/2020] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 11/23/2022]
Abstract
The presence of root resorption and its correlated factors are concerns that must be considered in orthodontic planning. This case report describes the orthodontic retreatment of a patient with a dental to facial midline discrepancy, a severe apical root resorption, and with maxillary and mandibular incisors presenting accentuated labial tipping and protrusion. The treatment included self-ligating brackets, maxillary unilateral distalization with skeletal anchorage and a mandibular extraction, followed by retraction. The orthodontic planning was based on simple and efficient mechanics and the treatment duration was of 19 months. Based on the acceptable final results it can be assumed that the treatment choices enabled a successful approach, maintaining a stable root condition.
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Kirschneck C, Wolf F, Cieplik F, Blanck-Lubarsch M, Proff P, Schröder A. Impact of NSAID etoricoxib on side effects of orthodontic tooth movement. Ann Anat 2020; 232:151585. [PMID: 32818660 DOI: 10.1016/j.aanat.2020.151585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/03/2020] [Accepted: 07/22/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The non-steroidal anti-inflammatory drug etoricoxib is the most highly selective inhibitor of cyclooxygenase-2 available (344:1) and has been approved for postoperative pain therapy following dental interventions in Europe. At clinically relevant doses it has been reported to only have marginal effects on the velocity of orthodontic tooth movement (OTM). Its effects on associated dental root resorptions, osteoclastogenesis, trabecular number in the alveolar bone and periodontal bone loss during OTM, however, have not yet been investigated. MATERIAL AND METHODS 40 male Fischer344 rats were divided into four groups: 1.5ml tap water/day p.o. (control, 1), additional 7.8mg/kg/day etoricoxib (normal dose) for three (2) or seven (3) days/week and 13.1mg/kg/day (high dose) for seven days/week, respectively (4). After a week of premedication, OTM in anterior direction of the first left upper molar was performed for 28 days by means of a nickel-titanium coil spring (0.25N). We quantified OTM-associated dental root resorptions, osteoclastogenesis, trabecular number and periodontal bone loss by histomorphometrical, histochemical and μCT analyses of the disected tooth-bearing upper jaw sections. RESULTS After 28 days of OTM, associated reduction of trabecular number seemed to be slightly alleviated by high doses of etoricoxib, whereas no significant other etoricoxib effects in the doses administered could be detected regarding OTM-induced or -associated dental root resorptions, osteoclastogenesis or periodontal bone loss. CONCLUSIONS Dental root resorptions, osteoclastogenesis and periodontal bone loss during OTM in rats were not significantly affected by etoricoxib in the clinically relevant dosages investigated with only a slight inhibitory effect on bone remodelling to be expected at high dosages. Etoricoxib is therefore not suitable for the prevention of these detrimental effects, but could be a suitable analgesic during OTM, as it has been reported not to affect tooth movement.
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Affiliation(s)
| | - Franziska Wolf
- Department of Orthodontics, University Hospital Regensburg, Germany
| | - Fabian Cieplik
- Department of Operative Dentistry and Periodontology, University Hospital Regensburg, Germany
| | | | - Peter Proff
- Department of Orthodontics, University Hospital Regensburg, Germany
| | - Agnes Schröder
- Department of Orthodontics, University Hospital Regensburg, Germany
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Shu J, Wang Q, Chong DYR, Liu Z. Impact of mandibular prognathism on morphology and loadings in temporomandibular joints. BIOMED ENG-BIOMED TE 2020; 66:/j/bmte.ahead-of-print/bmt-2019-0298/bmt-2019-0298.xml. [PMID: 32764160 DOI: 10.1515/bmt-2019-0298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/27/2020] [Indexed: 11/15/2022]
Abstract
Loadings in temporomandibular joints (TMJs) are essential factors in dysfunction of TMJs, and are barely noticed in treatment of maxillofacial deformity. The only approach, which can access stresses in TMJs, could expend day's even weeks to complete. The objective of the study was to compare the differences of the morphological and biomechanical characteristics of TMJs between asymptomatic subjects and patients with mandibular prognathism, and to preliminarily analyze the connection between the two kinds of characteristics. Morphological measurements and finite element analysis (FEA) corresponding to the central occlusion were carried out on the models of 13 mandibular prognathism patients and 10 asymptomatic subjects. The results indicated that the joint spaces of the patients were significantly lower than those of the asymptomatic subjects, while the stresses of patients were significantly greater than those of asymptomatic subjects, especially the stresses on discs. The results of Pearson correlation analysis showed that weak or no correlations were found between the von Mises stresses and the joint spaces of asymptomatic subjects, while moderate, even high correlations were found in the patients. Thus, it was shown to be a feasible way to use morphological parameters to predict the internal loads of TMJs.
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Affiliation(s)
- Jingheng Shu
- Key Laboratory for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
| | - Quanyi Wang
- Key Laboratory for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Zhan Liu
- Key Laboratory for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
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