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Dong L, Huang W, Wu H, Yu S, Zheng Y, Zhang Q, Ren D, Wu W, Yan X, Lv T, Yuan X. Evaluating stress and displacement in the craniomandibular complex using Twin Block appliances at varied angles: A finite element study. J Mech Behav Biomed Mater 2024; 156:106603. [PMID: 38815434 DOI: 10.1016/j.jmbbm.2024.106603] [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: 02/22/2024] [Revised: 05/07/2024] [Accepted: 05/25/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES The objective of this investigation was to assess the stress and displacement pattern of the craniomandibular complex by employing finite element methodology to simulate diverse angulations of inclined planes that are incorporated in the Twin Block appliance. METHODS A 3D finite element representation was established by use of Cone Beam Computed Tomography (CBCT) scans. This comprehensive structure included craniofacial skeletal components, the articular disc, a posterior disc elastic layer, dental elements, periodontal ligaments, and a Twin Block appliance. This investigation is the first to incorporated inclined planes featuring three distinct angulations (45, 60, and 70°) as the study models. Mechanical impacts were evaluated within the glenoid fossa, tooth, condylar, and articular disc regions. RESULTS In all simulations, the stress generated by the Twin Block appliance was distributed across teeth and periodontal ligament, facilitating the anterior movement of mandibular teeth and the posterior displacement of maxillary teeth. Within the temporomandibular joint region, compressive forces on the superior and posterior facets of the condyle diminished, coinciding with the stress configuration that fosters condylar and mandibular growth. Stress dispersion homogenized in the condylar anterior facet and articular disc, with considerable tensile stress in the glenoid fossa's posterior aspect conforming to stress distribution that promote fossa reconfiguration. The 70° inclined plane exerts the highest force on the tissues. The condyle's maximum and minimum principal stresses are 0.36 MPa and -0.15 MPa, respectively, while those of the glenoid fossa are 0.54 MPa and -0.23 MPa. CONCLUSION Three angled appliances serve the purpose of advancing the mandible. A 45° inclined plane relative to the occlusal plane exerts balanced anteroposterior and vertical forces on the mandibular arch. Steeper angles yield greater horizontal forces, which may enhance forward growth and efficient repositioning.
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Affiliation(s)
- Lirong Dong
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Wenli Huang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Haoting Wu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Shaoyang Yu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Yao Zheng
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Qiang Zhang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - DaPeng Ren
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Wei Wu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Xiao Yan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Tao Lv
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China.
| | - Xiao Yuan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China.
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Li A, Chong DYR, Shao B, Liu Z. An Improved Finite Element Model of Temporomandibular Joint in Maxillofacial System: Experimental Validation. Ann Biomed Eng 2024; 52:1908-1917. [PMID: 36689028 DOI: 10.1007/s10439-022-03124-7] [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: 09/27/2022] [Accepted: 12/25/2022] [Indexed: 01/24/2023]
Abstract
Finite element (FE) analysis has become a popular method of exploring the biomechanical characteristics of temporomandibular joint (TMJ). However, the FE model should be improved and its reliability should be verified further. This study developed a complete maxillofacial model by cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI). The integrity and physiological environment of TMJ were considered. Then the FE model and corresponding 3D printed model were developed and loaded under the same conditions. The strains on the mandible and upper surface of the left articular disc were measured on the experimental model and compared with the FE model. The differences of the strains on the mandible were less than 6%. The strain distributions on the disc were also approximate between the experimental and simulated results. It indicated that the strains calculated from the improved FE model were reliable on the mandible and inside the TMJ.
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Affiliation(s)
- Annan Li
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China
- Yinbin Institute of Industrial Technology/Sichuan University Yinbin Park, Yinbin, 644600, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, Dover, 138683, Singapore
| | - Bingmei Shao
- Yinbin Institute of Industrial Technology/Sichuan University Yinbin Park, Yinbin, 644600, China.
- Basic Mechanics Lab, Sichuan University, Chengdu, 610211, China.
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China.
- Yinbin Institute of Industrial Technology/Sichuan University Yinbin Park, Yinbin, 644600, China.
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Chen J, Wang J, Guo J, Wang X, Kang Y, Wang Y, Guo C. Prediction of jaw opening function after mandibular reconstruction using subject-specific musculoskeletal modelling. J Oral Rehabil 2024; 51:1050-1060. [PMID: 38544336 DOI: 10.1111/joor.13670] [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: 04/04/2023] [Revised: 02/09/2024] [Accepted: 02/16/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Mandibular reconstruction patients often suffer abnormalities in the mandibular kinematics. In silico simulations, such as musculoskeletal modelling, can be used to predict post-operative mandibular kinematics. It is important to validate the mandibular musculoskeletal model and analyse the factors influencing its accuracy. OBJECTIVES To investigate the jaw opening-closing movements after mandibular reconstruction, as predicted by the subject-specific musculoskeletal model, and the factors influencing its accuracy. METHODS Ten mandibular reconstruction patients were enrolled in this study. Cone-beam computed tomography images, mandibular movements, and surface electromyogram signals were recorded preoperatively. A subject-specific mandibular musculoskeletal model was established to predict surgical outcomes using patient-averaged muscle parameter changes as model inputs. Jaw bone geometry was replaced by surgical planning results, and the muscle insertion sites were registered based on the non-rigid iterative closest point method. The predicted jaw kinematic data were validated based on 6-month post-operative measurements. Correlations between the prediction accuracy and patient characteristics (age, pathology and surgical scope) were further analysed. RESULTS The root mean square error (RMSE) for lower incisor displacement was 31.4%, and the error for peak magnitude of jaw opening was 4.9 mm. Age, post-operative infection and radiotherapy influenced the prediction accuracy. The amount of masseter detachment showed little correlation with jaw opening. CONCLUSION The mandibular musculoskeletal model successfully predicted short-range jaw opening functions after mandibular reconstruction. It provides a novel surgical planning method to predict the risk of developing trismus.
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Affiliation(s)
- Junpeng Chen
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhejiang University Medical College, Zhejiang, China
| | - Jing Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jianqiao Guo
- MOE Key Laboratory of Dynamics and Control of Flight Vehicle, School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China
| | - Xinyue Wang
- MOE Key Laboratory of Dynamics and Control of Flight Vehicle, School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China
| | - Yanfeng Kang
- Department of Prosthodontics, Center for Oral Functional Diagnosis, Treatment and Research Peking University School of Stomatology, Beijing, China
| | - Yang Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Chuanbin Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Aftabi H, Sagl B, Lloyd JE, Prisman E, Hodgson A, Fels S. To what extent can mastication functionality be restored following mandibular reconstruction surgery? A computer modeling approach. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 250:108174. [PMID: 38640839 DOI: 10.1016/j.cmpb.2024.108174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/26/2024] [Accepted: 04/10/2024] [Indexed: 04/21/2024]
Abstract
STATEMENT OF PROBLEM Advanced cases of head and neck cancer involving the mandible often require surgical removal of diseased sections and subsequent replacement with donor bone. During the procedure, the surgeon must make decisions regarding which bones or tissues to resect. This requires balancing tradeoffs related to issues such as surgical access and post-operative function; however, the latter is often difficult to predict, especially given that long-term functionality also depends on the impact of post-operative rehabilitation programs. PURPOSE To assist in surgical decision-making, we present an approach for estimating the effects of reconstruction on key aspects of post-operative mandible function. MATERIAL AND METHODS We develop dynamic biomechanical models of the reconstructed mandible considering different defect types and validate them using literature data. We use these models to estimate the degree of functionality that might be achieved following post-operative rehabilitation. RESULTS We find significant potential for restoring mandibular functionality, even in cases involving large defects. This entails an average trajectory error below 2 mm, bite force comparable to a healthy individual, improved condyle mobility, and a muscle activation change capped at a maximum of 20%. CONCLUSION These results suggest significant potential for adaptability in the masticatory system and improved post-operative rehabilitation, leading to greater restoration of jaw function.
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Affiliation(s)
- Hamidreza Aftabi
- Department of ECE, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada.
| | - Benedikt Sagl
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, 1090, Austria
| | - John E Lloyd
- Department of ECE, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
| | - Eitan Prisman
- Department of Surgery, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, Vancouver, V5Z 1M9, BC, Canada
| | - Antony Hodgson
- Department of Mechanical Engineering, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
| | - Sidney Fels
- Department of ECE, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
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Ma H, Zheng T, Shao B, Liu Z. Evaluation of the effect of unilateral mastication on the morphology of temporomandibular joint from the perspective of dynamic joint space. J Oral Rehabil 2024; 51:795-804. [PMID: 38131438 DOI: 10.1111/joor.13646] [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: 12/18/2022] [Revised: 05/27/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Unbalanced alterations of temporomandibular joint morphology were associated with unilaterally masticatory habits. OBJECTIVE This study aimed to investigate the effect of unilateral mastication on the remodelling of the temporomandibular joint using dynamic joint space. METHODS Twelve volunteers with non-maxillofacial deformity and healthy temporomandibular joints were recruited. The 3D models of the mandible and the maxilla were reconstructed according to computed tomography. The subjects were asked to masticate French fries and peanuts unilaterally, which was recorded by a 3D motion capture system. The dynamic joint space during unilateral mastication was analysed. RESULTS During early closure, the joint space reduction on the non-masticatory side was significantly greater than on the masticatory side (p < .05). During later closure, the joint space reduction on the non-masticatory side was significantly lower than that on the masticatory side (p < .05). The difference in joint space reduction between both sides was greater than the French fries while masticating the peanuts. CONCLUSIONS Unilateral mastication resulted in a different major pressure area on the bilateral TMJs. Therefore, unilateral mastication might be an essential factor in the bilateral asymmetrical remodelling of the TMJ.
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Affiliation(s)
- Hedi Ma
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, China
| | - Tinghui Zheng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, China
| | - Bingmei Shao
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, China
- Basic Mechanics Lab, Sichuan University, Chengdu, China
| | - Zhan Liu
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, China
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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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Aftabi H, Zaraska K, Eghbal A, McGregor S, Prisman E, Hodgson A, Fels S. Computational models and their applications in biomechanical analysis of mandibular reconstruction surgery. Comput Biol Med 2024; 169:107887. [PMID: 38160502 DOI: 10.1016/j.compbiomed.2023.107887] [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: 07/15/2023] [Revised: 11/20/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
Advanced head and neck cancers involving the mandible often require surgical removal of the diseased parts and replacement with donor bone or prosthesis to recreate the form and function of the premorbid mandible. The degree to which this reconstruction successfully replicates key geometric features of the original bone critically affects the cosmetic and functional outcomes of speaking, chewing, and breathing. With advancements in computational power, biomechanical modeling has emerged as a prevalent tool for predicting the functional outcomes of the masticatory system and evaluating the effectiveness of reconstruction procedures in patients undergoing mandibular reconstruction surgery. These models offer cost-effective and patient-specific treatment tailored to the needs of individuals. To underscore the significance of biomechanical modeling, we conducted a review of 66 studies that utilized computational models in the biomechanical analysis of mandibular reconstruction surgery. The majority of these studies employed finite element method (FEM) in their approach; therefore, a detailed investigation of FEM has also been provided. Additionally, we categorized these studies based on the main components analyzed, including bone flaps, plates/screws, and prostheses, as well as their design and material composition.
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Affiliation(s)
- Hamidreza Aftabi
- Department of ECE, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada.
| | - Katrina Zaraska
- Department of Surgery, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, Vancouver, V5Z 1M9, BC, Canada
| | - Atabak Eghbal
- Department of ECE, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
| | - Sophie McGregor
- Department of Surgery, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, Vancouver, V5Z 1M9, BC, Canada
| | - Eitan Prisman
- Department of Surgery, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, Vancouver, V5Z 1M9, BC, Canada
| | - Antony Hodgson
- Department of Mechanical Engineering, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
| | - Sidney Fels
- Department of ECE, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
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Teng H, Shu J, Ma H, Shao B, Liu Z. Effect of pre-stress on dynamic finite element analysis of the temporomandibular joint. Comput Methods Biomech Biomed Engin 2023:1-11. [PMID: 38083841 DOI: 10.1080/10255842.2023.2290455] [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: 10/03/2023] [Accepted: 11/28/2023] [Indexed: 02/24/2024]
Abstract
The pre-stress of the temporomandibular joint (TMJ) at the intercuspal position (ICP) was often neglected, which would cause errors in the finite element analysis. The purpose of this study was to investigate the effect of pre-stress on dynamic finite element analysis of the TMJs. One healthy female adult was recruited for medical imaging and motion data acquisition of the reference position (RP) to the ICP and the clicking teeth. The three-dimensional maxillofacial model including the maxilla, mandible, articular cartilages, discs, and discal attachments was reconstructed. Motion from the RP to the ICP was simulated to obtain pre-stress at the ICP. Two groups of the clicking teeth were simulated: (1) the group without pre-stress (GWoP); (2) the group with pre-stress (GwP). Significant differences were found between the two groups at the initial moment of movement, during the open-mouth phase, and during the collision phase between the upper and lower teeth. The maximum difference in the discal contact stress between both groups was even more than double. The relaxation of the TMJ at the beginning of the mouth opening was simulated in the GwP. In addition, an increase in the TMJ stress during teeth tapping was simulated in the GwP. These were not reflected in the GWoP. If pre-stress at the ICP was not considered, part of the true results would be lost. It is necessary to consider pre-stress in the dynamic finite element analysis of the TMJ.
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Affiliation(s)
- Haidong Teng
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
| | - Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
| | - Hedi Ma
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
| | - Bingmei Shao
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
- Basic Mechanics Lab, Sichuan University, Chengdu, China
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
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Panagiotopoulou O, Robinson D, Iriarte-Diaz J, Ackland D, Taylor AB, Ross CF. Dynamic finite element modelling of the macaque mandible during a complete mastication gape cycle. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220549. [PMID: 37839457 PMCID: PMC10577025 DOI: 10.1098/rstb.2022.0549] [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: 06/08/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Three-dimensional finite element models (FEMs) are powerful tools for studying the mechanical behaviour of the feeding system. Using validated, static FEMs we have previously shown that in rhesus macaques the largest food-related differences in strain magnitudes during unilateral postcanine chewing extend from the lingual symphysis to the endocondylar ridge of the balancing-side ramus. However, static FEMs only model a single time point during the gape cycle and probably do not fully capture the mechanical behaviour of the jaw during mastication. Bone strain patterns and moments applied to the mandible are known to vary during the gape cycle owing to variation in the activation peaks of the jaw-elevator muscles, suggesting that dynamic models are superior to static ones in studying feeding biomechanics. To test this hypothesis, we built dynamic FEMs of a complete gape cycle using muscle force data from in vivo experiments to elucidate the impact of relative timing of muscle force on mandible biomechanics. Results show that loading and strain regimes vary across the chewing cycle in subtly different ways for different foods, something which was not apparent in static FEMs. These results indicate that dynamic three-dimensional FEMs are more informative than static three-dimensional FEMs in capturing the mechanical behaviour of the jaw during feeding by reflecting the asymmetry in jaw-adductor muscle activations during a gape cycle. This article is part of the theme issue 'Food processing and nutritional assimilation in animals'.
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Affiliation(s)
- Olga Panagiotopoulou
- Monash Biomedicine Discovery Institute, Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria 3800, Australia
| | - Dale Robinson
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria 3053, Australia
| | - Jose Iriarte-Diaz
- Department of Biology, University of the South, Sewanee, TN 37383, USA
| | - David Ackland
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria 3053, Australia
| | - Andrea B. Taylor
- Department of Foundational Biomedical Sciences, Touro University California, Vallejo, CA 94592, USA
| | - Callum F. Ross
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, IL 60637, USA
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Shen Z, Zhang P, Cheng B, Liu F, He D. Computational modelling of the fossa component fixation associated with alloplastic total temporomandibular joint replacements. J Mech Behav Biomed Mater 2023; 147:106104. [PMID: 37729840 DOI: 10.1016/j.jmbbm.2023.106104] [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: 07/05/2023] [Revised: 08/29/2023] [Accepted: 09/03/2023] [Indexed: 09/22/2023]
Abstract
The alloplastic total temporomandibular joint (TMJ) replacement is a complex surgical approach to end-stage TMJ disorders. The fixation of TMJ prostheses remains a critical issue for implant design and performance. For the fossa component, it is generally considered to use fixation screws to achieve tripod stability. However, the fossa may still come loose, and the mechanism remains unknown. A computational framework, consisting of a musculoskeletal model for calculating muscle and TMJ forces, and a finite element model for the fossa fixation simulation, was developed. A polyethylene (PE) fossa with stock prosthesis design was analyzed to predict contact pressures at the fixation interfaces, and stresses/strains in the fossa implant and bone during the static loading of normal chewing bite and maximum-force bite. The predicted maximum von Mises stresses were 33 MPa and 44 MPa for the bone, 13 MPa and 28 MPa for the PE fossa, and 131 MPa and 244 MPa for the screws, for the normal and maximum bites, respectively; the peak minimum principal strain was in the range of -2514 ∼ -3545 με for the bone. The results show that the sufficient initial mechanical strength of the fossa component fixation can be established using the screws in combination with bone support. The functional loads applied through the prosthetic TMJ bearing can be largely transferred to supporting bone without causing high level stresses. Tightening fixation screws with a pretension of 100 N can reduce transverse load to the screws and help prevent screw loosening. Further research is recommended to accurately quantify the transverse load and its influence on screw loosening during dynamic loading, and the frictional properties at the bone-implant interface.
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Affiliation(s)
- Zhenhao Shen
- School of Mechanical Engineering, North University of China, PR China
| | - Pengyu Zhang
- School of Mechanical Engineering, North University of China, PR China
| | - Bo Cheng
- School of Mechanical Engineering, North University of China, PR China
| | - Feng Liu
- School of Mechanical Engineering, North University of China, PR China.
| | - Dongmei He
- Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine & Shanghai Key Laboratory of Stomatology, PR China.
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Feng Y, Teng H, Shu J, Shao B, Chong DYR, Liu Z. Biomechanical comparison of the effect of bilateral sagittal split ramus osteotomy with or without Le Fort I osteotomy on the temporomandibular joints of the patients with maxillofacial deformities under centric occlusion. Comput Methods Biomech Biomed Engin 2023; 26:1732-1741. [PMID: 36322673 DOI: 10.1080/10255842.2022.2138707] [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: 06/08/2022] [Revised: 10/09/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
Mandibular deformities negatively affect the daily activities of the patients and may cause temporomandibular disorders (TMD). Bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I osteotomy are effective treatments to correct the mandibular deformities. The aim of this study was to investigate and compare the effects of the BSSRO with or without Le Fort I on the stress distributions of the temporomandibular joints (TMJs) of the patients with mandibular deformities under centric occlusion based on finite element (FE) method. Preoperative and postoperative cone-beam computed tomography (CBCT) images of twenty-four patients diagnosed with mandibular prognathism, including ten patients with BSSRO and another 14 patients with bimaxillary osteotomy (BSSRO with Le Fort I), were used to construct maxillofacial models. Ten asymptomatic individuals were also performed CBCT scanning and defined as the control group. In addition, the muscle forces and boundary conditions corresponding to centric occlusions were applied on each model. For the preoperative groups with both the BSSRO and bimaxillary osteotomies, the average peak contact stresses of the TMJs were both greater than those of the control group. After the surgeries, the contact stresses of the discs and temporal bones of both groups considerably decreased. However, the contact stresses on the condyles slightly increased after BSSRO but decreased after bimaxillary osteotomy. The TMJs of the patients with maxillofacial deformities suffered abnormal tensile and compressive stresses compared with the asymptomatic subjects under centric occlusion. Both of the BSSRO and bimaxillary osteotomy could improve the risk stress distributions of the TMJs.
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Affiliation(s)
- Yukai Feng
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China
| | - Haidong Teng
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China
| | - Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China
| | - Bingmei Shao
- Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China
- Basic Mechanics Lab, Sichuan University, Chengdu, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China
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12
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Helmer LML, Klop C, Lobbezoo F, de Lange J, Harm Koolstra J, Dubois L. Contact stress distribution after unilateral condylar fracture with angulation of the fractured part: A finite element model study. J Biomech 2023; 159:111769. [PMID: 37683378 DOI: 10.1016/j.jbiomech.2023.111769] [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: 12/22/2022] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023]
Abstract
After a fracture of the condyle, the head of the condyle is often pulled inwards, which causes the fractured part to angulate medially. This change can cause a disbalance in the masticatory system. The disbalance could lead to contact stress differences within the temporomandibular joints (TMJs) which might induce remodelling within the TMJ to restore the balance. The contact stress in the fractured condyle during open and closing movements is expected to decrease, while the contact stress in the non-fractured condyle will increase. In a clinical situation this is hard to investigate. Therefore, a finite element model (FEM) was used. In the FEM a fractured right condyle with an angulation was induced, which was placed at different degrees, varying from 5° to 50° in steps of 5°. This study shows only minor differences in amount of contact stress between the fractured and the non-fractured condyle. The amount of contact stress in the condyles does not increase with a higher degree of angulation. However, with larger angulations, the contact stress within the fractured condyle is more centralized. Clinically, this more centralized area could be associated with complaints, such as pain. In conclusion, due to the more centralized contact stress in the fractured condyle, one would expect some minor remodelling on the fractured side with more angulation.
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Affiliation(s)
- Loreine M L Helmer
- Department of Oral and Maxillofacial Surgery, Amsterdam Academic Medical Centers and Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Cornelis Klop
- Department of Oral and Maxillofacial Surgery, Amsterdam Academic Medical Centers and Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam Academic Medical Centers and Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jan Harm Koolstra
- Department of Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, the Netherlands
| | - Leander Dubois
- Department of Oral and Maxillofacial Surgery, Amsterdam Academic Medical Centers and Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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13
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Sánchez-Ayala A, Sánchez-Ayala A, Kolodzejezyk RC, Urban VM, Lagravère MÓ, Campanha NH. A three-dimensional method to calculate mechanical advantage in mandibular function : Intra- and interexaminer reliability study. J Orofac Orthop 2023; 84:321-339. [PMID: 35254453 DOI: 10.1007/s00056-022-00378-7] [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: 06/20/2021] [Accepted: 01/16/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Masticatory muscles are physically affected by several skeletal features. The muscle performance depends on muscle size, intrinsic strength, fiber direction, moment arm, and neuromuscular control. To date, for the masticatory apparatus, only a two-dimensional cephalometric method for assessing the mechanical advantage, which is a measure for the ratio of the output force to the input force in a system, is available. This study determined the reliability and errors of a three-dimensional (3D) mechanical advantage calculation for the masticatory system. METHODS Using cone-beam computed tomography images from teenage patients undergoing orthodontic treatments, 36 craniofacial landmarks were identified, and the moment arms for seven muscles and their load moment arms (biomechanical variables) were determined. The 3D mechanical advantage for each muscle was calculated. This procedure was repeated by three examiners. Reliability was verified using the intraclass correlation coefficient (ICC) and the errors by calculating the absolute differences, variance estimator and coefficient of variation (CV). RESULTS Landmark coordinates demonstrated excellent intra- and interexaminer reliability (ICC 0.998-1.000; p < 0.0001). Intraexaminer data showed errors < 1.5 mm. Unsatisfactory interexaminer errors ranged from 1.51-5.83 mm. All biomechanical variables presented excellent intraexaminer reliability (ICC 0.919-1.000, p < 0.0001; CV < 7%). Interexaminer results were almost excellent, but with lower values (ICC 0.750-1.000, p < 0.0001; CV < 10%). However, the muscle moment arm and 3D mechanical advantage of the lateral pterygoid muscles had ICCs < 0.500 (p < 0.05) and CV < 30%. Intra- and interexaminer errors were ≤ 0.01 and ≤ 0.05, respectively. CONCLUSIONS Both landmarks and biomechanical variables showed high reliability and acceptable errors. The proposed method is viable for the 3D mechanical advantage measure.
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Affiliation(s)
- Alejandro Sánchez-Ayala
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil
| | - Alfonso Sánchez-Ayala
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil.
| | - Rafaela Cristina Kolodzejezyk
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil
| | - Vanessa Migliorini Urban
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil
| | - Manuel Óscar Lagravère
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil
| | - Nara Hellen Campanha
- Orthodontic Graduate Program, University of Alberta, 116 St & 85 Ave, T6G 2R3, Edmonton, Alberta, Canada
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14
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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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15
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Feng SY, Lei J, Li YX, Shi WG, Wang RR, Yap AU, Wang YX, Fu KY. Increased joint loading induces subchondral bone loss of the temporomandibular joint via the RANTES-CCRs-Akt2 axis. JCI Insight 2022; 7:158874. [PMID: 36173680 PMCID: PMC9675482 DOI: 10.1172/jci.insight.158874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/21/2022] [Indexed: 12/15/2022] Open
Abstract
Early-stage temporomandibular joint osteoarthritis (TMJOA) is characterized by excessive subchondral bone loss. Emerging evidence suggests that TMJ disc displacement is involved, but the pathogenic mechanism remains unclear. Here, we established a rat model of TMJOA that simulated disc displacement with a capacitance-based force-sensing system to directly measure articular surface pressure in vivo. Micro-CT, histological staining, immunofluorescence staining, IHC staining, and Western blot were used to assess pathological changes and underlying mechanisms of TMJOA in the rat model in vivo as well as in RAW264.7 cells in vitro. We found that disc displacement led to significantly higher pressure on the articular surface, which caused rapid subchondral bone loss via activation of the RANTES-chemokine receptors-Akt2 (RANTES-CCRs-Akt2) axis. Inhibition of RANTES or Akt2 attenuated subchondral bone loss and resulted in improved subchondral bone microstructure. Cytological studies substantiated that RANTES regulated osteoclast formation by binding to its receptor CCRs and activating the Akt2 pathway. The clinical evidence further supported that RANTES was a potential biomarker for predicting subchondral bone loss in early-stage TMJOA. Taken together, this study demonstrates important functions of the RANTES-CCRs-Akt2 axis in the regulation of subchondral bone remodeling and provides further knowledge of how disc displacement causes TMJOA.
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Affiliation(s)
- Shi-Yang Feng
- Center for Temporomandibular Disorders & Orofacial Pain, and,Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China.,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Jie Lei
- Center for Temporomandibular Disorders & Orofacial Pain, and,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Yu-Xiang Li
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, China.,Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, China
| | - Wen-Ge Shi
- Center for Temporomandibular Disorders & Orofacial Pain, and,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Ran-Ran Wang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, China.,School of Chemistry and Materials Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, China
| | - Adrian Ujin Yap
- Center for Temporomandibular Disorders & Orofacial Pain, and,Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore.,National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
| | - Yi-Xiang Wang
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China.,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Kai-Yuan Fu
- Center for Temporomandibular Disorders & Orofacial Pain, and,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
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16
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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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17
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The effect of mandibular movement on temporomandibular joint morphology while eating French fries. Ann Anat 2022; 244:151992. [PMID: 36041696 DOI: 10.1016/j.aanat.2022.151992] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The preferred masticatory side was reported to be almost always the same as the affected side of the temporomandibular disorder. Unbalanced alterations of temporomandibular joint morphology were found to be associated with unilaterally masticatory habits. The aim of this study was to investigate the effect of the mandibular movement on the remodeling of temporomandibular joint during eating French fries using a 3D motion capture system. METHODS Twelve volunteers with non-maxillofacial deformity and a healthy temporomandibular joint were recruited. The 3D models of the mandible and the maxilla were reconstructed according to computed tomography. The subjects were asked to eat French fries by unilaterally mastication, which was recorded by a 3D motion capture system. The trajectories of the incisors and the condyles and the condylar acceleration during unilateral mastication were analyzed. RESULTS During incisal biting, there was no significant difference in the condylar trajectories between the left and right sides (P > 0.05). During unilateral mastication, the average displacement and acceleration of the masticatory condyles were significantly lower than those of the non-masticatory condyles (P < 0.05). The trajectory angles of the masticatory condyles were significantly steeper than those of the non-masticatory condyle (P < 0.05). During swallowing, there was no obvious movement of the mandible. CONCLUSIONS Between both temporomandibular joints, unilateral mastication resulted in significant differences in the regions of the condylar movement within the articular fossa, and then caused different compressive regions of the temporomandibular joints. Thus, unilateral mastication might result in a significantly different pattern of temporomandibular joint remodeling between the two sides.
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18
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Marcé-Nogué J. One step further in biomechanical models in palaeontology: a nonlinear finite element analysis review. PeerJ 2022; 10:e13890. [PMID: 35966920 PMCID: PMC9373974 DOI: 10.7717/peerj.13890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/21/2022] [Indexed: 01/19/2023] Open
Abstract
Finite element analysis (FEA) is no longer a new technique in the fields of palaeontology, anthropology, and evolutionary biology. It is nowadays a well-established technique within the virtual functional-morphology toolkit. However, almost all the works published in these fields have only applied the most basic FEA tools i.e., linear materials in static structural problems. Linear and static approximations are commonly used because they are computationally less expensive, and the error associated with these assumptions can be accepted. Nonetheless, nonlinearities are natural to be used in biomechanical models especially when modelling soft tissues, establish contacts between separated bones or the inclusion of buckling results. The aim of this review is to, firstly, highlight the usefulness of non-linearities and secondly, showcase these FEA tool to researchers that work in functional morphology and biomechanics, as non-linearities can improve their FEA models by widening the possible applications and topics that currently are not used in palaeontology and anthropology.
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Affiliation(s)
- Jordi Marcé-Nogué
- Department of Mechanical Engineering, Universitat Rovira i Virgili Tarragona, Tarragona, Catalonia, Spain,Institut Català de Paleontologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Catalonia, Spain
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19
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A Contemporary Approach to Non-Invasive 3D Determination of Individual Masticatory Muscle Forces: A Proof of Concept. J Pers Med 2022; 12:jpm12081273. [PMID: 36013222 PMCID: PMC9409695 DOI: 10.3390/jpm12081273] [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: 06/01/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
Over the past decade, the demand for three-dimensional (3D) patient-specific (PS) modelling and simulations has increased considerably; they are now widely available and generally accepted as part of patient care. However, the patient specificity of current PS designs is often limited to this patient-matched fit and lacks individual mechanical aspects, or parameters, that conform to the specific patient’s needs in terms of biomechanical acceptance. Most biomechanical models of the mandible, e.g., finite element analyses (FEA), often used to design reconstructive implants or total joint replacement devices for the temporomandibular joint (TMJ), make use of a literature-based (mean) simplified muscular model of the masticatory muscles. A muscle’s cross-section seems proportionally related to its maximum contractile force and can be multiplied by an intrinsic strength constant, which previously has been calculated to be a constant of 37 [N/cm2]. Here, we propose a contemporary method to determine the patient-specific intrinsic strength value of the elevator mouth-closing muscles. The hypothesis is that patient-specific individual mandible elevator muscle forces can be approximated in a non-invasive manner. MRI muscle delineation was combined with bite force measurements and 3D-FEA to determine PS intrinsic strength values. The subject-specific intrinsic strength values were 40.6 [N/cm2] and 25.6 [N/cm2] for the 29- and 56-year-old subjects, respectively. Despite using a small cohort in this proof of concept study, we show that there is great variation between our subjects’ individual muscular intrinsic strength. This variation, together with the difference between our individual results and those presented in the literature, emphasises the value of our patient-specific muscle modelling and intrinsic strength determination protocol to ensure accurate biomechanical analyses and simulations. Furthermore, it suggests that average muscular models may only be sufficiently accurate for biomechanical analyses at a macro-scale level. A future larger cohort study will put the patient-specific intrinsic strength values in perspective.
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20
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Shu J, Ma H, Liu Y, Zheng T, Shao B, Liu Z. In vivo biomechanical effects of maximal mouth opening on the temporomandibular joints and their relationship to morphology and kinematics. J Biomech 2022; 141:111175. [PMID: 35714380 DOI: 10.1016/j.jbiomech.2022.111175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/19/2022] [Accepted: 06/04/2022] [Indexed: 02/05/2023]
Abstract
The temporomandibular joints (TMJs) are the only joints in the human skull and regulate all mandibular motions. The functions of TMJs are considerably influenced by their biomechanical surroundings. However, owing to the unique characteristics of TMJs, comprehending their kinematic and biomechanical mechanisms remains challenging. As a result, understanding how biomechanics relate to TMJ structures and motions is critical in subsequent therapies. The goal of this study is to investigate any links between morphological or kinematic factors and discal stresses during mouth opening. Our study included eight asymptomatic participants who did not show any signs or symptoms of temporomandibular disorders. The morphological parameters, kinematic properties, and stresses were determined using computed tomography (CT), magnetic resonance imaging (MRI), and subject-specific movements. Following the investigation, we discovered that the opening of the mouth was not the primary cause of TMJ stress. The stress on the discs is directly linked to condylar displacements during mouth opening. Furthermore, morphological characteristics related to the relative position of the condyles in the glenoid fossa at the intercuspal position have a limited effect on condylar displacements and stresses. In conclusion, the morphological parameters, which are commonly employed in clinics, show only static conditions in the TMJs. The kinematic parameters provide dynamic information regarding the TMJs, which can be used in the examination, diagnosis, and treatment of TMJ diseases to reduce stress.
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Affiliation(s)
- Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China
| | - Hedi Ma
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China
| | - Yang Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tinghui Zheng
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China
| | - Bingmei Shao
- Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China; Basic Mechanics Lab, Sichuan University, Chengdu, China
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China.
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21
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Guo J, Chen J, Wang J, Ren G, Tian Q, Guo C. EMG-assisted forward dynamics simulation of subject-specific mandible musculoskeletal system. J Biomech 2022; 139:111143. [DOI: 10.1016/j.jbiomech.2022.111143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/17/2022] [Accepted: 05/09/2022] [Indexed: 01/17/2023]
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22
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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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23
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Gologorsky CJ, Middendorf JM, Cohen I, Bonassar LJ. Depth-dependent patterns in shear modulus of temporomandibular joint cartilage correspond to tissue structure and anatomic location. J Biomech 2021; 129:110815. [PMID: 34706301 DOI: 10.1016/j.jbiomech.2021.110815] [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: 04/20/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
To fully understand TMJ cartilage degeneration and appropriate repair mechanisms, it is critical to understand the native structure-mechanics relationships of TMJ cartilage and any local variation that may occur in the tissue. Here, we used confocal elastography and digital image correlation to measure the depth-dependent shear properties as well as the structural properties of TMJ cartilage at different anatomic locations on the condyle to identify depth-dependent changes in shear mechanics and structure. We found that samples at every anatomic location showed qualitatively similar shear modulus profiles as a function of depth. In every sample, four distinct zones of mechanical behavior were observed, with shear modulus values spanning 3-5 orders of magnitude across zones. However, quantitative characteristics of shear modulus profiles varied by anatomic location, particularly zone size and location, with the most significant variation in zonal width occurring in the fibrocartilage surface layer (zone 1). This anatomic variation suggests that different locations on the TMJ condyle may play unique mechanical roles in TMJ function. Furthermore, zones identified in the mechanical data corresponded on a sample-by-sample basis to zones identified in the structural data, indicating the known structural zones of TMJ cartilage may also play unique mechanical roles in TMJ function.
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Affiliation(s)
| | - Jill M Middendorf
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Itai Cohen
- Department of Physics, Cornell University, Clark Hall C7, Ithaca, NY 14853, USA
| | - Lawrence J Bonassar
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA.
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24
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Seyedpour SM, Nafisi S, Nabati M, Pierce DM, Reichenbach JR, Ricken T. Magnetic Resonance Imaging-based biomechanical simulation of cartilage: A systematic review. J Mech Behav Biomed Mater 2021; 126:104963. [PMID: 34894500 DOI: 10.1016/j.jmbbm.2021.104963] [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: 09/05/2020] [Revised: 10/30/2021] [Accepted: 11/06/2021] [Indexed: 11/19/2022]
Abstract
MRI-based mathematical and computational modeling studies can contribute to a better understanding of the mechanisms governing cartilage's mechanical performance and cartilage disease. In addition, distinct modeling of cartilage is needed to optimize artificial cartilage production. These studies have opened up the prospect of further deepening our understanding of cartilage function. Furthermore, these studies reveal the initiation of an engineering-level approach to how cartilage disease affects material properties and cartilage function. Aimed at researchers in the field of MRI-based cartilage simulation, research articles pertinent to MRI-based cartilage modeling were identified, reviewed, and summarized systematically. Various MRI applications for cartilage modeling are highlighted, and the limitations of different constitutive models used are addressed. In addition, the clinical application of simulations and studied diseases are discussed. The paper's quality, based on the developed questionnaire, was assessed, and out of 79 reviewed papers, 34 papers were determined as high-quality. Due to the lack of the best constitutive models for various clinical conditions, researchers may consider the effect of constitutive material models on the cartilage disease simulation. In the future, research groups may incorporate various aspects of machine learning into constitutive models and MRI data extraction to further refine the study methodology. Moreover, researchers should strive for further reproducibility and rigorous model validation and verification, such as gait analysis.
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Affiliation(s)
- S M Seyedpour
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany
| | - S Nafisi
- Faculty of Pharmacy, Istinye University, Maltepe, Cirpici Yolu B Ck. No. 9, 34010 Zeytinburnu, Istanbul, Turkey
| | - M Nabati
- Department of Mechanical Engineering, Faculty of Engineering, Boğaziçi University, 34342 Bebek, Istanbul, Turkey
| | - D M Pierce
- Department of Mechanical Engineering, University of Connecticut, 191 Auditorium Road, Unit 3139, Storrs, CT, 06269, USA; Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, CT, 06269, USA
| | - J R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany; Center of Medical Optics and Photonics, Friedrich Schiller University Jena, Germany; Michael Stifel Center for Data-driven and Simulation Science Jena, Friedrich Schiller University Jena, Germany
| | - T Ricken
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany.
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25
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Sagl B, Schmid-Schwap M, Piehslinger E, Rausch-Fan X, Stavness I. An in silico investigation of the effect of bolus properties on TMJ loading during mastication. J Mech Behav Biomed Mater 2021; 124:104836. [PMID: 34544017 DOI: 10.1016/j.jmbbm.2021.104836] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/12/2021] [Indexed: 11/16/2022]
Abstract
Mastication is the motor task with the highest muscle activations of the jaw region, potentially leading to high temporomandibular joint (TMJ) loading. Since increased loading of the TMJ is associated with temporomandibular disorders (TMD), TMJ mechanics during chewing has potential clinical relevance in TMD treatment. TMD self-management guidelines suggest eating soft and small pieces of food to reduce TMJ pain. Since TMJ loading cannot be measured in vivo, due to patient safety restrictions, computer modeling is an important tool for investigations of the potential connection between TMJ loading and TMD. The objective of this study is to investigate the effect of food bolus variables on mechanical TMJ loading to help inform better self-management guidelines for TMD. A combined rigid-body-finite-element model of the jaw region was used to investigate the effect of bolus size, stiffness, and position. Mandibular motion and TMJ disc von Mises stress were reported. Computed mandibular motion generally agrees well with previous literature. Disc stress was higher during the closing phase of the chewing cycle and for the non-working side disc. Smaller and softer food boluses overall lead to less TMJ loading. The results reinforce current guidelines regarding bolus modifications and provide new potential guidelines for bolus positioning that could be verified through a future clinical trial. The paper presents a first in silico investigation of dynamic chewing with detailed TMJ stress for different bolus properties. The results help to strengthen the confidence in TMD self-management recommendations, potentially reducing pain levels of patients.
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Affiliation(s)
- Benedikt Sagl
- Center of Clinical Research, 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
| | - Xiaohui Rausch-Fan
- Center of 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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26
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Luo H, Shu J, Liu Z. Biomechanical effects of high acceleration on the temporomandibular joint. Comput Methods Biomech Biomed Engin 2021; 25:333-341. [PMID: 34310250 DOI: 10.1080/10255842.2021.1955105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The symptoms of temporomandibular disorders (TMD) are easily developed in pilots after long flights, such as joint pain, anterior displacement disc and so on. Related studies have suggested that abnormal high acceleration would cause temporomandibular joint (TMJ) lesions. Therefore, the purpose of this study is to analyze the biomechanical effects of high acceleration on the TMJs. The 3D models of the maxilla, mandible, articular disc were generated by Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) of a healthy volunteer without any TMD symptoms. Then, the loads were added according to the various operating conditions of the aircraft. The maximum tensile stress, occurred in the anterior band of the discs, exceeded the failure stress. Compared with the low acceleration, the contact stresses between the discs and the articular cartilages were much greater under the high acceleration. High acceleration had a negative impact on the stress distributions of the articular discs and cartilages and easily led to TMJ damage. Lateral acceleration will cause asymmetric stress distribution of the TMJs.
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Affiliation(s)
- Haotian Luo
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China.,Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
| | - Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China.,Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China.,Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
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27
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Feng Y, Shu J, Liu Y, Zheng T, Shao B, Liu Z. Biomechanical analysis of temporomandibular joints during mandibular protrusion and retraction motions: A 3d finite element simulation. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 208:106299. [PMID: 34352689 DOI: 10.1016/j.cmpb.2021.106299] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/17/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Temporomandibular disorders (TMDs) represent a wide range of musculoskeletal disorders associated with the maxillofacial system, which negatively affect the daily activities of patients. TMD symptoms are caused by the temporomandibular joint (TMJ) overloading. TMJ motions are frequent and can trigger overloading and imbalanced loads on the TMJs, which are assumed to be dangerous. The condyles move forward a lot during mandibular protrusion, which is possibly harmful to the biomechanical environment of the TMJs. The aim of this study was to investigate the biomechanical behavior of TMJs during mandibular protrusion and retraction. METHODS Six three-dimensional maxillofacial system models from asymptomatic subjects were established through computed tomography (CT) and magnetic resonance imaging (MRI). The mandibular protrusion and retraction were recorded using an optical tracking system. Finite element analysis was used to simulate the biomechanical behaviors of the TMJs during the movements. RESULTS The simulation results were validated to be effective by comparison with the MRIs. The results indicated that the stresses during the protrusion and retraction were approximately equal at the same condylar displacement. Meanwhile the discal stresses, relatively correlated with the condylar displacement, increased as the condylar displacement increased during the protrusion and decreased as the condylar displacement decreased in the retraction. In addition, the average peak maximum and minimum principal stresses of the discs were 0.186 and -0.192 MPa, respectively. CONCLUSIONS The models were reasonable for the investigation of the TMJs motion. Based on the results, three quadratic polynomials were proposed to describe the relationship between the stresses and the condylar displacements. In clinical diagnosis, the functions are helpful in the prediction of the discal stresses by measuring the condylar displacement.
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Affiliation(s)
- Yukai Feng
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China.
| | - Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China.
| | - Yang Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Tinghui Zheng
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China.
| | - Bingmei Shao
- Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China; Basic Mechanics Lab, Sichuan University, Chengdu, China.
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China.
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28
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Clemente MP, Moreira A, Pinto JC, Amarante JM, Mendes J. The Challenge of Dental Education After COVID-19 Pandemic - Present and Future Innovation Study Design. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211018293. [PMID: 34105420 PMCID: PMC8193649 DOI: 10.1177/00469580211018293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The present work suggests research and innovation on the topic of dental education after the COVID-19 pandemic, is highly justified and could lead to a step change in dental practice. The challenge for the future in dentistry education should be revised with the COVID-19 and the possibility for future pandemics, since in most countries dental students stopped attending the dental faculties as there was a general lockdown of the population. The dental teaching has an important curriculum in the clinic where patients attend general dentistry practice. However, with SARS-CoV-2 virus, people may be reluctant having a dental treatment were airborne transmission can occur in some dental procedures. In preclinical dental education, the acquisition of clinical, technical skills, and the transfer of these skills to the clinic are extremely important. Therefore, dental education has to adapt the curriculum to embrace new technology devices, instrumentations systems, haptic systems, simulation based training, 3D printer machines, to permit validation and calibration of the technical skills of dental students.
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Affiliation(s)
| | | | | | | | - Joaquim Mendes
- Faculdade de Engenharia, Universidade do Porto, Portugal.,INEGI, Porto, Portugal
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29
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Pachnicz D, Stróżyk P. A Biomechanical Analysis of Muscle Force Changes After Bilateral Sagittal Split Osteotomy. Front Physiol 2021; 12:679644. [PMID: 34149457 PMCID: PMC8209381 DOI: 10.3389/fphys.2021.679644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
A basic procedure affecting maxillofacial geometry is the bilateral sagittal split osteotomy. During the surgery, the bony segments are placed in a new position that provides the correct occlusion. Changes in the geometry of the mandible will affect the surrounding structures and will have a significant impact on the functioning of the masticatory system. As a result of the displacement of the bone segment, the biomechanical conditions change, i.e., the load and the position of the muscles. The primary aim of this study was to determine the changes in the values of the muscular forces caused by mandible geometry alteration. The study considered the translation and rotation of the distal segment, as well as rotations of the proximal segments in three axes. Calculations were performed for the unilateral, static loading of a model based on rigid body mechanics. Muscles were modeled as spring elements, and a novel approach was used to determine muscle stiffness. In addition, an attempt was made, based on the results obtained for single displacements separately, to determine the changes in muscle forces for geometries with complex displacements. Based on the analysis of the results, it was shown that changes in the geometry of the mandibular bone associated with the bilateral sagittal split osteotomy will have a significant effect on the values of the masticatory muscle forces. Displacement of the distal segment has the greatest effect from -21.69 to 26.11%, while the proximal segment rotations affected muscle force values to a less extent, rarely exceeding 1%. For Yaw and Pitch rotations, the opposite effect of changes within one muscle is noticed. Changes in muscle forces for complex geometry changes can be determined with a high degree of accuracy by the appropriate summation of results obtained for simple cases.
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Affiliation(s)
- Dominik Pachnicz
- Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Wrocław, Poland
| | - Przemysław Stróżyk
- Department of Mechanics, Materials and Biomedical Engineering, Wrocław University of Science and Technology, Wrocław, Poland
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30
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Duggal I, Sidhu MS, Chawla A, Dabas A, Dhimole VK. Effects of miniplate anchored Herbst appliance on skeletal, dental and masticatory structures of the craniomandibular apparatus: A finite element study. Int Orthod 2021; 19:301-309. [PMID: 33933415 DOI: 10.1016/j.ortho.2021.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To analyze the stress distribution in the hard and soft tissue structures of craniomandibular complex during mandibular advancement with miniplate anchored rigid fixed functional appliance (FFA) using Finite Element Analysis (FEA). MATERIAL AND METHODS The virtual model consisting of all the maxillofacial bones (up to calvaria), the mandible and temporomandibular joint (TMJ) was generated using the volumetric data from pre-treatment CBCT-scan of a growing patient. The masticatory muscles, other soft tissues, Herbst appliance and plate geometry were modelled mathematically. Force vectors simulating muscle contraction at rest and advanced mandibular positions, with protraction force of 8N were applied. The final model was imported into ANSYS for analysis after assigning material properties. RESULTS The maximum von Mises stress of 11.69MPa and 11.96MPa magnitude was observed in the region of pterygoid plates and at the bone-miniplate interface respectively, with the mandibular advancement of 7mm. Stress patterns were also noted at the condylar neck. The stress values observed in the medial and lateral pterygoid muscles were of 10.42MPa and 4.16MPa magnitude, respectively. Stress was noted in the bucco-cervical region of the upper posterior teeth, but negligible change was seen on the lower anterior teeth and periodontal ligament. CONCLUSION Miniplate Anchored Herbst Appliance brought about Class II skeletal correction in growing children as it was accompanied by minimal changes in the inclination of the lower incisors. Soft tissue structures like pterygoid muscles and discal ligaments exhibited increased stress whereas masseter muscle displayed reduction in stresses.
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Affiliation(s)
- Isha Duggal
- SGT University, Faculty of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, 122505 Gurugram, Haryana, India.
| | - Maninder Singh Sidhu
- SGT University, Faculty of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, 122505 Gurugram, Haryana, India
| | - Anoop Chawla
- Indian Institute of Technology, Department of Mechanical Engineering, 110016 New Delhi, India
| | - Ashish Dabas
- SGT University, Faculty of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, 122505 Gurugram, Haryana, India
| | - Vivek Kumar Dhimole
- Indian Institute of Technology, Department of Mechanical Engineering, 110016 New Delhi, India
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Zhou J, Fu Y, Yu L, Li Z, Chen S. A novel three-dimensional morphological analysis of idiopathic condylar resorption following stabilisation splint treatment. J Oral Rehabil 2021; 48:560-567. [PMID: 33539541 DOI: 10.1111/joor.13154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 12/30/2022]
Abstract
Bone modelling evaluation is important for monitoring idiopathic condylar resorption (ICR) progress. To compare condylar modelling in ICR patients treated with or without stabilisation splints (SSs). Eighty-four condyles from 84 ICR patients were studied: 42 received SS therapy (SS group); 42 received conventional therapy (control group). Cone-beam computed tomography images at diagnosis (T0) and after at least 6 months (T1) were used for three-dimensional reconstruction. Volume differences between T0 and T1 (δV) were used to evaluate the amount of modelling. Percentage of growth area (PCT) was used to assess the condylar surface growth tendency. No significant change in condylar volume was found in the SS group, whereas that in the control group was significantly decreased at T1 (P <.0001). The amount of modelling differed among condylar subregions within the SS group: among 6 subregions (P =.0137), between anterior and posterior regions (P =.0336) and between lateral, intermediate and medial regions (P =.0275). Control group condylar subregions showed no significant differences in the amount of modelling. The anabolic modelling tendency of the total condylar surface in the SS group was greater than that in the control group (P =.0251); however, there were no statistical differences in PCTs among condylar subregions in either group. SS therapy effectively reduced further bone destruction and promoted condylar modelling. Three-dimensional morphological analysis is a novel method that can accurately evaluate the amount of bone modelling and growth tendency in ICR patients.
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Affiliation(s)
- Jialiang Zhou
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yujie Fu
- School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Lixia Yu
- State Key Laboratory of Oral Disease, Department of Temporomandibular Joint, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ziyu Li
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Song Chen
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Alemzadeh K, Jones SB, Davies M, West N. Development of a Chewing Robot With Built-in Humanoid Jaws to Simulate Mastication to Quantify Robotic Agents Release From Chewing Gums Compared to Human Participants. IEEE Trans Biomed Eng 2021; 68:492-504. [PMID: 32746044 DOI: 10.1109/tbme.2020.3005863] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Medicated chewing gum has been recognised as a new advanced drug delivery method, with a promising future. Its potential has not yet been fully exploited because currently there is no gold standard for testing the release of agents from chewing gum in vitro. This study presents a novel humanoid chewing robot capable of closely replicating the human chewing motion in a closed environment, incorporating artificial saliva and allowing measurement of xylitol release from the gum. The release of xylitol from commercially available chewing gum was quantified following both in vitro and in vivo mastication. The chewing robot demonstrated a similar release rate of xylitol as human participants. The greatest release of xylitol occurred during the first 5 minutes of chewing and after 20 minutes of chewing only a low amount of xylitol remained in the gum bolus, irrespective of the chewing method used. Saliva and artificial saliva solutions respectively were collected after 5, 10, 15 and 20 minutes of continuous chewing and the amount of xylitol released from the chewing gum determined. Bioengineering has been implemented as the key engineering strategy to create an artificial oral environment that closely mimics that found in vivo. These results demonstrate the chewing robot with built-in humanoid jaws could provide opportunities for pharmaceutical companies to investigate and refine drug release from gum, with reduced patient exposure and reduced costs using this novel methodology.
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33
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Woodford SC, Robinson DL, Edelmann C, Mehl A, Röhrle O, Vee Sin Lee P, Ackland DC. Low-Profile Electromagnetic Field Sensors in the Measurement and Modelling of Three-Dimensional Jaw Kinematics and Occlusal Loading. Ann Biomed Eng 2021; 49:1561-1571. [PMID: 33409850 DOI: 10.1007/s10439-020-02688-6] [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] [Received: 07/15/2020] [Accepted: 11/04/2020] [Indexed: 11/30/2022]
Abstract
Dynamic occlusal loading during mastication is clinically relevant in the design and functional assessment of dental restorations and removable dentures, and in evaluating temporomandibular joint dysfunction. The aim of this study was to develop a modelling framework to evaluate subject-specific dynamic occlusal loading during chewing and biting over the entire dental arch. Measurements of jaw motion were performed on one healthy male adult using low-profile electromagnetic field sensors attached to the teeth, and occlusal anatomy quantified using an intra-oral scanner. During testing, the subject chewed and maximally compressed a piece of rubber between both second molars, first molars, premolars and their central incisors. The occlusal anatomy, rubber geometry and experimentally measured rubber material properties were combined in a finite element model. The measured mandibular motion was used to kinematically drive model simulations of chewing and biting of the rubber sample. Three-dimensional dynamic bite forces and contact pressures across the occlusal surfaces were then calculated. Both chewing and biting on the first molars produced the highest bite forces across the dental arch, and a large amount of anterior shear force was produced at the incisors and the second molars. During chewing, the initial tooth-rubber contact evolved from the buccal sides of the molars to the lingual sides at full mouth closure. Low-profile electromagnetic field sensors were shown to provide a clinically relevant measure of jaw kinematics with sufficient accuracy to drive finite element models of occlusal loading during chewing and biting. The modelling framework presented provides a basis for calculation of physiological, dynamic occlusal loading across the dental arch.
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Affiliation(s)
- Sarah C Woodford
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Dale L Robinson
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Cornelia Edelmann
- Centre of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Albert Mehl
- Centre of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Oliver Röhrle
- Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Stuttgart, Germany
| | - Peter Vee Sin Lee
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia
| | - David C Ackland
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia.
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Labus KM, Kuiper JP, Rawlinson J, Puttlitz CM. Mechanical characterization and viscoelastic model of the ovine temporomandibular joint Disc in indentation, uniaxial tension, and biaxial tension. J Mech Behav Biomed Mater 2020; 116:104300. [PMID: 33454627 DOI: 10.1016/j.jmbbm.2020.104300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/10/2020] [Accepted: 12/26/2020] [Indexed: 11/17/2022]
Abstract
There have been recent investigations into developing disc replacements and regenerative medicine to treat internal derangements of the temporomandibular joint (TMJ) disc. Previous attempts at disc replacements have faced challenges related in part to a limited understanding of the TMJ's complex mechanical environment. The purpose of this study was to characterize the mechanical behavior of the ovine TMJ disc and to derive viscoelastic constitutive models from the experimental data. Fresh ovine TMJ discs were tested in indentation stress-relaxation tests on the inferior surface, uniaxial tension tests to failure, and dynamic biaxial tensile tests. Results showed an order of magnitude stiffer behavior in tension in the anteroposterior (primary fiber) direction compared to the mediolateral direction. The stiffness in tension was much greater than in compression. Regional comparisons showed greater elastic moduli in indentation in the posterior and anterior bands compared to the central region. A hyper-viscoelastic constitutive model captured the dynamic stress-stretch behavior in both indentation and biaxial tension with good agreement. These data will support ongoing and future computational modeling of local TMJ mechanics, aid in biomaterials identification, and ultimately enhance development of implant designs for TMJ disc replacement.
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Affiliation(s)
- Kevin M Labus
- Department of Mechanical Engineering, Colorado State University, 1374 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA
| | - Jason P Kuiper
- Department of Mechanical Engineering, Colorado State University, 1374 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA
| | - Jennifer Rawlinson
- Department of Clinical Sciences, Colorado State University, 1678 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA
| | - Christian M Puttlitz
- Department of Mechanical Engineering, Colorado State University, 1374 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA; Department of Clinical Sciences, Colorado State University, 1678 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA; School of Biomedical Engineering, Colorado State University, 1376 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA.
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35
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Jurt A, Lee JY, Gallo LM, Colombo V. Influence of bolus size and chewing side on temporomandibular joint intra-articular space during mastication. Med Eng Phys 2020; 86:41-46. [PMID: 33261732 DOI: 10.1016/j.medengphy.2020.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 11/17/2022]
Abstract
Previous studies suggested that, during mastication, magnitude and location of mechanical load in the temporomandibular joint (TMJ) might depend on chewing side and bolus size. Aim of this study was to dynamically measure the TMJ space while chewing on standardized boluses to assess the relationship among minimum intra-articular distances (MID), their location on the condylar surface, bolus size, and chewing side. Mandibular movements of 12 participants (6f, 24±1y.o.; 6 m, 28±6y.o.) were tracked optoelectronically while chewing unilaterally on rubber boluses of 15 × 15 × 5, 15 × 15 × 10, and 15 × 15 × 15 mm3 size. MID and their location along the main condylar axis were determined with dynamic stereometry. MID were normalized on the intra-articular distance in centric occlusion. Repeated measures ANOVA (α = 0.05) showed that MID were smaller on the balancing (0.74±0.19) than on the working condyle (0.89±0.16) independently of bolus size (p < 0.0001). MIDs did not differ between 5 and 10 mm bolus thicknesses (0.80±0.17) but increased for 15 mm (0.85±0.22, p = 0.024) and were located mostly laterally, close to the condylar center. This study confirmed higher reduction of TMJ space on the balancing than on the working condyle during mastication. Intra-articular distances increased significantly for the greatest bolus thickness. Loaded areas were located laterally, for both working and balancing joint.
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Affiliation(s)
- Alice Jurt
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jeong-Yun Lee
- Department of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University, Daehak-Ro 101, Jongno-Gu, Seoul 110-744, Republic of Korea (ROK)
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Vera Colombo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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36
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Woodford SC, Robinson DL, Mehl A, Lee PVS, Ackland DC. Measurement of normal and pathological mandibular and temporomandibular joint kinematics: A systematic review. J Biomech 2020; 111:109994. [PMID: 32971491 DOI: 10.1016/j.jbiomech.2020.109994] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/27/2020] [Accepted: 08/08/2020] [Indexed: 01/08/2023]
Abstract
Motion of the mandible and temporomandibular joint (TMJ) plays a pivotal role in the function of the dentition and associated hard and soft tissue structures, and facilitates mastication, oral communication and access to respiratory and digestive systems. Quantification of TMJ kinematics is clinically relevant in cases of prosthetic rehabilitations, TMJ disorders, osteoarthritis, trauma, tumour resection and congenital abnormalities, which are known to directly influence mandibular motion and loading. The objective of this systematic review was to critically investigate published literature on historic and contemporary measurement modalities used to quantify in vivo mandibular and TMJ kinematics in six degrees of freedom. The electronic databases of Scopus, Web of Science, Medline, Embase and Central were searched and 109 relevant articles identified. Publication quality was documented using a modified Downs and Black checklist. Axiography and ultrasonic tracking are commonly employed in the clinical setting due to their simplicity and capacity to rapidly acquire low-fidelity mandibular motion data. Magnetic and optoelectronic tracking have been used in combination with dental splints to produce higher accuracy measurements while minimising skin motion artefact, but at the expense of setup time and cost. Four-dimensional computed tomography provides direct 3D measurement of mandibular and TMJ motion while circumventing skin motion artefact entirely, but employs ionising radiation, is restricted to low sampling frequencies, and requires time-consuming image processing. Recent advances in magnetic tracking using miniature sensors adhered to the teeth in combination with intraoral scanning may facilitate rapid and high precision mandibular kinematics measurement in the clinical setting. The findings of this review will guide selection and application of mandibular and TMJ kinematic measurement for both clinical and research applications.
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Affiliation(s)
- Sarah C Woodford
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Dale L Robinson
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Albert Mehl
- Centre of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Peter V S Lee
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - David C Ackland
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia.
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37
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Shu J, Ma H, Jia L, Fang H, Chong DYR, Zheng T, Yao J, Liu Z. Biomechanical behaviour of temporomandibular joints during opening and closing of the mouth: A 3D finite element analysis. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2020; 36:e3373. [PMID: 32453468 DOI: 10.1002/cnm.3373] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/09/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
Temporomandibular joints (TMJs) constitute a pair of joints that connect the jawbone to the skull. TMJs are bilateral joints which work as one unit in conducting daily functions such as speaking, mastication, and other activities associated with the movement of the jaw. Issues associated with the TMJs may arise due to various factors-one such factor being the internal load on the TMJ. These issues may contribute to temporomandibular disorders (TMD). This study aims to evaluate the mandibular trajectories and the associated stress changes during the process of opening the mouth on the TMJs of an asymptomatic subject. The mouth opening motion was recorded by a motion capturing system using models of the mandible and maxilla constructed based on the computed tomography (CT). Two discs constructed based on magnetic resonance imaging (MRI). Finite element analysis was performed on the relative motion of the mandible to the maxilla and validated. The process modelled by these displacements provided less than 10% error in terms of deformation. The simulation results indicate that the lateral intermediate zone-the head and neck of the mandible-and the articular eminence sustained the most significant stresses during the mouth opening motion. The results also suggested that the stresses increase as the range of opening increases with the greatest von Mises stress, tensile, and compressive stress found at the position of maximal opening.
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Affiliation(s)
- Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
| | - Hedi Ma
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
| | - Lirong Jia
- The Radiology Department, Western Theater of Air Force Hospital, Chengdu, China
| | - Hongyang Fang
- The Radiology Department, Western Theater of Air Force Hospital, Chengdu, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Tinghui Zheng
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
| | - Jie Yao
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
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秦 文, 丛 明, 任 翔, 温 海, 刘 冬. [Design and performance analysis of elastic temporomandibular joint structure of biomimetic masticatory robot]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2020; 37:512-518. [PMID: 32597094 PMCID: PMC10319578 DOI: 10.7507/1001-5515.201812051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Indexed: 06/11/2023]
Abstract
Masticatory robots have a broad application prospect in the field of denture material tests and mandible rehabilitation. Mechanism type of temporomandibular joint structure is an important factor influencing the performance of the masticatory robot. In view of the wide application of elastic components in the field of the biomimetic robot, an elastic component was adopted to simulate the buffering characteristics of the temporomandibular joint disc and formed the elastic temporomandibular joint structure on the basis of point-contact high pair. Secondly, the influences of the elastic temporomandibular joint structure (on mechanism degree, kinematics, dynamics, etc.) were discussed. The position and velocity of the temporomandibular joint were analyzed based on geometric constraints of the joint surface, and the dynamic analysis based on the Lagrange equation was carried out. Finally, the influence of the preload and stiffness of the elastic component was analyzed by the response surface method. The results showed that the elastic temporomandibular joint structure could effectively guarantee the flexible movement and stable force of the joint. The elastic joint structure proposed in this paper further improves the biomimetic behavior of masticatory robots. It provides new ideas for the biomimetic design of viscoelastic joint discs.
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Affiliation(s)
- 文龙 秦
- 大连理工大学 机械工程学院(辽宁大连 116024)School of Mechanical Engineering, Dalian University of Technology, Dalian, Liaoning 116024, P.R.China
| | - 明 丛
- 大连理工大学 机械工程学院(辽宁大连 116024)School of Mechanical Engineering, Dalian University of Technology, Dalian, Liaoning 116024, P.R.China
| | - 翔 任
- 大连理工大学 机械工程学院(辽宁大连 116024)School of Mechanical Engineering, Dalian University of Technology, Dalian, Liaoning 116024, P.R.China
| | - 海营 温
- 大连理工大学 机械工程学院(辽宁大连 116024)School of Mechanical Engineering, Dalian University of Technology, Dalian, Liaoning 116024, P.R.China
| | - 冬 刘
- 大连理工大学 机械工程学院(辽宁大连 116024)School of Mechanical Engineering, Dalian University of Technology, Dalian, Liaoning 116024, P.R.China
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Abdi AH, Sagl B, Srungarapu VP, Stavness I, Prisman E, Abolmaesumi P, Fels S. Characterizing Motor Control of Mastication With Soft Actor-Critic. Front Hum Neurosci 2020; 14:188. [PMID: 32528267 PMCID: PMC7264096 DOI: 10.3389/fnhum.2020.00188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 04/27/2020] [Indexed: 11/28/2022] Open
Abstract
The human masticatory system is a complex functional unit characterized by a multitude of skeletal components, muscles, soft tissues, and teeth. Muscle activation dynamics cannot be directly measured on live human subjects due to ethical, safety, and accessibility limitations. Therefore, estimation of muscle activations and their resultant forces is a longstanding and active area of research. Reinforcement learning (RL) is an adaptive learning strategy which is inspired by the behavioral psychology and enables an agent to learn the dynamics of an unknown system via policy-driven explorations. The RL framework is a well-formulated closed-loop system where high capacity neural networks are trained with the feedback mechanism of rewards to learn relatively complex actuation patterns. In this work, we are building on a deep RL algorithm, known as the Soft Actor-Critic, to learn the inverse dynamics of a simulated masticatory system, i.e., learn the activation patterns that drive the jaw to its desired location. The outcome of the proposed training procedure is a parametric neural model which acts as the brain of the biomechanical system. We demonstrate the model's ability to navigate the feasible three-dimensional (3D) envelope of motion with sub-millimeter accuracies. We also introduce a performance analysis platform consisting of a set of quantitative metrics to assess the functionalities of a given simulated masticatory system. This platform assesses the range of motion, metabolic efficiency, the agility of motion, the symmetry of activations, and the accuracy of reaching the desired target positions. We demonstrate how the model learns more metabolically efficient policies by integrating a force regularization term in the RL reward. We also demonstrate the inverse correlation between the metabolic efficiency of the models and their agility and range of motion. The presented masticatory model and the proposed RL training mechanism are valuable tools for the analysis of mastication and other biomechanical systems. We see this framework's potential in facilitating the functional analyses aspects of surgical treatment planning and predicting the rehabilitation performance in post-operative subjects.
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Affiliation(s)
- Amir H Abdi
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada
| | - Benedikt Sagl
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Venkata P Srungarapu
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - Eitan Prisman
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Purang Abolmaesumi
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada
| | - Sidney Fels
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada
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