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Sagl B, Schmid-Schwap M, Piehslinger E, Yao H, Rausch-Fan X, Stavness I. The effect of bolus properties on muscle activation patterns and TMJ loading during unilateral chewing. J Mech Behav Biomed Mater 2024; 151:106401. [PMID: 38237207 DOI: 10.1016/j.jmbbm.2024.106401] [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: 09/28/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/03/2024]
Abstract
Mastication is a vital human function and uses an intricate coordination of muscle activation to break down food. Collection of detailed muscle activation patterns is complex and commonly only masseter and anterior temporalis muscle activation are recorded. Chewing is the orofacial task with the highest muscle forces, potentially leading to high temporomandibular joint (TMJ) loading. Increased TMJ loading is often associated with the onset and progression of temporomandibular disorders (TMD). Hence, studying TMJ mechanical stress during mastication is a central task. Current TMD self-management guidelines suggest eating small and soft pieces of food, but patient safety concerns inhibit in vivo investigations of TMJ biomechanics and currently no in silico model of muscle recruitment and TMJ biomechanics during chewing exists. For this purpose, we have developed a state-of-the-art in silico model, combining rigid body bones, finite element TMJ discs and line actuator muscles. To solve the problems regarding muscle activation measurement, we used a forward dynamics tracking approach, optimizing muscle activations driven by mandibular motion. We include a total of 256 different combinations of food bolus size, stiffness and position in our study and report kinematics, muscle activation patterns and TMJ disc von Mises stress. Computed mandibular kinematics agree well with previous measurements. The computed muscle activation pattern stayed stable over all simulations, with changes to the magnitude relative to stiffness and size of the bolus. Our biomedical simulation results agree with the clinical guidelines regarding bolus modifications as smaller and softer food boluses lead to less TMJ loading. The computed mechanical stress results help to strengthen the confidence in TMD self-management recommendations of eating soft and small pieces of food to reduce TMJ pain.
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Affiliation(s)
- Benedikt Sagl
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria.
| | - Martina Schmid-Schwap
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria
| | - Eva Piehslinger
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria
| | - Hai Yao
- Department of Bioengineering, Clemson University, 29634, Clemson, SC, United States; Department of Oral Health Sciences, Medical University of South Carolina, 29425, Charleston, SC, United States
| | - Xiaohui Rausch-Fan
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, SK S7N 5C9 Saskatoon, Saskatchewan, Canada
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Cheng ESW, Lai DKH, Mao YJ, Lee TTY, Lam WK, Cheung JCW, Wong DWC. Computational Biomechanics of Sleep: A Systematic Mapping Review. Bioengineering (Basel) 2023; 10:917. [PMID: 37627802 PMCID: PMC10451553 DOI: 10.3390/bioengineering10080917] [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: 06/30/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Biomechanical studies play an important role in understanding the pathophysiology of sleep disorders and providing insights to maintain sleep health. Computational methods facilitate a versatile platform to analyze various biomechanical factors in silico, which would otherwise be difficult through in vivo experiments. The objective of this review is to examine and map the applications of computational biomechanics to sleep-related research topics, including sleep medicine and sleep ergonomics. A systematic search was conducted on PubMed, Scopus, and Web of Science. Research gaps were identified through data synthesis on variants, outcomes, and highlighted features, as well as evidence maps on basic modeling considerations and modeling components of the eligible studies. Twenty-seven studies (n = 27) were categorized into sleep ergonomics (n = 2 on pillow; n = 3 on mattress), sleep-related breathing disorders (n = 19 on obstructive sleep apnea), and sleep-related movement disorders (n = 3 on sleep bruxism). The effects of pillow height and mattress stiffness on spinal curvature were explored. Stress on the temporomandibular joint, and therefore its disorder, was the primary focus of investigations on sleep bruxism. Using finite element morphometry and fluid-structure interaction, studies on obstructive sleep apnea investigated the effects of anatomical variations, muscle activation of the tongue and soft palate, and gravitational direction on the collapse and blockade of the upper airway, in addition to the airflow pressure distribution. Model validation has been one of the greatest hurdles, while single-subject design and surrogate techniques have led to concerns about external validity. Future research might endeavor to reconstruct patient-specific models with patient-specific loading profiles in a larger cohort. Studies on sleep ergonomics research may pave the way for determining ideal spine curvature, in addition to simulating side-lying sleep postures. Sleep bruxism studies may analyze the accumulated dental damage and wear. Research on OSA treatments using computational approaches warrants further investigation.
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Affiliation(s)
- Ethan Shiu-Wang Cheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Department of Electronic and Information Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Ye-Jiao Mao
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Timothy Tin-Yan Lee
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong
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Sagl B, Schmid-Schwap M, Piehslinger E, Rausch-Fan X, Stavness I. The effect of tooth cusp morphology and grinding direction on TMJ loading during bruxism. Front Physiol 2022; 13:964930. [PMID: 36187792 PMCID: PMC9521318 DOI: 10.3389/fphys.2022.964930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/12/2022] [Indexed: 12/05/2022] Open
Abstract
Increased mechanical loading of the temporomandibular joint (TMJ) is often connected with the onset and progression of temporomandibular joint disorders (TMD). The potential role of occlusal factors and sleep bruxism in the onset of TMD are a highly debated topic in literature, but ethical considerations limit in vivo examinations of this problem. The study aims to use an innovative in silico modeling approach to thoroughly investigate the connection between morphological parameters, bruxing direction and TMJ stress. A forward-dynamics tracking approach was used to simulate laterotrusive and mediotrusive tooth grinding for 3 tooth positions, 5 lateral inclination angles, 5 sagittal tilt angles and 3 force levels, giving a total of 450 simulations. Muscle activation patterns, TMJ disc von Mises stress as well as correlations between mean muscle activations and TMJ disc stress are reported. Computed muscle activation patterns agree well with previous literature. The results suggest that tooth inclination and grinding position, to a smaller degree, have an effect on TMJ loading. Mediotrusive bruxing computed higher loads compared to laterotrusive simulations. The strongest correlation was found for TMJ stress and mean activation of the superficial masseter. Overall, our results provide in silico evidence that TMJ disc stress is related to tooth morphology.
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Affiliation(s)
- Benedikt Sagl
- Center of Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- *Correspondence: Benedikt Sagl,
| | - Martina Schmid-Schwap
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Eva Piehslinger
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Center of Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK, Canada
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Malakoutian M, Sanchez CA, Brown SHM, Street J, Fels S, Oxland TR. Biomechanical Properties of Paraspinal Muscles Influence Spinal Loading—A Musculoskeletal Simulation Study. Front Bioeng Biotechnol 2022; 10:852201. [PMID: 35721854 PMCID: PMC9201424 DOI: 10.3389/fbioe.2022.852201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/15/2022] [Indexed: 11/13/2022] Open
Abstract
Paraspinal muscles are vital to the functioning of the spine. Changes in muscle physiological cross-sectional area significantly affect spinal loading, but the importance of other muscle biomechanical properties remains unclear. This study explored the changes in spinal loading due to variation in five muscle biomechanical properties: passive stiffness, slack sarcomere length (SSL), in situ sarcomere length, specific tension, and pennation angle. An enhanced version of a musculoskeletal simulation model of the thoracolumbar spine with 210 muscle fascicles was used for this study and its predictions were validated for several tasks and multiple postures. Ranges of physiologically realistic values were selected for all five muscle parameters and their influence on L4-L5 intradiscal pressure (IDP) was investigated in standing and 36° flexion. We observed large changes in IDP due to changes in passive stiffness, SSL, in situ sarcomere length, and specific tension, often with interesting interplays between the parameters. For example, for upright standing, a change in stiffness value from one tenth to 10 times the baseline value increased the IDP only by 91% for the baseline model but by 945% when SSL was 0.4 μm shorter. Shorter SSL values and higher stiffnesses led to the largest increases in IDP. More changes were evident in flexion, as sarcomere lengths were longer in that posture and thus the passive curve is more influential. Our results highlight the importance of the muscle force-length curve and the parameters associated with it and motivate further experimental studies on in vivo measurement of those properties.
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Affiliation(s)
- Masoud Malakoutian
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
- ICORD, University of British Columbia, Vancouver, BC, Canada
| | - C. Antonio Sanchez
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Stephen H. M. Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - John Street
- ICORD, University of British Columbia, Vancouver, BC, Canada
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
| | - Sidney Fels
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Thomas R. Oxland
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
- ICORD, University of British Columbia, Vancouver, BC, Canada
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- *Correspondence: Thomas R. Oxland,
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Péan F, Favre P, Goksel O. Computational analysis of subscapularis tears and pectoralis major transfers on muscular activity. Clin Biomech (Bristol, Avon) 2022; 92:105541. [PMID: 34999390 DOI: 10.1016/j.clinbiomech.2021.105541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Pectoralis major is the most common muscle transfer procedure to restore joint function after subscapularis tears. Limited information is available on how the neuromuscular system adjusts to the new configuration, which could explain the mixed outcomes of the procedure. The purpose of this study is to assess how muscles activation patterns change after pectoralis major transfers and report their biomechanical implications. METHODS We compare how muscle activation change with subscapularis tears and after its treatment by pectoralis major transfers of the clavicular, sternal, or both these segments, during three activities of daily living and a computational musculoskeletal model of the shoulder. FINDINGS Our results indicate that subscapularis tears require a compensatory activation of the supraspinatus and is accompanied by a reduced co-contraction of the infraspinatus, both of which can be partially recovered after transfer. Furthermore, although the pectoralis major acts asynchronously to the subscapularis before the transfer, its activation pattern changes significantly after the transfer. INTERPRETATION The capability of a transferred muscle segment to activate similarly to the intact subscapularis is found to be dependent on the given motion. Differences in the activation patterns between intact subscapularis and the segments of pectoralis major may explain the difficulty in adapting psycho-motor patterns during the rehabilitation period. Thereby, rehabilitation programs could benefit from targeted training on specific motion and biofeedback programs. Finally, the condition of the anterior deltoid should be considered to improve joint function.
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Affiliation(s)
- Fabien Péan
- Computer-assisted Applications in Medicine, ETH Zurich, Switzerland
| | | | - Orcun Goksel
- Computer-assisted Applications in Medicine, ETH Zurich, Switzerland; Department of Information Technology, Uppsala University, Sweden.
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Sagl B, Schmid-Schwap M, Piehslinger E, Kundi M, Stavness I. Effect of facet inclination and location on TMJ loading during bruxism: An in-silico study. J Adv Res 2022; 35:25-32. [PMID: 35024193 PMCID: PMC8721353 DOI: 10.1016/j.jare.2021.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/14/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023] Open
Abstract
Sheds new light on the important potential connection between tooth grinding and temporomandibular joint loading Demonstrates a larger effect of grinding inclination than grinding position on TMJ loading Creates a novel computer simulation of TMJ disc stress during dynamic tooth grinding tasks Uses state-of-the-art in silico methods for a highly multidisciplinary investigation, which is not feasible in vivo Presents a tracking simulation approach to work around the highly complicated recording of masticatory muscle EMG acquisition
Introduction Functional impairment of the masticatory region can have significant consequences that range from a loss of quality of life to severe health issues. Increased temporomandibular joint loading is often connected with temporomandibular disorders, but the effect of morphological factors on joint loading is a heavily discussed topic. Due to the small size and complex structure of the masticatory region in vivo investigations of these connections are difficult to perform. Objectives We propose a novel in silico approach for the investigation of the effect of wear facet inclination and position on TMJ stress. Methods We use a forward-dynamics tracking approach to simulate lateral bruxing on the canine and first molar using 6 different inclinations, resulting in a total of 12 simulated cases. By using a computational model, we control a single variable without interfering with the system. Muscle activation pattern, maximum bruxing force as well as TMJ disc stress are reported for all simulations. Results Muscle activation patterns and bruxing forces agree well with previously reported EMG findings and in vivo force measurements. The simulation results show that an increase in inclination leads to a decrease in TMJ loading. Wear facet position seems to play a smaller role with regard to bruxing force but might be more relevant for TMJ loading. Conclusion Together these results suggest a possible effect of tooth morphology on TMJ loading during bruxism.
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Affiliation(s)
- Benedikt Sagl
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Martina Schmid-Schwap
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Eva Piehslinger
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Michael Kundi
- Institute of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, SK S7N 5C9 Saskatoon, Saskatchewan, Canada
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Abstract
OBJECTIVE Musculoskeletal models play an important role in surgical planning and clinical assessment of gait and movement. Faster and more accurate simulation of muscle paths in such models can result in better predictions of forces and facilitate real-time clinical applications, such as rehabilitation with real-time feedback. We propose a novel and efficient method for computing wrapping paths across arbitrary surfaces, such as those defined by bone geometry. METHODS A muscle path is modeled as a massless, frictionless elastic strand that uses artificial forces, applied independently of the dynamic simulation, to wrap tightly around intervening obstacles. Contact with arbitrary surfaces is computed quickly using a distance grid, which is interpolated quadratically to provide smoother results. RESULTS Evaluation of the method demonstrates good accuracy, with mean relative errors of 0.002 or better when compared against simple cases with exact solutions. The method is also fast, with strand update times of around 0.5 msec for a variety of bone shaped obstacles. CONCLUSION Our method has been implemented in the open source simulation system ArtiSynth (www.artisynth.org) and helps solve the problem of muscle wrapping around bones and other structures. SIGNIFICANCE Muscle wrapping on arbitrary surfaces opens up new possibilities for patient-specific musculoskeletal models where muscle paths can directly conform to shapes extracted from medical image data.
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Sagl B, Schmid-Schwap M, Piehslinger E, Kundi M, Stavness I. A Dynamic Jaw Model With a Finite-Element Temporomandibular Joint. Front Physiol 2019; 10:1156. [PMID: 31607939 PMCID: PMC6757193 DOI: 10.3389/fphys.2019.01156] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/28/2019] [Indexed: 12/22/2022] Open
Abstract
The masticatory region is an important human motion system that is essential for basic human tasks like mastication, speech or swallowing. An association between temporomandibular disorders (TMDs) and high temporomandibular joint (TMJ) stress has been suggested, but in vivo joint force measurements are not feasible to directly test this assumption. Consequently, biomechanical computer simulation remains as one of a few means to investigate this complex system. To thoroughly examine orofacial biomechanics, we developed a novel, dynamic computer model of the masticatory system. The model combines a muscle driven rigid body model of the jaw region with a detailed finite element model (FEM) disk and elastic foundation (EF) articular cartilage. The model is validated using high-resolution MRI data for protrusion and opening that were collected from the same volunteer. Joint stresses for a clenching task as well as protrusive and opening movements are computed. Simulations resulted in mandibular positions as well as disk positions and shapes that agree well with the MRI data. The model computes reasonable disk stress patterns for dynamic tasks. Moreover, to the best of our knowledge this model presents the first ever contact model using a combination of EF layers and a FEM body, which results in a clear decrease in computation time. In conclusion, the presented model is a valuable tool for the investigation of the human TMJ and can potentially help in the future to increase the understanding of the masticatory system and the relationship between TMD and joint stress and to highlight potential therapeutic approaches for the restoration of orofacial function.
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Affiliation(s)
- Benedikt Sagl
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Martina Schmid-Schwap
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Eva Piehslinger
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Michael Kundi
- Institute of Environmental Health, Medical University of Vienna, Vienna, Austria
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK, Canada
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