Nondeterministic multiobjective optimization of 3D printed ceramic tissue scaffolds.

Despite significant advances in the design optimization of bone scaffolds for enhancing their biomechanical properties, the functionality of these synthetic constructs remains suboptimal. One of the main challenges in the structural optimization of bone scaffolds is associated with the large uncertainties caused by the manufacturing process, such as variations in scaffolds' geometric features and constitutive material properties after fabrication. Unfortunately, such non-deterministic issues have not been considered in the existing optimization frameworks, thereby limiting their reliability. To address this challenge, a novel multiobjective robust optimization approach is proposed here such that the effects of uncertainties on the optimized design can be minimized. This study first conducted computational analyses of a parameterized ceramic scaffold model to determine its effective modulus, structural strength, and permeability. Then, surrogate models were constructed to formulate explicit mathematical relationships between the geometrical parameters (design variables) and mechanical and fluidic properties. The Non-Dominated Sorting Genetic Algorithm II (NSGA-II) was adopted to generate the robust Pareto solutions for an optimal set of trade-offs between the competing objective functions while ensuring the effects of the noise parameters to be minimal. Note that the nondeterministic optimization of tissue scaffold presented here is the first of its kind in open literature, which is expected to shed some light on this significant topic of scaffold design and additive manufacturing in a more realistic way.

An experimental and numerical study of the microstructural and biomechanical properties of human peripheral nerve endoneurium for the design of tissue scaffolds.

Biomimetic design of scaffold architectures represents a promising strategy to enable the repair of tissue defects. Natural endoneurium extracellular matrix (eECM) exhibits a sophisticated microstructure and remarkable microenvironments conducive for guiding neurite regeneration. Therefore, the analysis of eECM is helpful to the design of bionic scaffold. Unfortunately, a fundamental lack of understanding of the microstructural characteristics and biomechanical properties of the human peripheral nerve eECM exists. In this study, we used microscopic computed tomography (micro-CT) to reconstruct a three-dimensional (3D) eECM model sourced from mixed nerves. The tensile strength and effective modulus of human fresh nerve fascicles were characterized experimentally. Permeability was calculated from a computational fluid dynamic (CFD) simulation of the 3D eECM model. Fluid flow of acellular nerve fascicles was tested experimentally to validate the permeability results obtained from CFD simulations. The key microstructural parameters, such as porosity is 35.5 ± 1.7%, tortuosity in endoneurium (X axis is 1.26 ± 0.028, Y axis is 1.26 ± 0.020 and Z axis is 1.17 ± 0.03, respectively), tortuosity in pore (X axis is 1.50 ± 0.09, Y axis is 1.44 ± 0.06 and Z axis is 1.13 ± 0.04, respectively), surface area-to-volume ratio (SAVR) is 0.165 ± 0.007 µm-1 and pore size is 11.8 ± 2.8 µm, respectively. These were characterized from the 3D eECM model and may exert different effects on the stiffness and permeability. The 3D microstructure of natural peripheral nerve eECM exhibits relatively lower permeability (3.10 m2 × 10-12 m2) than other soft tissues. These key microstructural and biomechanical parameters may play an important role in the design and fabrication of intraluminal guidance scaffolds to replace natural eECM. Our findings can aid the development of regenerative therapies and help improve scaffold design.

On interaction between fatigue of reconstruction plate and time-dependent bone remodeling.

BACKGROUND AND OBJECTIVE: The fibula free flap (FFF) has been extensively used to repair large segmental bone defects in the maxillofacial region. The reconstruction plate plays a key role in maintaining stability and load-sharing while the fibula unites with adjacent bone in the course of healing and remodeling. However, not all fibula flaps would fully unite, and fatigue of prosthetic devices has been recognized as one major concern for long-term load-bearing applications. This study aims to develop a numerical approach for predicting the fatigue life of the reconstruction plate by taking into account the effect of ongoing bone remodeling. METHODS: The patient-specific mandible reconstruction with a prosthetic system is studied in this work. The 3D finite element model with heterogeneous material properties obtained from clinical computerized tomography (CT) data is developed for bone, and eXtended Finite Element Method (XFEM) is adopted for the fatigue analysis of the plate. During the remodeling process, the changing apparent density and Young's modulus of bone are simulated in a step-wise fashion on the basis of Wolff's law, which is correlated with the specific clinical follow-up. The maximum biting forces were considered as the driving force on the bone remodeling, which are measured clinically at different time points (4, 16 and 28 months) after reconstruction surgery. RESULTS: Under various occlusal loadings, the interaction between fatigue crack growth and bone remodeling is investigated to gain new insights for the future design of prosthetic devices. The simulation results reveal that appropriate remodeling of grafted bone could extend the fatigue life of fixation plates in a positive way. On the other hand, the rising occlusal load associated with healing and remodeling could lead to fatigue fracture of fixation plate and potentially cause severe bone resorption. CONCLUSION: This study proposes an effective approach for more realistically predicting fatigue life of prosthetic devices subject to a tissue remodeling condition in-silico. It is anticipated to provide a guideline for deriving an optimal design of patient-specific prosthetic devices to better ensure longevity.

Mechanical failure of posterior teeth due to caries and occlusal wear- A modelling study.

OBJECTIVES: The purpose of the present work is to explore the effect of occlusal wear and different types and degrees of caries on the mechanical performance and structural integrity of posterior teeth. METHODS: Three-dimensional (3D) computational models with different combinations of caries parameters (caries location, caries size and caries induced pulp shrinkage) and occlusal wear factors (enamel thickness, marginal ridge height and cuspal slope) were developed and analyzed using the extended finite element method (XFEM) to identify the stress distribution, crack initiation load and ultimate fracture load values. The effect of a non-drilling conservative treatment using resin infiltration on the recovery of mechanical properties of carious molar teeth was also investigated. RESULTS: Presence of fissural caries, worn proximal marginal ridge and decreased enamel thickness due to occlusal wear, imparted a significant negative effect on the crack initiation load value of the lower molar models. Accordingly, models with intact and strong proximal marginal ridge, generally exhibited higher crack initiation loading, regardless of caries size and location. Presence of fissure caries drastically decreased (55%-70%) the crack initiation load compared to sound teeth. The depth of the fissural lesion and the presence of proximal caries did not have a major effect on crack initiation load values. However, increasing the caries size resulted in lower final fracture load values in most of the cases. Accordingly, the groups with combined and connected large fissural and proximal lesions experienced the largest drop in the fracture load values compared to sound tooth models. The worst condition consisted of two connected large proximal and fissural caries with no proximal marginal ridge, in which the fracture load dramatically decreased to only 25% of that for sound teeth with intact marginal ridge. On the other hand, decreased cuspal slope due to occlusal wear and shrinkage of the pulp due to caries appeared to have a protective role and a direct relation with the fracture resistance of the tooth. Following the application of resin infiltration on the carious models, the crack initiation load and the fracture load could recover up to 75% and 90% of the values for the corresponding sound tooth models, respectively. SIGNIFICANCE: Presence of fissural caries, if not treated (either with remineralization, resin infiltration or restoration), can be a major risk factor in the initiation of tooth fracture. When combined with decreased enamel thickness and loss of proximal marginal ridge due to mechanical or chemical wear, the weakening effect of the caries will be amplified specially in teeth with steep cuspal slopes. The application of a conservative treatment with resin infiltration can be an effective approach in prevention of further mechanical failure of demineralized enamel. The findings of this study emphasize the importance of early interventions in the management of caries for the prevention of future cuspal or tooth fracture especially in subjects with higher risk factors for tooth fracture such as caries, wear and bruxism.

Monolithic crowns fracture analysis: The effect of material properties, cusp angle and crown thickness.

OBJECTIVES: This study aimed to investigate the collective influence of material properties and design parameters on the fracture behavior of monolithic dental crowns. METHODS: Three-dimensional (3D) models (N=90) with different combinations of design parameters (thickness, cusp angle and occlusal notch geometry) and material type (lithium disilicate, feldspar ceramic, zirconia, hybrid resin ceramic and hybrid polymer-infiltrated ceramic) were developed for the failure analysis using extended finite element method (XFEM) to identify the stress distribution, crack initiation load, fracture surface area and fracture pattern. Analytical formulation, in vitro fracture tests and fractographic analysis of dedicated models were also performed to validate the findings of the XFEM simulation. RESULTS: For all material types considered, crowns with a sharp occlusal notch design had a significantly lower fracture resistance against occlusal loading. In most of the models, greater crown thickness and cusp angle resulted in a higher crack initiation load. However, the effect of cusp angle was dominant when the angle was in the low range of 50° for which increasing thickness did not enhance the crack initiation load. SIGNIFICANCE: Comparing the critical load of crack initiation for different models with the maximum biting force revealed that for the studied monolithic materials excluding zirconia, a design with a rounded occlusal notch, 70° cusp angle and medium thickness (1.5mm occlusal) is an optimum combination of design parameters in terms of tooth conservation and fracture resistance. Zirconia crowns exhibited sufficient strength for a more conservative design with less thickness (1.05mm occlusal) and sharper cusp angle (60°).

Effect of different implant configurations on biomechanical behavior of full-arch implant-supported mandibular monolithic zirconia fixed prostheses.

Mechanical failure of zirconia-based full-arch implant-supported fixed dental prostheses (FAFDPs) remains a critical issue in prosthetic dentistry. The option of full-arch implant treatment and the biomechanical behaviour within a sophisticated screw-retained prosthetic structure have stimulated considerable interest in fundamental and clinical research. This study aimed to analyse the biomechanical responses of zirconia-based FAFDPs with different implant configurations (numbers and distributions), thereby predicting the possible failure sites and the optimum configuration from biomechanical aspect by using finite element method (FEM). Five 3D finite element (FE) models were constructed with patient-specific heterogeneous material properties of mandibular bone. The results were reported using volume-averaged von-Mises stresses (σVMVA) to eliminate numerical singularities. It was found that wider placement of multi-unit copings was preferred as it reduces the cantilever effect on denture. Within the limited areas of implant insertion, the adoption of angled multi-unit abutments allowed the insertion of oblique implants in the bone and wider distribution of the multi-unit copings in the prosthesis, leading to lower stress concentration on both mandibular bone and prosthetic components. Increasing the number of supporting implants in a FAFDPs reduced loading on each implant, although it may not necessarily reduce the stress concentration in the most posterior locations significantly. Overall, the 6-implant configuration was a preferable configuration as it provided the most balanced mechanical performance in this patient-specific case.

Three-dimensional reconstruction of internal fascicles and microvascular structures of human peripheral nerves.

Biofabricated nanostructured and microstructured scaffolds have exhibited great potential for nerve tissue regeneration and functional restoration, and prevascularization and biotransportation within 3D fascicle structures are critical. Unfortunately, an ideal internal fascicle and microvascular model of human peripheral nerves is lacking. In this study, we used microcomputed tomography (microCT) to acquire high-resolution images of the human sciatic nerve. We propose a novel deep-learning network technique, called ResNetH3D-Unet, to segment fascicles and microvascular structures. We reconstructed 3D intraneural fascicles and microvascular topography to quantify the fascicle volume ratio (FVR), microvascular volume ratio (MVR), microvascular to fascicle volume ratio (MFVR), fascicle surface area to volume ratio (FSAVR), and microvascular surface area to volume ratio (MSAVR) of human samples. The frequency distributions of the fascicle diameter, microvascular diameter, and fascicle-to-microvasculature distance were analyzed. The obtained microCT analysis and reconstruction provided high-resolution microstructures of human peripheral nerves. Our proposed ResNetH3D-Unet method for fascicle and microvasculature segmentation yielded a mean intersection over union (IOU) of 92.1% (approximately 5% higher than the U-net IOU). The 3D reconstructed model showed that the internal microvasculature runs longitudinally within the internal epineurium and connects to the external vasculature at some points. Analysis of the 3D data indicated a 48.2 ± 3% FVR, 23.7 ± 1.8% MVR, 4.9 ± 0.5% MFVR, 7.26 ± 2.58 mm-1 FSAVR, and 1.52 ± 0.52 mm-1 MSAVR. A fascicle diameter of 0.98 mm, microvascular diameter of 0.125 mm, and microvasculature-to-fascicle distance of 0.196 mm were most frequent. This study provides fundamental data and structural references for designing bionic scaffolding constructs with 3D microvascular and fascicle distributions.

Investigation on masticatory muscular functionality following oral reconstruction - An inverse identification approach.

The human masticatory system has received significant attention in the areas of biomechanics due to its sophisticated co-activation of a group of masticatory muscles which contribute to the fundamental oral functions. However, determination of each muscular force remains fairly challenging in vivo; the conventional data available may be inapplicable to patients who experience major oral interventions such as maxillofacial reconstruction, in which the resultant unsymmetrical anatomical structure invokes a more complex stomatognathic functioning system. Therefore, this study aimed to (1) establish an inverse identification procedure by incorporating the sequential Kriging optimization (SKO) algorithm, coupled with the patient-specific finite element analysis (FEA) in silico and occlusal force measurements at different time points over a course of rehabilitation in vivo; and (2) evaluate muscular functionality for a patient with mandibular reconstruction using a fibula free flap (FFF) procedure. The results from this study proved the hypothesis that the proposed method is of certain statistical advantage of utilizing occlusal force measurements, compared to the traditionally adopted optimality criteria approaches that are basically driven by minimizing the energy consumption of muscle systems engaged. Therefore, it is speculated that mastication may not be optimally controlled, in particular for maxillofacially reconstructed patients. For the abnormal muscular system in the patient with orofacial reconstruction, the study shows that in general, the magnitude of muscle forces fluctuates over the 28-month rehabilitation period regardless of the decreasing trend of the maximum muscular capacity. Such finding implies that the reduction of the masticatory muscle activities on the resection side might lead to non-physiological oral biomechanical responses, which can change the muscular activities for stabilizing the reconstructed mandible.

Modelling of stress distribution and fracture in dental occlusal fissures.

The aim of this study was to investigate the fracture behaviour of fissural dental enamel under simulated occlusal load in relation to various interacting factors including fissure morphology, cuspal angle and the underlying material properties of enamel. Extended finite element method (XFEM) was adopted here to analyse the fracture load and crack length in tooth models with different cusp angles (ranging from 50° to 70° in 2.5° intervals), fissural morphologies (namely U shape, V shape, IK shape, I shape and Inverted-Y shape) and enamel material properties (constant versus graded). The analysis results showed that fissures with larger curved morphology, such as U shape and IK shape, exhibit higher resistance to fracture under simulated occlusal load irrespective of cusp angle and enamel properties. Increased cusp angle (i.e. lower cusp steepness), also significantly enhanced the fracture resistance of fissural enamel, particularly for the IK and Inverted-Y shape fissures. Overall, the outcomes of this study explain how the interplay of compositional and structural features of enamel in the fissural area contribute to the resistance of the human tooth against masticatory forces. These findings may provide significant indicators for clinicians and technicians in designing/fabricating extra-coronal dental restorations and correcting the cuspal inclinations and contacts during clinical occlusal adjustment.

Quantitative/qualitative analysis of adhesive-dentin interface in the presence of 10-methacryloyloxydecyl dihydrogen phosphate.

Dental adhesive provides effective retention of filling materials via adhesive-dentin hybridization. The use of co-monomers, such as 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP), is thought to be crucial for hybridization owing to their ionic-binding to calcium and co-polymerization in the polymerizable adhesives. Optimal hybridization partly depends on the mechanical properties of polymerized adhesives, which are likely to be proportional to the degree of conversion ratio. This study assessed the correlation between polymerization quality and mechanical properties at the adhesive-dentin interfaces in the presence or absence of 10-MDP. In situ Raman microspectroscopy and nanoindentation tests were used concurrently to quantify the degree of conversion ratio and dynamic mechanical properties across the adhesive-dentin interfaces. Despite the excellent diffusion and apparent higher degree of co-polymerization, 10-MDP reduced the elastic modulus of the interface. The higher viscoelastic properties of the adhesive are suggestive of poor polymerization, namely polymerization linearity related to the long carboxyl chain of 10-MDP. Such reduced mechanical integrity of hybridization could also be associated with the inhibition of nano-layering between 10-MDP and mineralized tissue in the presence of hydroxyethyl methacrylate (HEMA). This potential drawback of HEMA necessitates further qualitative/quantitative characterization of adhesive-dentin hybridization using a HEMA-free/low concentration experimental 10-MDP monomer, which theoretically possesses superior chemical bonding potential to the current HEMA-rich protocol.

Exceptional contact elasticity of human enamel in nanoindentation test.

OBJECTIVE: Tooth enamel has unsurpassed hardness and stiffness among mammalian tissue structures. Such stiff materials are usually brittle, yet mature enamel can survive for a lifetime. Understanding the nanoscale origin of enamel durability is important for developing advanced load-bearing biomaterials. Here, nanoscale exceptional contact elasticity of the human tooth enamel, based on nanoindentation tests, is reported. METHODS: Spherical indenter tips with radii of 243 and 1041nm were used to determine stress-strain curves of enamel. Force-displacement curves were recorded using quasi-static loading strain rates of 0.031, 0.041, and 0.061s-1. The storage moduli from a superimposed signal amplitude (dynamic strain at 220Hz) embedded during primary quasi-static loading and from quasi-static elastic theory were simultaneously measured. Modulus mapping was considered to be an extremely low quasi-static loading strain rate indentation test. RESULTS: The elastic limits were 7-9GPa and 5-6GPa for the small and large indenters, respectively. The elastic-plastic transition point and elastic modulus value increased with substantially increased quasi-static loading strain rate. The results suggested that the increase of the elastic limit during high-loading strain was associated with exceptional contact elasticity at the nanoscale of the enamel structure and the consequent extension of the contact area (i.e., a temporary pile-up response, dependent on the enamel nanocrystals and protein glue). SIGNIFICANCE: Structural modification at this scale effectively prevents the initiation of cracking from localized strain, thus reinforcing the bulk structure. These results may provide valuable insight for conceptualizing bio-inspired nanocomposites.

Nanomechanical characterization of time-dependent deformation/recovery on human dentin caused by radiation-induced glycation.

An increase in non-enzymatic collagen matrix cross-links, such as advanced glycation end-products (AGEs), is known to be a major complication in human mineralized tissues, often causing abnormal fractures. However, degradation of mechanical properties in relation to AGEs has not been fully elucidated at the material level. Here, we report nanoscale time-dependent deformation and dimensional recovery of human tooth dentin that has undergone glycation induced by x-ray irradiation. The reduction in enzymatic collagen cross-linking and the increased level of AGEs with concomitant growth of disordered collagen matrix diminished creep deformation recovery in the lower mineralized target region. However, the elevated AGEs level alone did not cause a reduction in time-dependent deformation and its recovery in the higher mineralized target region. In addition to the elevated AGEs level, the degradation of the mechanical properties of mineralized tissues should be assessed with care in respect to multiple parameters in the collagen matrix at the molecular level.

Nondestructive characterization of bone tissue scaffolds for clinical scenarios.

OBJECTIVES: This study aimed to develop a simple and efficient numerical modeling approach for characterizing strain and total strain energy in bone scaffolds implanted in patient-specific anatomical sites. MATERIALS AND METHODS: A simplified homogenization technique was developed to substitute a detailed scaffold model with the same size and equivalent orthotropic material properties. The effectiveness of the proposed modeling approach was compared with two other common homogenization methods based on periodic boundary conditions and the Hills-energy theorem. Moreover, experimental digital image correlation (DIC) measurements of full-field surface strain were conducted to validate the numerical results. RESULTS: The newly proposed simplified homogenization approach allowed for fairly accurate prediction of strain and total strain energy in tissue scaffolds implanted in a large femur mid-shaft bone defect subjected to a simulated in-vivo loading condition. The maximum discrepancy between the total strain energy obtained from the simplified homogenization approach and the one obtained from detailed porous scaffolds was 8.8%. Moreover, the proposed modeling technique could significantly reduce the computational cost (by about 300 times) required for simulating an in-vivo bone scaffolding scenario as the required degrees of freedom (DoF) was reduced from about 26 million for a detailed porous scaffold to only 90,000 for the homogenized solid counterpart in the analysis. CONCLUSIONS: The simplified homogenization approach has been validated by correlation with the experimental DIC measurements. It is fairly efficient and comparable with some other common homogenization techniques in terms of accuracy. The proposed method is implicating to different clinical applications, such as the optimal selection of patient-specific fixation plates and screw system.

Identification of dynamic load for prosthetic structures.

Dynamic load exists in numerous biomechanical systems, and its identification signifies a critical issue for characterizing dynamic behaviors and studying biomechanical consequence of the systems. This study aims to identify dynamic load in the dental prosthetic structures, namely, 3-unit implant-supported fixed partial denture (I-FPD) and teeth-supported fixed partial denture. The 3-dimensional finite element models were constructed through specific patient's computerized tomography images. A forward algorithm and regularization technique were developed for identifying dynamic load. To verify the effectiveness of the identification method proposed, the I-FPD and teeth-supported fixed partial denture structures were investigated to determine the dynamic loads. For validating the results of inverse identification, an experimental force-measuring system was developed by using a 3-dimensional piezoelectric transducer to measure the dynamic load in the I-FPD structure in vivo. The computationally identified loads were presented with different noise levels to determine their influence on the identification accuracy. The errors between the measured load and identified counterpart were calculated for evaluating the practical applicability of the proposed procedure in biomechanical engineering. This study is expected to serve as a demonstrative role in identifying dynamic loading in biomedical systems, where a direct in vivo measurement may be rather demanding in some areas of interest clinically.

Micro-CT based modelling for characterising injection-moulded porous titanium implants.

Design of prosthetic implants to ensure rapid and stable osseointegration remains a significant challenge, and continuous efforts have been directed to new implant materials, structures and morphology. This paper aims to develop and characterise a porous titanium dental implant fabricated by metallic powder injection-moulding. The surface morphology of the specimens was first examined with a scanning electron microscope (SEM), followed by microscopic computerised tomography (µ-CT) scanning to capture its 3D microscopic features non-destructively. The nature of porosity and pore sizes were determined statistically. A homogenisation technique based on the Hills-energy theorem was adopted to evaluate its directional elastic moduli, and the conservation of mass theorem was employed to quantify the oxygen diffusivity for bio-transportation feature. This porous medium was found to have pore sizes varying from 50 to 400 µm and the average porosity of 46.90 ± 1.83%. The anisotropic principal elastic moduli were found fairly close to the upper range of cortical bone, and the directional diffusivities could potentially enable radial osseous tissue ingrowth and vascularisation. This porous titanium successfully reduces the elastic modulus mismatch between implant and bone for dental and orthopaedic applications, and provides improved capacity for transporting oxygen, nutrient and waste for pre-vascular network formation. Copyright © 2016 John Wiley & Sons, Ltd.

Fracture behaviors of ceramic tissue scaffolds for load bearing applications.

Healing large bone defects, especially in weight-bearing locations, remains a challenge using available synthetic ceramic scaffolds. Manufactured as a scaffold using 3D printing technology, Sr-HT-Gahnite at high porosity (66%) had demonstrated significantly improved compressive strength (53 ± 9 MPa) and toughness. Nevertheless, the main concern of ceramic scaffolds in general remains to be their inherent brittleness and low fracture strength in load bearing applications. Therefore, it is crucial to establish a robust numerical framework for predicting fracture strengths of such scaffolds. Since crack initiation and propagation plays a critical role on the fracture strength of ceramic structures, we employed extended finite element method (XFEM) to predict fracture behaviors of Sr-HT-Gahnite scaffolds. The correlation between experimental and numerical results proved the superiority of XFEM for quantifying fracture strength of scaffolds over conventional FEM. In addition to computer aided design (CAD) based modeling analyses, XFEM was conducted on micro-computed tomography (µCT) based models for fabricated scaffolds, which took into account the geometric variations induced by the fabrication process. Fracture strengths and crack paths predicted by the µCT-based XFEM analyses correlated well with relevant experimental results. The study provided an effective means for the prediction of fracture strength of porous ceramic structures, thereby facilitating design optimization of scaffolds.

Fracture behavior of inlay and onlay fixed partial dentures - An in-vitro experimental and XFEM modeling study.

OBJECTIVES: This study aimed to explore the "sensitivity" of the fracture load and initiation site to loading position on the central occlusal surface of a pontic tooth for both all-ceramic inlay retained and onlay supported partial denture systems. MATERIALS AND METHODS: Three dimensional (3D) finite element (FE) inlay retained and onlay supported partial denture models were established for simulating crack initiation and propagation by using the eXtended Finite Element Method (XFEM). The models were subjected to a mastication force up to 500N on the central fossa of the pontic. The loading position was varied to investigate its influence on fracture load and crack path. RESULTS: Small perturbation of the loading position caused the fracture load and crack pattern to vary considerably. For the inlay fixed partial dentures (FPDs), the fracture origins changed from the bucco-gingival aspect of the molar embrasure to the premolar embrasure when the indenter force location is slightly shifted from the mesial to distal side. In contrast, for onlay FPDs, cracking initiated from bucco-gingival aspect of the premolar embrasure when the indenter is slightly shifted to the buccal side and from molar embrasure when the indenter is shifted to the lingual side. CONCLUSIONS: The fracture load and cracking path were found to be very sensitive to loading position in the all-ceramic inlay and onlay FPDs. The study provides a basis for improved understanding on the role of localized contact loading of the cusp surface in all-ceramic FPDs.

Characterization of tissue scaffolds for time-dependent biotransport criteria - a novel computational procedure.

This study aims to establish a new computational framework that allows modeling transient oxygen diffusion in tissue scaffolds more efficiently. It has been well known that the survival of cells strongly relies on continuous oxygen/nutrient supply and metabolite removal. With optimal design in scaffold architecture, its ability to sustain long distance oxygen supply could be improved considerably. In this study, finite element based homogenization procedure is first used to characterize the initial effective biotransport properties in silico. These initial properties are proper indicators to prediction of the on-going performance of tissue scaffolds over time. The transient model by adopting an edge-based smoothed finite element method with combination of mass-redistributed method is then established to more efficiently simulate the transient oxygen transfer process in tissue scaffolds. The proposed new method allows large time steps to model the oxygen diffusion process without losing numerical accuracy, thereby enhancing the computational efficiency significantly, in particular for the design optimization problems which typically require numerous analysis iterations. A number of different scaffold designs are examined either under net diffusion without cell seeding, or under cellular oxygen/nutrient uptake with or without considering cell viability. The association between the homogenized effective diffusivity of net scaffold microstructures and corresponding transient diffusion and time-dependent cellular activities is divulged. This study provides some insights into scaffold design.

Effects of design parameters on fracture resistance of glass simulated dental crowns.

OBJECTIVE: This study aimed to individually quantify the effects of various design parameters, including margin thickness, convergence angle of abutment, and bonding conditions on fracture resistance of resin bonded glass dental crown systems (namely, glass simulated crown). MATERIALS AND METHODS: An in vitro experimental test and an in silico computational eXtended Finite Element Method (XFEM) were adopted to explore crack initiation and propagation in glass simulated crown models with the margin thickness ranging from 0.8 to 1.2mm, convergence angle from 6° to 12°, and three different bonding conditions, namely non-bonded (NB), partially bonded (PB), fully bonded (FB). RESULTS: The XFEM modeling results of cracking initiation loads and subsequent growth in the glass simulated crown models were correlated with the experimental results. It was found that the margin thickness has a more significant effect on the fracture resistance than the convergence angle. The adhesively bonded state has the highest fracture resistance among these three different bonding conditions. CONCLUSION: Crowns with thicker margins, smaller convergence angle and fully bonded are recommended for increasing fracture resistance of all-ceramic crowns. This numerical modeling study, supported by the experimental tests, provides more thorough mechanical insight into the role of margin design parameters, thereby forming a novel basis for clinical guidance as to preparation of tapered abutments for all-ceramic dental crowns.

Mechanical benefits of conservative restoration for dental fissure caries.

The principle of minimal intervention dentistry (MID) is to limit removal of carious tooth tissue while maximizing its repair and survival potential. The objective of this study is to explore the fracture resistance of a permanent molar tooth with a fissure carious lesion along with three clinical restoration procedures, namely one traditional and two conservative approaches, based upon MID. The traditional restoration employs extensive surgical removal of enamel and dentine about the cavity to eliminate potential risk of further caries development, while conservative method #1 removes significantly less enamel and infected dentine, and conservative method #2 only restores the overhanging enamel above the cavity and leaves the infected and affected dentine as it was. An extended finite element method (XFEM) is adopted here to analyze the fracture behaviors of both two-dimensional (2D) and three-dimensional (3D) modeling of these four different scenarios. It was found that the two conservative methods exhibited better fracture resistance than the traditional restorative method. Although conservative method #2 has less fracture resistance than method #1, it had significantly superior fracture resistance compared to other restorations. More important, after cavity sealing it may potentially enhance the opportunity for remineralization and improved loading bearing capacity and fracture resistance.