Implant-bone interface stress distribution in immediately loaded implants of different diameters: a three-dimensional finite element analysis.

PURPOSE: To establish a 3D finite element model of a mandible with dental implants for immediate loading and to analyze stress distribution in bone around implants of different diameters. MATERIALS AND METHODS: Three mandible models, embedded with thread implants (ITI, Straumann, Switzerland) with diameters of 3.3, 4.1, and 4.8 mm, respectively, were developed using CT scanning and self-developed Universal Surgical Integration System software. The von Mises stress and strain of the implant-bone interface were calculated with the ANSYS software when implants were loaded with 150 N vertical or buccolingual forces. RESULTS: When the implants were loaded with vertical force, the von Mises stress concentrated on the mesial and distal surfaces of cortical bone around the neck of implants, with peak values of 25.0, 17.6 and 11.6 MPa for 3.3, 4.1, and 4.8 mm diameters, respectively, while the maximum strains (5854, 4903, 4344 muepsilon) were located on the buccal cancellous bone around the implant bottom and threads of implants. The stress and strain were significantly lower (p < 0.05) with the increased diameter of implant. When the implants were loaded with buccolingual force, the peak von Mises stress values occurred on the buccal surface of cortical bone around the implant neck, with values of 131.1, 78.7, and 68.1 MPa for 3.3, 4.1, and 4.8 mm diameters, respectively, while the maximum strains occurred on the buccal surface of cancellous bone adjacent to the implant neck, with peak values of 14,218, 12,706, and 11,504 microm, respectively. The stress of the 4.1-mm diameter implants was significantly lower (p < 0.05) than those of 3.3-mm diameter implants, but not statistically different from that of the 4.8 mm implant. CONCLUSIONS: With an increase of implant diameter, stress and strain on the implant-bone interfaces significantly decreased, especially when the diameter increased from 3.3 to 4.1 mm. It appears that dental implants of 10 mm in length for immediate loading should be at least 4.1 mm in diameter, and uniaxial loading to dental implants should be avoided or minimized.

Influence of anisotropy on peri-implant stress and strain in complete mandible model from CT.

This paper reveals the influence of elastic anisotropy for the peri-implant stress and strain in personalized mandible. First, from CT data, the individual geometry of the complete range of mandible was well reproduced, also the separation between cortical and cancellous bone. Then, by an ad hoc automatic mesh generator integrated with anisotropic material assignment function, high quality anisotropic finite element model of the complete mandible was created, with two standard threaded implants embedded in posterior zone. The values of principal stress and strain in surrounding bone were evaluated under buccolingual oblique loading, and compared to that of the same FE model with equivalent isotropic material. Results of the analyses demonstrated that the percentage increase of stress and strain in anisotropic case reached up to 70%. It is concluded that anisotropy has significant effects on peri-implant stress and strain and careful consideration should be given to its use in biomechanical FE studies.

Anisotropic finite element modeling for patient-specific mandible.

This paper presents an ad hoc modular software tool to quasi-automatically generate patient-specific three-dimensional (3D) finite element (FE) model of the human mandible. The main task is taking into account the complex geometry of the individual mandible, as well as the inherent highly anisotropic material law. At first, by computed tomography data (CT), the individual geometry of the complete range of mandible was well reproduced, also the separation between cortical and cancellous bone. Then, taking advantage of the inherent shape nature as 'curve' long bone, the algorithm employed a pair of B-spline curves running along the entire upper and lower mandible borders as auxiliary baselines, whose directions are also compatible with that of the trajectory of maximum material stiffness throughout the cortical bone of the mandible. And under the guidance of this pair of auxiliary baselines, a sequence of B-spline surfaces were interpolated adaptively as curve cross-sections to cut the original geometry. Following, based on the produced curve contours and the corresponding curve cross-section surfaces, quite well structured FE volume meshes were constructed, as well as the inherent trajectory vector fields of the anisotropic material (orthotropic for cortical bone and transversely isotropic for cancellous bone). Finally, a sensitivity analysis comprising various 3D FE simulations was carried out to reveal the relevance of elastic anisotropy for the load carrying behavior of the mandible.

Influence of Trabecular Bone on Peri-Implant Stress and Strain Based on Micro-CT Finite Element Modeling of Beagle Dog.

The objective of this investigation is to analyze the influence of trabecular microstructure modeling on the biomechanical distribution of the implant-bone interface. Two three-dimensional finite element mandible models, one with trabecular microstructure (a refined model) and one with macrostructure (a simplified model), were built. The values of equivalent stress at the implant-bone interface in the refined model increased compared with those of the simplified model and strain on the contrary. The distributions of stress and strain were more uniform in the refined model of trabecular microstructure, in which stress and strain were mainly concentrated in trabecular bone. It was concluded that simulation of trabecular bone microstructure had a significant effect on the distribution of stress and strain at the implant-bone interface. These results suggest that trabecular structures could disperse stress and strain and serve as load buffers.

Automatic Tooth Segmentation of Dental Mesh Based on Harmonic Fields.

An important preprocess in computer-aided orthodontics is to segment teeth from the dental models accurately, which should involve manual interactions as few as possible. But fully automatic partition of all teeth is not a trivial task, since teeth occur in different shapes and their arrangements vary substantially from one individual to another. The difficulty is exacerbated when severe teeth malocclusion and crowding problems occur, which is a common occurrence in clinical cases. Most published methods in this area either are inaccurate or require lots of manual interactions. Motivated by the state-of-the-art general mesh segmentation methods that adopted the theory of harmonic field to detect partition boundaries, this paper proposes a novel, dental-targeted segmentation framework for dental meshes. With a specially designed weighting scheme and a strategy of a priori knowledge to guide the assignment of harmonic constraints, this method can identify teeth partition boundaries effectively. Extensive experiments and quantitative analysis demonstrate that the proposed method is able to partition high-quality teeth automatically with robustness and efficiency.

Interactive tooth partition of dental mesh base on tooth-target harmonic field.

The accurate tooth partition of dental mesh is a crucial step in computer-aided orthodontics. However, tooth boundary identification is not a trivial task for tooth partition, since different shapes and their arrangements vary substantially among common clinical cases. Though curvature field is traditionally used for identifying boundaries, it is normally not reliable enough. Other methods may improve the accuracy, but require intensive user interaction. Motivated by state-of-the-art general interactive mesh segmentation methods, this paper proposes a novel tooth-target partition framework that employs harmonic fields to partition teeth accurately and effectively. In addition, a refining strategy is introduced to successfully segment teeth from the complicated dental model with indistinctive tooth boundaries on its lingual side surface, addressing an issue that had not been solved properly before. To utilise high-level information provided by the user, smart and intuitive user interfaces are also proposed with minimum interaction. In fact, most published interactive methods specifically designed for tooth partition are lacking efficient user interfaces. Extensive experiments and quantitative analyses show that our tooth partition method outperforms the state-of-the-art approaches in terms of accuracy, robustness and efficiency.

Influence of orthotropy on biomechanics of peri-implant bone in complete mandible model with full dentition.

OBJECTIVE: The study was to investigate the impact of orthotropic material on the biomechanics of dental implant, based on a detailed mandible with high geometric and mechanical similarity. MATERIALS AND METHODS: Multiple data sources were used to elaborate detailed biological structures and implant CAD models. In addition, an extended orthotropic material assignment methodology based on harmonic fields was used to handle the alveolar ridge region to generate compatible orthotropic fields. The influence of orthotropic material was compared with the commonly used isotropic model and simplified orthotropic model. RESULTS: The simulation results showed that the values of stress and strain on the implant-bone interface almost increased in the orthotropic model compared to the isotropic case, especially for the cancellous bone. However, the local stress concentration was more obvious in the isotropic case compared to that in orthotropic case. The simple orthotropic model revealed irregular stress and strain distribution, compared to the isotropic model and the real orthotropic model. The influence of orthotropy was little on the implant, periodontal ligament, tooth enamel, and dentin. CONCLUSION: The orthotropic material has significant effect on stress and strain of implant-bone interface in the mandible, compared with the isotropic simulation. Real orthotropic mechanical properties of mandible should be emphasized in biomechanical studies of dental implants.

[Construction and validation of a three-dimensional finite element model of cranio-maxillary complex with sutures in unilateral cleft lip and palate patient].

PURPOSE: To explore an effective method to construct and validate a finite element model of the unilateral cleft lip and palate(UCLP) craniomaxillary complex with sutures, which could be applied in further three-dimensional finite element analysis (FEA). METHODS: One male patient aged 9 with left complete lip and palate cleft was selected and CT scan was taken at 0.75mm intervals on the skull. The CT data was saved in Dicom format, which was, afterwards, imported into Software Mimics 10.0 to generate a three-dimensional anatomic model. Then Software Geomagic Studio 12.0 was used to match, smoothen and transfer the anatomic model into a CAD model with NURBS patches. Then, 12 circum-maxillary sutures were integrated into the CAD model by Solidworks (2011 version). Finally meshing by E-feature Biomedical Modeler was done and a three-dimensional finite element model with sutures was obtained. A maxillary protraction force (500 g per side, 20° downward and forward from the occlusal plane) was applied. Displacement and stress distribution of some important craniofacial structures were measured and compared with the results of related researches in the literature. RESULTS: A three-dimensional finite element model of UCLP craniomaxillary complex with 12 sutures was established from the CT scan data. This simulation model consisted of 206 753 individual elements with 260 662 nodes, which was a more precise simulation and a better representation of human craniomaxillary complex than the formerly available FEA models. By comparison, this model was proved to be valid. CONCLUSIONS: It is an effective way to establish the three-dimensional finite element model of UCLP cranio-maxillary complex with sutures from CT images with the help of the following softwares: Mimics 10.0, Geomagic Studio 12.0, Solidworks and E-feature Biomedical Modeler.

A newly designed big cup nitinol stent for gastric outlet obstruction.

AIM: To find out whether a newly designed big cup nitinol stent is suitable for treatment of patients with gastric outlet obstruction resulting from gastric cancer. METHODS: The new stent is composed of a proximal big cup segment (20 mm in length and 48-55 mm in diameter), a middle part (60 mm in length and 20 mm in diameter) covered by a polyethylene membrane and a distal sphericity (20 mm in length and 28 mm in diameter). Half of the proximal big cup segment is also covered by a polyethylene membrane, which is adjacent to the middle part of the stent. The stent is preloaded in a 6.0-mm-diameter introducer system. Thirteen patients with gastric outlet obstruction resulting from gastric cancer received the new stents under endoscopic and fluoroscopic guidance. RESULTS: Technical success was achieved in 12 of 13 (92.3%) patients. Among the 12 patients in whom endoscopic stent was placed successfully, the clinical success rate was 91.7% during a follow-up of average 6.5 mo. During the first month follow-up, the migration rate was 0%, recurrent obstruction 0% and gastric bleeding 8.3%. During the follow-up between 2-12 mo, no migration, recurrent obstruction and gastric bleeding occurred. CONCLUSION: The proximal big cup segment seems to be effective and promising for technical efficacy, clinical outcome, and preventing migration and tumor ingrowth and increasing the emptying rate of sinus ventriculi.

Effect of diameter and length on stress distribution of the alveolar crest around immediate loading implants.

BACKGROUND: Many clinical observations have shown that immediate loading is indicated when the stabilization of the bone/implant is optimal and when the estimated loads are not excessively high. Nonetheless, more experimental studies are needed to consider the immediate loading protocol as a safe procedure. Mechanical analysis using the finite element (FE) method analysis has been employed by many authors to understand the biomechanical behavior around dental implants. PURPOSE: This study was to evaluate the effect of the diameter and length on the stress and strain distribution of the crestal bone around implants under immediate loading. MATERIALS AND METHODS: By an ad hoc automatic mesh generator, high-quality FE models of complete range mandible was constructed from computer tomography, with three Straumann (Straumann Institute, Waldenburg, Switzerland) implants of various sizes embedded in the anterior zone. The implant diameter ranged from 3.3 to 4.8 mm, and length ranged from 6 to 14 mm, resulting in seven designs. The implant-bone interface was simulated by nonlinear frictional contact algorithm. For each design, vertical and oblique loadings of 150 N were applied, respectively, to each implant, and stresses and strains in the surrounding cortical bone were evaluated. RESULTS: The biomechanics analysis provided results that the oblique loading would induce significantly higher interfacial stresses and strains than the vertical loading, while the intergroup stress difference significant levels was evaluated using t-tests method and the level of significance (.05) that was accepted for significance. Under both loadings, the maximal values were recorded in the 3.3 (diameter) x 10 (length) mm implant configuration, whose mean and peak values were both higher than that of others with significant statistical differences. The second maximal one is 4.1 x 6 mm configuration, and the minimal stresses were recorded in 4.8 x 10 mm configuration, whose strains were also near to lowest. CONCLUSIONS: Increasing the diameter and length of the implant decreased the stress and strain on the alveolar crest, and the stress and strain values notably increased under buccolingual loading as compared with vertical loading, but diameter had a more significant effect than length to relieve the crestal stress and strain concentration.

[Three dimension finite element analysis of anisotropic mandible with dental implants effect on implant-bone interface].

OBJECTIVE: To establish anisotropic mandible model with dental implants and to investigate the effect of anisotropy material on stress and strain distribution of implant-bone interface. METHODS: Three-dimensional finite element models of whole mandible with anisotropic and equivalent isotropic material were created by CT scanning and universal surgical integration system (USIS) software developed by the authors. Two ITI threaded implants were implanted in the posterior teeth area. The values of principal stress and principal strain on the bone around dental implants were calculated in two different finite element models with buccolingual load. RESULTS: In the anisotropic mandible model, nearly all values of the principal stress and principal strain on cortical and cancellous bone increased compared with the equivalent isotropy model, 2.1%-74.1% for principal stress and 4.7%-57.3% for principal strain, but 10. 3%-71.4% for principal stress and 19.5%-63.4% for principal strain on cancellous bone. CONCLUSIONS: In the three-dimensional finite element analysis, anisotropic mandible model with dental implants has an apparent effect on the stress and strains of the implant-bone interface. Anisotropic mechanical properties of mandible should be emphasized in biomechanical study.

[Establishment of a three-dimensional finite element model of mandible with dental implants for immediate loading].

PURPOSE: To establish a three-dimensional finite element model of mandible with dental implants for immediate loading, which will provide a basis for study of the biomechanical characteristics of the immediate loading implant-bone interface. METHODS: A female edentulous mandible was adopted for CT scanning, the scanned data were saved with the form of DICOM, and then input into compute. Universal Surgical Integration System which was developed by ourselves and ANSYS 10.0 were used to divide mesh and establish finite element model. Three dental implants simulating the real shape of ITI thread implant were embedded in the anterior region of the mandible, of which implant-bone interface was granted with situation of smooth friction simulating the case of immediate loading. RESULTS: The accurate finite element model of mandible with dental implants for immediate loading was established, which included 127811 tetrahedron elements with 182252 nodes. A single dental implant model comprised 13924 elements with 21420 nodes, the thread of it was continuous and smooth. CONCLUSION: The biomechanical similarity, the geometrical analogy and clinical indication of the model were quite good. The three-dimensional finite element model developed by this method can apply for precise analysis of the rule of biomechanics on the implant-bone interface for immediate loading.