New highlights on effects of rapid palatal expansion on the skull base: a finite element analysis study.

OBJECTIVE: The objective of this study was to evaluate the effect of the rapid palatal expansion (RPE) on the pterygoid process (PP), spheno-occipital synchondrosis (SOS) and sella turcica (ST) in the skull of a patient with transversal maxillary collapse, and identify the distribution of mechanical stresses and displacement, by finite element analysis (FEA). METHODS: Cone-beam computed tomography (CBCT) was employed to examine the skull of a patient in this study. The patient was a 13-year-old boy, with Class II skeletal relationship due to transverse atresia and maxillary protrusion. The computer-aided design (CAD) geometry of skull was imported into the SimLab v. 13.1 software, to build the finite element mesh. For the simulation, a displacement of 1 mm, 3 mm and 5 mm in a transverse direction was defined at the midpalatal suture, thereby representing the RPE. For the analysis of results, maximum principal stress (MPS) and displacements were evaluated by identifying different nodes, which were represented by the points as per the areas of interest in the study. RESULTS: In MPS, the maximum tensile stress was found at point 2 (366.50 MPa) and point 3 (271.50 Mpa). The maximum compressive stress was found at point 8 (-5.84 Mpa). The higher displacements in the transversal plane and the lateral segment were located at point 1 (2.212 mm), point 2 (0.903 mm) and point 3 (0.238 mm). CONCLUSIONS: RPE has a direct effect on PP, SOS and ST in the Class II model skeletal relationship with a transversal maxillary collapse. PP supported a higher tensile stress and displacement.

Effect of bone quality and bone loss level around internal and external connection implants: A finite element analysis study.

STATEMENT OF PROBLEM: A consensus regarding the biomechanical effects of vertical bone loss in normal and osteoporotic bone tissue according to different implant-abutment interfaces is lacking. PURPOSE: The purpose of this finite element analysis study was to evaluate the effect of vertical bone loss (without bone loss; with 1.5-mm bone loss; with 3-mm bone loss; and with 4.5-mm bone loss) in normal and osteoporotic bone that received a Ø4×10-mm implant with different implant-abutment connections (external connection [external hexagon] and internal connection [Morse taper]) by using 3D finite element analysis. MATERIAL AND METHODS: Sixteen 3D models were simulated. Axial and oblique forces of 200 N and 100 N, respectively, were applied on the occlusal surfaces of the prostheses. Maximum principal stress and microstrain were determined from the bone tissue of each model. von Mises stress analysis was used to evaluate the stress distribution in implants and prosthetic components (fixation screws, abutment, and crown). RESULTS: The results showed higher stress concentrations in models with bone loss as increased vertical bone loss contributed to higher stress and microstrain in the bone tissue, regardless of the quality of bone and implant-abutment connection. Osteoporotic bone contributed to increase in microstrain in the trabecular bone. The internal connection showed lower stress than the external connection implants only in models without marginal bone loss. Furthermore, higher stress concentrations were observed in the implants and fixation screws in models with increased bone loss and external connection implants, mainly under oblique loading. Osteoporotic bone did not affect stress distribution in the implants and prosthetic components. CONCLUSIONS: Progressive bone loss contributed to higher stress in the bone tissue, implants, and prosthetic components. The osteoporotic bone affects only the microstrain in the trabecular bone, but not the stress in the implants and prosthetic components. The internal connection implants showed lower stress in the cortical bone only in models without bone loss, while external connection implants exhibited higher stress in the implants and screws under oblique loading.

Characterization of Residual Stresses in Veneering Ceramics for Prostheses with Zirconia Framework.

The aim of this study was to evaluate the influence of the coefficient of thermal expansion (CTE or α) and glass transition temperature (Tg) of three veneering ceramics used with zirconia frameworks of full-arch fixed prostheses. The generation of residual stresses and linear contraction after the simulation of the cooling process and mechanical loading were measured. The analysis was based on the finite element method in three-dimensional model of a maxillary full-arch fixed prosthesis with zirconia framework (e.max ZirCAD) and veneer by felsdpathic ceramics (GEC - IPS e.max Ceram, GVM - Vita VM9 and GLC - Lava Ceram). The linear contraction simulation was performed by cooling the structures from the Tg of each veneer ceramic at room temperature (25°C). A loading of 100 N on the occlusal region of the first molar was performed. The magnitude of the maximum principal stress (smax) and linear contraction were evaluated. The levels of CTE mismatch between veneering ceramics and framework showed no relevant influence on smax and linear contraction. The Tg values of the veneer ceramic showed to be directly proportional to amount of smax and linear contraction. The GEC presented the highest values of smax and linear contraction. The GVM and GLC did not present significant differences between them. In conclusion, GVM was similar to GLC, while GEC presented differences in relation to other veneer ceramics in terms of residual stress and linear contraction.

Splinted and Nonsplinted Crowns with Different Implant Lengths in the Posterior Maxilla by Three-Dimensional Finite Element Analysis.

The aim of this study was to evaluate stress distribution in the implants/components and bone tissue for splinted and nonsplinted prostheses with different lengths of implants using three-dimensional finite element analysis. Six models from the posterior maxillary area were used in simulations. Each model simulated three Morse taper implants of 4.0 mm diameter with different lengths, which supported metal-ceramic crowns. An axial load of 400 N and an oblique load of 200 N were used as loading conditions. Splinted prostheses exhibited better stress distribution for the implants/components, whereas nonsplinted prostheses exhibited higher stress in the first molar under axial/oblique loading. Implant length did not influence stress distribution in the implants/components. In cortical bone tissue, splinted prostheses decreased the tensile stress in the first molar, whereas nonsplinted prostheses were subjected to higher tensile stress in the first molar; implant length had no influence on stress distribution. Within the limitations of this study, we conclude that splinted prostheses contributed to better stress distribution in the implant/abutment and cortical bone tissue; however, the reduction in the implant length did not influence the stress distribution.

Characterization of residual stresses in veneering ceramics for prostheses with zirconia framework

Abstract The aim of this study was to evaluate the influence of the coefficient of thermal expansion (CTE or α) and glass transition temperature (Tg) of three veneering ceramics used with zirconia frameworks of full-arch fixed prostheses. The generation of residual stresses and linear contraction after the simulation of the cooling process and mechanical loading were measured. The analysis was based on the finite element method in three-dimensional model of a maxillary full-arch fixed prosthesis with zirconia framework (e.max ZirCAD) and veneer by felsdpathic ceramics (GEC - IPS e.max Ceram, GVM - Vita VM9 and GLC - Lava Ceram). The linear contraction simulation was performed by cooling the structures from the Tg of each veneer ceramic at room temperature (25°C). A loading of 100 N on the occlusal region of the first molar was performed. The magnitude of the maximum principal stress (smax) and linear contraction were evaluated. The levels of CTE mismatch between veneering ceramics and framework showed no relevant influence on smax and linear contraction. The Tg values of the veneer ceramic showed to be directly proportional to amount of smax and linear contraction. The GEC presented the highest values of smax and linear contraction. The GVM and GLC did not present significant differences between them. In conclusion, GVM was similar to GLC, while GEC presented differences in relation to other veneer ceramics in terms of residual stress and linear contraction.

Resumo O objetivo neste estudo foi avaliar a influência do coeficiente de expansão térmica (CET) e da temperatura de transição vítrea (Tg) de três cerâmicas feldspáticas utilizadas para o recobrimento da infraestrutura de zircônia em prótese total fixa. A tensão residual e contração linear após a simulação do processo de esfriamento e carga oclusal foram mensuradas. A análise foi efetuada pelo método por elementos finitos num modelo tridimensional de uma prótese total maxilar com infraestrutura em zircônia (e.max ZirCAD) recoberta por três cerâmicas felsdpáticas (GEC - IPS e.max Ceram, GVM - Vita VM9 ou GLC - Lava Ceram). A simulação da contração linear foi realizada pelo esfriamento da estrutura a partir da Tg de cada cerâmica de cobertura até a temperatura ambiente (25 °C). Em seguida, um carregamento de 100 N foi realizado na região oclusal de primeiro molar. A magnitude da tensão máxima principal (smax) e contração linear foram avaliadas. Os níveis de diferença de CTE entre cerâmica de cobertura e infraestrutura não apresentaram influência significante na smax e na contração linear. Os valores da Tg da cerâmica de cobertura foram diretamente proporcionais à quantidade de smax e contração linear. O grupo GEC apresentou os maiores valores de smax e contração linear, enquanto os grupos GVM e GLC com menores valores não apresentaram diferenças significantes entre si. Em conclusão, o grupo GVM foi similar ao GLC, enquanto o grupo GEC apresentou diferenças em relação a outras cerâmicas de cobertura quanto à tensão residual e contração linear.

Biomechanical behavior of 2-implant- and single-implant-retained mandibular overdentures with conventional or mini implants.

STATEMENT OF PROBLEM: The use of single or mini dental implants to retain mandibular overdentures is still questionable. PURPOSE: The purpose of this finite element analysis (FEA) study was to investigate the biomechanical behavior of 2- and single-implant-retained mandibular overdentures with conventional or mini implants. MATERIAL AND METHODS: Four 3-dimensional (3D) finite element models were constructed with the following designs of mandibular overdentures: 2 (group 2-C) and single (group 1-C) conventional external hexagon implants with ball or O-ring attachment and 2 (group 2-M) and single (group 1-M) 1-piece mini implants. A 150-N axial load was applied bilaterally and simultaneously on the first molar. Overdenture displacement, von Mises equivalent stress (implants and/or prosthetic components), and maximum principal stresses (peri-implant bone) were recorded numerically and then color-coded and compared among the groups. RESULTS: The overdenture displacement (in mm) was higher for the 1-M (0.16) and 2-M (0.17) groups when compared with 1-C (0.09) and 2-C (0.08). Irrespective of the type of implant, the single-implant groups presented higher values of stress (in MPa) on the implants than did the 2-implant groups (1-C=52.53; 1-M=2.95; 2-C=34.66; 2-M=2.37), ball attachment (1-C=201.33; 2-C=159.06), housing or O-ring (1-C=125.01; 1-M=1.96; 2-C=88.84; 2-M=1.27), and peri-implant cortical bone (1-C=19.37; 1-M=1.47; 2-C=15.70; 2-M=1.06). The mini implant overdentures presented lower stress values on the implants, housing or O-ring, and peri-implant bone than did the conventional implant overdentures, regardless of the number of implants. CONCLUSIONS: The 2-implant-retained overdentures exhibited lower stresses than the single- implant-retained overdentures, irrespective of the type of implant. The mini implants demonstrated higher overdenture displacement and lower stresses than did conventional implant overdentures for single- and 2-implant-retained overdentures.

Finite Element Evaluation of Stable Fixation in Combined Mandibular Fractures.

PURPOSE: The fixation of combined mandibular fractures, especially symphyseal-condylar fractures, although occurring commonly and having a higher complication rate in the clinic, is rarely investigated regarding predictable therapeutic approaches. Thus this study's aim was to assess different forms of condylar fixation when combined with symphyseal fracture fixation. MATERIALS AND METHODS: Using finite element models, we analyzed the stress distribution that occurs when a condylar fracture is fixed with 1 miniplate, 2 miniplates, or a trapezoidal condylar miniplate and when a symphyseal fracture is fixed with 2 parallel plates, 2 perpendicular plates, or 2 lag screws. The null hypothesis was that there would be no differences among the different fixation techniques. RESULTS: The results showed a stress concentration in the anterior region of the condyle, close to the sigmoid notch. Moreover, adequate fixation in the symphysis could result in less tension at the condylar region. Therefore, when the symphysis was fixed with a lag-screw technique, condylar fixation was less required, showing a more adequate stress distribution when the condyle was fixed with 1 or 2 plates. Conversely, when the symphyseal fixation was less effective, by use of perpendicular plates, there was a change in the stress distribution at the condylar region, altering fixation behavior and resulting in more tension and displacement in the condyle, especially when a trapezoidal plate was used. CONCLUSIONS: A lag screw and parallel double plates appear to be suitable for symphyseal fixation, whereas 2 straightly positioned plates and a trapezoidal plate are suitable for condylar fixation. However, the combination of perpendicular plates in symphyseal fixation and a trapezoidal plate in condylar fixation showed an altered stress distribution.

Three-dimensional geometric model of the middle segment of the thoracic spine based on graphical images for finite element analysis

Abstract Introduction: Biomedical studies involve complex anatomical structures, which require specific methodology to generate their geometric models. The middle segment of the thoracic spine (T5-T10) is the site of the highest incidence of vertebral deformity in adolescents. Traditionally, its geometries are derived from computed tomography or magnetic resonance imaging data. However, this approach may restrict certain studies. The study aimed to generate two 3D geometric model of the T5-T10 thoracic spine segment, obtained from graphical images, and to create mesh for finite element studies. Methods A 3D geometric model of T5-T10 was generated using two anatomical images of T6 vertebra (side and top). The geometric model was created in Autodesk® Maya® 3D 2013, and the mesh process in HiperMesh and MeshMixer (v11.0.544 Autodesk). Results The T5-T10 thoracic segment model is presented with its passive components, bones, intervertebral discs and flavum, intertransverse and supraspinous ligaments, in different views, as well as the volumetric mesh. Conclusion The 3D geometric model generated from graphical images is suitable for application in non-patient-specific finite element model studies or, with restrictions, in the use of computed tomography or magnetic resonance imaging. This model may be useful for biomechanical studies related to the middle thoracic spine, the most vulnerable site for vertebral deformations.

Comparison between all-on-four and all-on-six treatment concepts and framework material on stress distribution in atrophic maxilla: A prototyping guided 3D-FEA study.

We evaluated two treatment concepts for the rehabilitation of moderate atrophic maxilla with dental implants (all-on-four and all-on-six) and the effect of framework material on the stress distribution of implant-support system. A three-dimensional finite element model based on a prototype was built to simulate an entirely edentulous maxilla with moderate sinus pneumatization that was rehabilitated with a full-arch fixed dental prosthesis. Four standard implants were positioned according to the all-on-four concept and four standard implants and two short implants were placed according to the all-on-six concept. Three framework materials were evaluated: cobalt-chrome (CoCr), titanium (Ti) and zirconia (Zr), totalizing six groups. A unilateral oblique force of 150N was applied to the posterior teeth. The von Mises (σVM), maximum (σmax) and minimum (σmin) principal stress and displacements were obtained. All-on-six showed smaller σmin, σVM and σmax values on the cortical bone, implants and trabecular bone, respectively. All-on-four exhibited higher displacement levels. Ti presented the highest stress values on the cortical bone, implants, abutments, prosthetic screws and displacement levels. In conclusion, the all-on-six approach and framework stiffer materials showed the most favorable biomechanical behavior. However, the stress values did not exceed the bone resistance limits for both treatment concepts.

Three-Dimensional Finite Element Analysis of the Biomechanical Behaviors of Implants with Different Connections, Lengths, and Diameters Placed in the Maxillary Anterior Region.

PURPOSE: To evaluate the biomechanical behaviors of multiple implant-supported prostheses with different implant lengths, connections, locations, and restoration materials in the maxillary anterior region using three-dimensional finite element analysis. MATERIALS AND METHODS: A finite element model of a maxillary image was created from a tomography data bank. The simulations were executed in two types of models based on the treatment plan: (1) two implants with 4.0-mm diameters placed in the maxillary central incisors to simulate an implant-supported fixed prosthesis with four elements with a cantilever of both maxillary lateral incisors; (2) two implants with 3.75-mm diameters placed in the maxillary lateral incisors to simulate a conventional fixed prosthesis with four elements with pontics for maxillary central incisors. Subsequently, the models created were subdivided into eight subgroups according to implant length, connection type, and restoration material. A total static oblique load of 150 N was applied to the cingulum area of the palatal surfaces of the four incisors at an angle of 45 degrees to the long axis of the implant in the palatal-labial direction. Bone stresses were analyzed through maximum and minimum principal stresses and ductile material as implant, framework, and abutments were analyzed using von Mises stress criterion. RESULTS: Regardless of implant diameter and type of treatment, the 8.5-mm-long implants exhibited the lowest tensile and compressive stresses. Maximum and minimum principal stresses were identified in the cortical bone. The lowest von Mises equivalent stress values were identified in the metal-ceramic prostheses, with the exception of the cantilever prosthesis model with flat top connection. Conical cone implant models exhibited maximum von Mises equivalent stress in contact with the abutment. CONCLUSION: The lowest principal stresses in the peri-implant bone were observed in implants with conical cone connection and 8.5 mm in length. Also, in most cases, the models with metal-ceramic restorations exhibited better stress distributions.

Total deformation of multiple implant-supported prostheses through three-dimensional finite element analysis / Deformación total de prótesis múltiple implanto-soportadas a través de un análisis tridimensional por elementos finitos

The purpose of this study was to evaluate through finite element analysis (FEA) the total deformation or displacement as a whole system of multiple implant-supported prostheses in the maxillary anterior region with different implant's length, connection, location and restoration material. An edentulous anterior region of a hemi-maxilla model was used in finite element analysis. The simulations were divided in two groups according to treatment plan: 1) two implants were placed in the upper central incisors, simulating an implant-supported fixed prosthesis (acrylic resin and metal-ceramic) of four elements with cantilever of both upper lateral incisors; 2) two implants placed in the upper lateral incisors, simulating a conventional fixed prosthesis of four elements with both upper central incisors as pontic. Models with cantilever prosthesis in acrylic resin showed the highest values of total deformation, which were 17 times higher than those of metal-ceramic in the distal face of the lateral incisors, regardless of the type of implant connection. In conventional prostheses in acrylic resin, external hexagon connections had lower total deformation values compared with morse taper connection. Also, the implant length was found to have no effect on the values of total deformation. In conclusion, total deformation was substantially greater in all models with acrylic resin restorations.

El propósito de este estudio fue evaluar mediante análisis de elementos finitos (FEA) la deformación total o desplazamiento como un sistema completo de prótesis múltiples implanto-soportadas en la región anterior de la maxila con diferentes longitudes, conexiones y posiciones del implantes y variando el material de restauración. Se utlizó un modelo hemi-maxilar de una región anterior desdentada de un modelo para ser analizado por medio de elementos finitos. Las simulaciones fueron divididas en dos grupos de acuerdo con el plan de tratamiento: 1) dos implantes se colocaron en los incisivos centrales superiores, simulando una prótesis fija implanto-soportada (resina acrílica y metal-cerámica) de cuatro elementos con cantilever de ambos incisivos laterales superiores; 2) dos implantes colocados en los incisivos laterales superiores, simulando una prótesis fija convencional de cuatro elementos con los dos incisivos centrales superiores como póntico. Los modelos con prótesis en cantilever en resina acrílica mostraron los mayores valores de deformación total, siendo 17 veces mayor a los de metal-cerámica en la cara distal de los incisivos laterales, independientemente del tipo de conexión del implante. En las prótesis convencionales en resina acrílica, las conexiones hexagonales externas tenían valores deformación total más bajos en comparación con la conexión cono morse. También, se encontró que la longitud del implante no mostró ninguna influencia en los valores de la deformación total. En conclusión, la deformación total fue sustancialmente mayor en todos los modelos con restauraciones de resina acrílica.

Development of a Titanium Plate for Mandibular Angle Fractures with a Bone Defect in the Lower Border: Finite Element Analysis and Mechanical Test.

OBJECTIVES: The aim of the present study was to develop a plate to treat mandibular angle fractures using the finite element method and mechanical testing. MATERIAL AND METHODS: A three-dimensional model of a fractured mandible was generated using Rhinoceros 4.0 software. The models were exported to ANSYS(®), in which a static application of displacement (3 mm) was performed in the first molar region. Three groups were assessed according to the method of internal fixation (2 mm system): two non-locking plates; two locking plates and a new design locking plate. The computational model was transferred to an in vitro experiment with polyurethane mandibles. Each group contained five samples and was subjected to a linear loading test in a universal testing machine. RESULTS: A balanced distribution of stress was associated with the new plate design. This plate modified the mechanical behavior of the fractured region, with less displacement between the fractured segments. In the mechanical test, the group with two locking plates exhibited greater resistance to the 3 mm displacement, with a statistically significant difference when compared with the new plate group (ANOVA, P = 0.016). CONCLUSIONS: The new plate exhibited a more balanced distribution of stress. However, the group with two locking plates exhibited greater mechanical resistance.

Finite element analysis and fracture resistance testing of a new intraradicular post.

OBJECTIVES: The objective of the present study was to evaluate a prefabricated intraradicular threaded pure titanium post, designed and developed at the São José dos Campos School of Dentistry - UNESP, Brazil. This new post was designed to minimize stresses observed with prefabricated post systems and to improve cost-benefits. MATERIAL AND METHODS: Fracture resistance testing of the post/core/root complex, fracture analysis by microscopy and stress analysis by the finite element method were used for post evaluation. The following four prefabricated metal post systems were analyzed: group 1, experimental post; group 2, modification of the experimental post; group 3, Flexi Post, and group 4, Para Post. For the analysis of fracture resistance, 40 bovine teeth were randomly assigned to the four groups (n=10) and used for the fabrication of test specimens simulating the situation in the mouth. The test specimens were subjected to compressive strength testing until fracture in an EMIC universal testing machine. After fracture of the test specimens, their roots were sectioned and analyzed by microscopy. For the finite element method, specimens of the fracture resistance test were simulated by computer modeling to determine the stress distribution pattern in the post systems studied. RESULTS: The fracture test presented the following averages and standard deviation: G1 (45.63 ± 8.77), G2 (49.98 ± 7.08), G3 (43.84 ± 5.52), G4 (47.61 ± 7.23). Stress was homogenously distributed along the body of the intraradicular post in group 1, whereas high stress concentrations in certain regions were observed in the other groups. These stress concentrations in the body of the post induced the same stress concentration in root dentin. CONCLUSIONS: The experimental post (original and modified versions) presented similar fracture resistance and better results in the stress analysis when compared with the commercial post systems tested (08/2008-PA/CEP).

Finite element analysis and fracture resistance testing of a new intraradicular post

OBJECTIVES: The objective of the present study was to evaluate a prefabricated intraradicular threaded pure titanium post, designed and developed at the São José dos Campos School of Dentistry - UNESP, Brazil. This new post was designed to minimize stresses observed with prefabricated post systems and to improve cost-benefits. MATERIAL AND METHODS: Fracture resistance testing of the post/core/root complex, fracture analysis by microscopy and stress analysis by the finite element method were used for post evaluation. The following four prefabricated metal post systems were analyzed: group 1, experimental post; group 2, modification of the experimental post; group 3, Flexi Post, and group 4, Para Post. For the analysis of fracture resistance, 40 bovine teeth were randomly assigned to the four groups (n=10) and used for the fabrication of test specimens simulating the situation in the mouth. The test specimens were subjected to compressive strength testing until fracture in an EMIC universal testing machine. After fracture of the test specimens, their roots were sectioned and analyzed by microscopy. For the finite element method, specimens of the fracture resistance test were simulated by computer modeling to determine the stress distribution pattern in the post systems studied. RESULTS: The fracture test presented the following averages and standard deviation: G1 (45.63±8.77), G2 (49.98±7.08), G3 (43.84±5.52), G4 (47.61±7.23). Stress was homogenously distributed along the body of the intraradicular post in group 1, whereas high stress concentrations in certain regions were observed in the other groups. These stress concentrations in the body of the post induced the same stress concentration in root dentin. CONCLUSIONS: The experimental post (original and modified versions) presented similar fracture resistance and better results in the stress analysis when compared with the commercial post systems tested (08/2008-PA/CEP).