Thermoplastic clear dental aligners under cyclic compression loading: A mechanical performance analysis using acoustic emission technique.

The objective of this work is to analyse the performance of clear aligners made of thermoplastic materials. Within this framework, the damage evolution stages and damage states of the aligners at different cycles of the compressive loading are evaluated using the Acoustic Emission (AE) technique. Three different clear aligner systems were prepared: thermoformed PET-g (polyethylene terephthalate glycol) and PU (polyurethane), and additively manufactured PU. Cyclic compression tests are performed to simulate 22500 swallows. The mechanical results show that the energy absorbed by the thermoformed PET-g aligner remains stable around 4 Nmm throughout the test. Although the PU-based aligners show a higher energy absorption of about 7 Nmm during the initial phase of the cyclic loading, this gradually decreases after 12500 cycles. The time-domain based, and frequency-based parameters of the stress wave acoustic signals generated by the aligners under compression loading are used to identify the damage evolution stages. The machine learning-based AE results reveal the initiation and termination of the different damage states in the aligners and the frequency-based results distinguish the different damage sources. Finally, the microscopy results validated the damage occurrences in the aligners identified by the AE results. The mechanical test results indicate that the thermoformed PET-g has the potential to match the performance and requirements of the dentistry of the popular Invisalign (additively manufactured PU). The AE results have the potential to identify at which cycles the aligners may start losing their functionality.

In Vitro Effects of Low-energy Ultrasound Treatment on Healthy CD3/CD8+ Lymphocytes, Red blood cells, Acute Myeloid leukemia cells, and Jurkat cell line.

The study of the biological effects of low-energy ultrasound and its applications is a rapidly expanding research area. Low-energy ultrasound could be used as anti-tumoral therapy with or without the pharmacological combination even if the second situation has been scarcely investigated up to now. Very little information is available about the ultrasound effects on healthy red blood cells, CD3, and mainly CD8 subset lymphocytes which is the main subset cell having cytotoxic function towards cancer cells. In this study, we investigated in vitro the bioeffects of low energy ultrasound on red blood cells and PBMCs isolated from healthy donors as well as on two myeloid leukemia cell lines (OCI- AML-3 MOLM-13) and lymphoblastic Jurkat cell line. Using low-energy ultrasound (US), a study was conducted to determine how it affects CD3/CD8 lymphocytes and leukemia cells, as well as its potential role in treating blood cancers, by analyzing changes in mitochondrial membrane potential, phosphatidylserine asymmetry, morphological changes for myeloid AML cell lines, proliferation and cytotoxic activation of healthy lymphocytes, and apoptosis for RBCs after US exposure. Overall, we demonstrated that CD3/CD8 lymphocytes proliferation/activation and cytotoxic functions are fully preserved after ultrasound treatments, whereas leukemia cell lines undergo apoptosis and stop proliferating suggesting a potential method of treating blood cancer.

A full-field DIC analysis of the mechanical-deformation behavior of polyethylene terephthalate glycol (PET-G) aligners.

OBJECTIVES: The aim was to investigate the full-field mechanical-deformation behavior of clear aligners made by polyethylene terephthalate glycol (PET-G) subjected to cyclic compression tests. METHODS: Digital Image Correlation (DIC) (Chu et al., 1985; Schreier et al., 2009), a contactless full-field measurement technique, and Optical Microscope (OM) analysis were applied to study two PET-G aligners thermoformed from discs of a thickness of 0.75 mm and 0.88 mm. The clear aligners were placed on dental shape resin casts and were subjected to cyclic compression up to 13000 load cycles from 0 to 50 N at room temperature. The chosen number of load cycles simulates the average load history to which an aligner is subjected for one week. Local displacements and strains were measured for each test at 2, 6, 10, 20, 1000, 5000 and 13000 loading cycles. RESULTS: Both aligners showed greater displacements in the early stages of loading, more pronounced for the 0.88 mm one. Local displacement and strain maps are derived both along the load direction and to the transverse one (never done from other researchers). Load-displacement cyclic curves allowed to evaluate the evolution of the stored energy and the stiffness during the test. The OM analyses showed significant morphological variations on the aligners' surface, such as wear and tear, high depressions and cracks, especially for the 0.75 mm specimen. SIGNIFICANCE: Full-field analysis allowed to understand the mechanical behavior of device with complex geometry and complex load distribution, like invisible aligners. The knowledge of the stiffness and the direction of the total displacement helps the orthodontist to implement the best strategy to improve the patient's comfort and the treatment time.

Experimental Study of the Pressures and Points of Application of the Forces Exerted between Aligner and Tooth.

The analysis of forces, moments and pressure points has long been of great interest in orthodontics. Hence, we set out to define a method for measuring the pressure exerted by aligners on the teeth, and specifically to identify the precise points of pressure exertion. Intraoral scans were performed on a patient with optimal alignment and levelling before and after 2º vestibularisation of the upper central incisor. Pressure sensor film was placed in a dedicated housing between the aligner and teeth in order to record the pressure exerted after 15 s of aligner application. The images captured by the film were scanned, digitised, and subsequently analysed. Areas and amounts of pressure generated by the aligners were evaluated, and the net force of each was calculated, adjusted to take into consideration passive values. The method revealed the areas of contact by which the aligner transmits force on the teeth, and the pressures at which it does so. The pressure exerted by an aligner is not evenly distributed across the entire surface of the tooth during lingual tipping of an upper incisor. The areas of force concentration were not identical, as these are influenced by factors resulting from the manufacturing and casting processes.

An Optical System to Monitor the Displacement Field of Glass-fibre Posts Subjected to Thermal Loading.

Endocanalar posts are necessary to build up and retain coronal restorations but they do not reinforce dental roots. It was observed that the dislodgement of post-retained restorations commonly occurs after several years of function and long-term retention may be influenced by various factors such as temperature changes. Temperature changes, in fact, produce micrometric deformations of post and surrounding tissues/materials that may generate high stress concentrations at the interface thus leading to failure. In this study we present an optical system based on the projection moiré technique that has been utilized to monitor the displacement field of endocanalar glass-fibre posts subjected to temperature changes. Measurements were performed on forty samples and the average displacement values registered at the apical and middle region were determined for six different temperature levels. A total of 480 displacement measurements was hence performed. The values of the standard deviation computed for each of the tested temperatures over the forty samples appear reasonably small which proves the robustness and the reliability of the proposed optical technique. The possible implications for the use of the system in the applicative context were discussed.

Study of cellular response induced by low intensity ultrasound frequency sweep pattern on myelomonocytic lymphoma U937 cells.

PURPOSE: This study will analyze the mechanical effects (immediate lysis) and biological effects (cell survival, apoptosis, cell cycle) on U937 cells subjected to different sonication conditions with increasing and decreasing frequencies and burst rate (number of burst of a repeating signal in a specific time unit), in order to determine the best conditions of sonication to produce high mortality, apoptosis and inhibition of hyperproliferation. METHOD: Cells are been stressed by pulse wave ultrasounds with increasing and decreasing frequencies between 400 and 620 kHz, at burst rates of 0.5, 10, 50 Hz and 50 % duty cycle (percentage of one period in which a signal is active), ultrasound intensities (spatial average-temporal peak) 0.045 and 0.09 W/cm(2). The sonication durations were 90 and 180 s. RESULTS: The decreasing mode was found to be better than the increasing mode for 10 and 50 Hz burst rates, while at 0.5 Hz the increasing mode gave better results for the time of 180 s. For 10 Hz burst rate, decreasing frequency, 180 s, 0.09 W/cm(2), 20 % survival rate was found; after 6-h incubation, cells showed 13 % of early apoptosis and 11 % of late apoptosis. For these conditions of sonication, the hyperproliferation of cells was inhibited. CONCLUSION: Survival rate decreases for increasing intensity and duration with each burst rate. The best performance is decreasing mode in a range between 620 and 400 kHz, duty cycle 50 %, burst rate 10 Hz. In these conditions after 180 s duration, the average survival rate is 20 %, the survived cells manifest apoptosis after 6-h incubation and hyperproliferation is prevented. The results seem to lead toward a non-invasive and effective purging of leukemic cells.

Effect of AFM probe geometry on visco-hyperelastic characterization of soft materials.

Atomic force microscopy (AFM) nanoindentation is very suited for nano- and microscale mechanical characterization of soft materials. Although the structural response of polymeric networks that form soft matter depends on viscous effects caused by the relative slippage of polymeric chains, the usual assumption made in the AFM-based characterization is that the specimen behaves as a purely elastic material and viscous forces are negligible. However, for each geometric configuration of the AFM tip, there will be a limit indentation rate above which viscous effects must be taken into account to correctly determine mechanical properties. A parametric finite element study conducted on 12 geometric configurations of a blunt cone AFM tip (overall, the study included about 200 finite element analyses) allowed us to determine the limit indentation rate for each configuration. The selected tip dimensions cover commercially available products and account for changes in tip geometry caused by serial measurements. Nanoindentation rates cover typical experimental conditions set in AFM bio-measurements on soft matter. Viscous effects appear to be more significant in the case of sharper tips. This implies that, if quantitative data on sample viscosity are not available, using a rounded indenter and carrying out experiments below the limit indentation rate will allow errors in the determination of mechanical properties to be minimized.

Roughness Analysis on Composite Materials (Microfilled, Nanofilled and Silorane) After Different Finishing and Polishing Procedures.

The finishing and polishing of composite materials affect the restoration lifespan. The market shows a variety of finishing and polishing procedures and the choice among them is conditioned by different factors such as the resulting surface roughness. In the present study, 156 samples were realized with three composite materials, -microfilled, nanofilled and silorane-, and treated with different finishing and polishing procedures. Profilometric analyses were carried out on the samples' surface, the measured roughness values were submitted to statistical analysis. A complete factorial plan was drawn up and two-way analysis of variance (ANOVA) was carried out to investigate whether the following factors affect the values of roughness: (i) material; (ii) polishing/finishing procedure. Tukey post-hoc test was also conducted to evaluate any statistically significant differences between the material/procedure combinations. The results show that the tested materials do not affect the resulting surface quality but roughness values depend on the finishing/polishing procedure adopted. The procedures that involve: (a) the finishing with medium Sof-Lex discs and (b) the finishing with two tungsten carbide multi-blade milling cutters Q series and UF series are those that allow the lowest values of roughness to be obtained.

Remarks on residual stress measurement by hole-drilling and electronic speckle pattern interferometry.

Hole drilling is the most widespread method for measuring residual stress. It is based on the principle that drilling a hole in the material causes a local stress relaxation; the initial residual stress can be calculated by measuring strain in correspondence with each drill depth. Recently optical techniques were introduced to measure strain; in this case, the accuracy of the final results depends, among other factors, on the proper choice of the area of analysis. Deformations are in fact analyzed within an annulus determined by two parameters: the internal and the external radius. In this paper, the influence of the choice of the area of analysis was analysed. A known stress field was introduced on a Ti grade 5 sample and then the stress was measured in correspondence with different values of the internal and the external radius of analysis; results were finally compared with the expected theoretical value.

A comparison of shear bond strength of ceramic and resin denture teeth on different acrylic resin bases.

The purpose of this study is to compare the shear bond strength of different resin bases and artificial teeth made of ceramic or acrylic resin materials and whether tooth-base interface may be treated with aluminium oxide sandblasting. Experimental measurements were carried on 80 specimens consisting of a cylinder of acrylic resin into which a single tooth is inserted. An ad hoc metallic frame was realized to measure the shear bond strength at the tooth-base interface. A complete factorial plan was designed and a three-way ANalysis Of VAriance (ANOVA) was carried out to investigate if shear bond strength is affected by the following factors: (i) tooth material (ceramic or resin); (ii) base material (self-curing or thermal-curing resin); (iii) presence or absence of aluminium oxide sandblasting treatment at the tooth-base interface. Tukey post hoc test was also conducted to evaluate any statistically significant difference between shear strength values measured for the dif-ferently prepared samples. It was found from ANOVA that the above mentioned factors all affect shear strength. Furthermore, post hoc analysis indi-cated that there are statistically significant differences (p-value=0.000) between measured shear strength values for: (i) teeth made of ceramic material vs. teeth made of acrylic resin material; (ii) bases made of self-curing resin vs. thermal-curing resin; (iii) specimens treated with aluminium oxide sandblasting vs. untreated specimens. Shear strength values measured for acryl-ic resin teeth were on average 70% higher than those measured for ceramic teeth. The shear bond strength was maximized by preparing samples with thermal-curing resin bases and resin teeth submitted to aluminium oxide sandblasting.

Friction forces during sliding of various brackets for malaligned teeth: an in vitro study.

AIMS: To measure the friction force generated during sliding mechanics with conventional, self-ligating (Damon 3 mx, Smart Clip, and Time 3) and low-friction (Synergy) brackets using different archwire diameters and ligating systems in the presence of apical and buccal malalignments of the canine. METHODS: An experimental setup reproducing the right buccal segment of the maxillary arch was designed to measure the friction force generated at the bracket/wire and wire/ligature interfaces of different brackets. A complete factorial plan was drawn up and a three-way analysis of variance (ANOVA) was carried out to investigate whether the following factors affect the values of friction force: (i) degree of malalignment, (ii) diameter of the orthodontic wire, and (iii) bracket/ligature combination. Tukey post hoc test was also conducted to evaluate any statistically significant differences between the bracket/ligature combinations analyzed. RESULTS: ANOVA showed that all the above factors affect the friction force values. The friction force released during sliding mechanics with conventional brackets is about 5-6times higher than that released with the other investigated brackets. A quasilinear increase of the frictional forces was observed for increasing amounts of apical and buccal malalignments. CONCLUSION: The Synergy bracket with silicone ligature placed around the inner tie-wings appears to yield the best performance.

Structural Response of Polyethylene Foam-Based Sandwich Panels Subjected to Edgewise Compression.

This study analyzes the mechanical behavior of low density polyethylene foam core sandwich panels subjected to edgewise compression. In order to monitor panel response to buckling, strains generated in the facesheets and overall out-of-plane deformations are measured with strain gages and projection moiré, respectively. A finite element (FE) model simulating the experimental test is developed. Numerical results are compared with moiré measurements. After having been validated against experimental evidence, the FE model is parameterized, and a trade study is carried out to investigate to what extent the structural response of the panel depends on the sandwich wall construction and facesheet/core interface defects. The projection moiré set-up utilized in this research is able to capture the sudden and very localized buckling phenomena occurring under edgewise compression of foam-based sandwich panels. Results of parametric FE analyses indicate that, if the total thickness of the sandwich wall is fixed, including thicker facesheets in the laminate yields a larger deflection of the panel that becomes more sensitive to buckling. Furthermore, the mechanical response of the foam sandwich panel is found to be rather insensitive to the level of waviness of core-facesheet interfaces.

Effect of different irrigating solutions and endodontic sealers on bond strength of the dentin-post interface with and without defects.

AIMS: To investigate how the interfacial shear strength of the dentin-post interface with and without defects changes for different combinations irrigant/sealer. METHODS: In forty human decoronated and instrumented teeth, fibreglass posts were inserted. The obtained root segments were randomly assigned to four different groups according to the irrigant adopted and the cement used to seal the root canal. The root segments were processed for metyl-methacrylate embedding. Serial sections were obtained and submitted to histomorphometric analyses in order to observe any defect of adhesion at the dentin-post interface and to measure the defects' dimension. The serial sections were also submitted to micro-push-out test. The measured shear strength values were subjected to statistical analysis by one-way ANOVA. The values of bond strength determined for the defective samples were correlated with the dimension of the defects. Finite element models were built to interpret and corroborate the experimental findings. RESULTS: ANOVA showed that the generic combination irrigant/sealer does not affect the interfacial shear strength values. The bond strength of the samples without defects was averagely twice as large as that of the defective samples. The defects occupying more than 12% of the total transverse section area of the endodontic cement layer led to a reduction of the bond strength of about 70%. The predictions of the finite element models were in agreement with the experimental results. CONCLUSION: Defects occupying less than 2% of the total transverse section area of the cement layer were shown to be acceptable as they have rather negligible effects on the shear strength values. Technologies/protocols should be developed to minimize the number and the size of the defects.

Whole-depth change in bovine zona pellucida biomechanics after fertilization: how relevant in hindering polyspermy?

Polyspermy is a common problem in bovine in vitro fertilization (IVF) and has a still unclear etiology. In this specie, after IVF, despite the lack of a biochemical post-fertilization hardening, the stiffness of the outer ZP layer is significantly increased. Therefore, polyspermy might be related to an incomplete or insufficient stiffening of the ZP. We obtained, by using atomic force spectroscopy in physiological conditions, a complete characterization of the biomechanical changes of the inner and outer ZP layers occurring during oocyte maturation/fertilization and correlated them to the ultrastructural changes observed by transmission electron microscopy using ruthenium red and saponin technique. In both the inner and outer ZP layers, stiffness decreased at maturation while, conversely, increased after fertilization. Contextually, at the nanoscale, during maturation both ZP layers displayed a fine filaments network whose length increased while thickness decreased. After fertilization, filaments partially recovered the immature features, appearing again shorter and thicker. Overall, the observed biomechanical modifications were substantiated by ultrastructural findings in the ZP filament mesh. In fertilized ZP, the calculated force necessary to displace ZP filaments resulted quite similar to that previously reported as generated by bovine sperm flagellum. Therefore, in bovine IVF biomechanical modifications of ZP appear ineffective in hindering sperm transit, highlighting the relevance of additional mechanisms operating in vivo.

Nanoscale characterization of the biomechanical hardening of bovine zona pellucida.

The zona pellucida (ZP) is an extracellular membrane surrounding mammalian oocytes. The so-called zona hardening plays a key role in fertilization process, as it blocks polyspermy, which may also be caused by an increase in the mechanical stiffness of the ZP membrane. However, structural reorganization mechanisms leading to ZP's biomechanical hardening are not fully understood yet. Furthermore, a correct estimate of the elastic properties of the ZP is still lacking. Therefore, the aim of the present study was to investigate the biomechanical behaviour of ZP membranes extracted from mature and fertilized bovine oocytes to better understand the mechanisms involved in the structural reorganization of the ZP that may lead to the biomechanical hardening of the ZP. For that purpose, a hybrid procedure is developed by combining atomic force microscopy nanoindentation measurements, nonlinear finite element analysis and nonlinear optimization. The proposed approach allows us to determine the biomechanical properties of the ZP more realistically than the classical analysis based on Hertz's contact theory, as it accounts for the nonlinearity of finite indentation process, hyperelastic behaviour and material heterogeneity. Experimental results show the presence of significant biomechanical hardening induced by the fertilization process. By comparing various hyperelastic constitutive models, it is found that the Arruda-Boyce eight-chain model best describes the biomechanical response of the ZP. Fertilization leads to an increase in the degree of heterogeneity of membrane elastic properties. The Young modulus changes sharply within a superficial layer whose thickness is related to the characteristic distance between cross-links in the ZP filamentous network. These findings support the hypothesis that biomechanical hardening of bovine ZP is caused by an increase in the number of inter-filaments cross-links whose density should be higher in the ZP inner side.

A novel design of ventricular assist device: an in vitro feasibility study.

Left ventricular assist devices (LVADs) work as a bypass between the left ventricular apex and the ascending aorta. The surgical procedure for their insertion requires the opening of the cardiac cavities and the dissection of the great vessels, the blood is constrained to flow through the device components and the risk can be run of thrombogenesis, haemolysis and infections. A possible strategy to overcome this limitation consists in utilizing external systems that assist the heart in its contraction from the outside without directly transporting the blood. In this study we conduct the feasibility analysis of a novel external LVAD design that does not require the opening of the cardiac cavities and the dissection of the great vessels and that allows the removal procedure to be easily achieved. The device, including a stepper motor, three metallic wires and three elastic elements, works alternatively between a contraction condition where it induces an elastic compulsion on the heart and a release condition where it elastically releases the organ. The values of force acting on the wires and the values of current supplied to the motor were measured and utilized for a preliminary study design. The experimental measurements demonstrated the feasibility of the system.

A mechano-regulation model of fracture repair in vertebral bodies.

In this study a multi-scale mechano-regulation model was developed in order to investigate the mechanobiology of trabecular fracture healing in vertebral bodies. A macro-scale finite element model of the spinal segment L3-L4-L5, including a mild wedge fracture in the body of the L4 vertebra, was used to determine the boundary conditions acting on a micro-scale finite element model simulating a portion of fractured trabecular bone. The micro-scale model, in turn, was utilized to predict the local patterns of tissue differentiation within the fracture gap and then how the equivalent mechanical properties of the macro-scale model change with time. The patterns of tissue differentiation predicted by the model appeared consistent with those observed in vivo. Bone formation occurred primarily through endochondral ossification. New woven bone was predicted to occupy the majority of the space within the fracture site approximately 7-8 weeks after the fracture event. Remodeling of cancellous bone architecture was then predicted, with complete new trabeculae forming due to bridging of the microcallus between the remnant trabeculae.

Analysis of the performance of a standardized method for the polishing of methacrylic resins.

Adhesion of micro-organisms to resin surface may be caused by inadequate polishing. Most of the studies published in literature are relative to manually prepared samples and do not take into account that test repeatability is not guaranteed a priori since skills may change from one operator to another and the quality of the work done by the same expert operator may depend on "human" factors such as the level of attention, wrist trembling, etc.This paper aims to investigate on the efficiency and reliability of a standardized protocol for polishing methacrylic resins. For that purpose, five different methacrylic resins are considered. For each resin, 20 specimens are realized: 10 are polished by the same expert operator and 10 are polished by means of a mechanical system comprised of a milling tool, a mobile support for samples and a micrometric advance isoparallelometer. Roughness measurements are carried out with a +/-0.01 microm resolution profilometer. An extensive statistical analysis is conducted on a population of 100 specimens. Two-way Analysis of Variance (ANOVA) is carried out taking the type of resin (i) and the polishing technique (ii) as predictors in order to evaluate how those variables will finally affect the roughness of the polished surface. The significance of the variable interaction term is assessed. The null hypothesis Ho where response is independent from individual factors as well as from their interaction is assumed to hold true for p-values>0.05 (interval of confidence of the 95%). Experimental data confirm that mechanical polishing leads to obtaining surfaces of much more uniform quality. In fact, statistical dispersion of roughness parameters can decrease significantly. This behavior is observed for all of the tested resins. Therefore, the new approach can eliminate the influence of "human" factors thus making it possible to assess the inherent features of each resin and compare different dental materials submitted to polishing.

An alternative approach to the polishing technique for acrylic resin surfaces.

This study aimed to (1) devise a standardized method of polishing and finishing acrylic resins, (2) eliminate the variable linked to the single operator, and (3) guarantee the reproducibility of the conditions in which smoothness surface values are obtained for comparative purposes. Twenty acrylic resin samples were fabricated (Lucitone, Dentsply). Samples in group 1 were manually polished by a single experienced operator, while samples in group 2 were polished using an isoparallelometer. Surface roughness was measured for both groups with a +/- 0.01-microm resolution profilometer (Mahr, GD25). Data analysis showed that mechanical polishing results in a more uniform surface quality. This preliminary investigation underscores the merits of a standardized method for polishing dental acrylic resins. This approach can eliminate the effect of human factors, thereby making it possible to assess and compare the inherent features of each polished dental material.

Comparison of different orthodontic devices for mandibular symphyseal distraction osteogenesis: a finite element study.

INTRODUCTION: In this study, we aimed to analyze the displacement field and the level of stability for a human mandible that had symphyseal distraction osteogenesis. The mandible was fitted with various orthodontic devices: tooth borne, bone borne, and hybrid. Three-dimensional nonlinear finite element analyses were performed to study differences between the nominal aperture of the device and the actual mandibular distraction. Furthermore, displacement fields of the mandibular arch evaluated with and without mastication forces were compared to determine the level of stability of each appliance. METHODS: Computed tomography scan images of the mandible were processed to create the finite element model, which was completed by modeling the distraction device. Three cases were considered: the distraction device attached to the first molar and the first premolar (tooth borne), to the canine and basal bones (hybrid), or only to the basal bone (bone borne). The nominal aperture of each device was 2 mm. Mandibular displacements in the mastication phase were analyzed in the case of unilateral occlusion on the second premolar. RESULTS AND CONCLUSIONS: Tooth-borne and hybrid devices allow orthodontists to better control the effective displacement transferred to the mandible by the distractor. Displacements of the mandibular arch were closer to the nominal aperture of the distractor than in the case of the bone-borne device. Hybrid devices were more stable under functional loads. However, parasitic rotations of the mandibular arms caused by mastication might counteract the benefits of distraction.