Accuracy of computer-aided geometric 3D reconstruction based on histological serial microgrinding preparation

Purpose: For our research on computer-optimised and automated cochlear implant surgery, we pursue a model-based approach to overcome the limitations of currently available clinical imaging modalities. A serial cross section preparation procedure has been developed and evaluated concerning accuracy to serve for modelling of a digital anatomic atlas to make delicate soft tissue structures available for pre-operative planning.

Methods: A special grinding tool was developed allowing the setting of a specific amount of abrasion as equidistant slice thickness was considered a crucial step. Additionally, each actual abrasion was accurately measured and used during three-dimensional reconstruction of the serial cross-sectional images obtained via digital photo documentation after each microgrinding step. A well-known reference object was prepared using this procedure and evaluated in terms of accuracy.

Results: Reconstruction of the whole sample was achieved with an error less than 0.4%, and the edge lengths in the direction of abrasion could be reconstructed with an average error of 0.6 ± 0.3 mm; both prove the realisation of equidistant abrasion. Using artificial registration fiducials and a custom-made algorithm for image alignment, parallelism and rectangularity could be preserved with average errors less than 0.4° ± 0.3°.

Conclusion: We present a systematic, practicable and reliable method for the geometrically accurate reconstruction of anatomical structures, which is especially suitable for the middle and inner ear anatomy including soft tissue structures. For the first time, the quality of such a reconstruction process has been quantified and successfully proven for its usability.     

The Biomechanical Effects of Sagittal Split Ramus Osteotomy on Temporomandibular Joint

Abstract

The aim of this study was to evaluate the stress distributions and deformations of the temporomandibular joint (TMJ) during different periods before and after sagittal split ramus osteotomy (SSRO). A three-dimensional finite element model of the mandible and TMJ was established, based on the preoperative CT of a patient with mandibular prognathism. Numerical SSRO was performed and the models of three postoperative periods were established. Contact elements were used to simulate the interaction between the articular discs and the articular cartilages. Nonlinear cable elements were used to simulate the disc attachments and the ligaments. Muscle forces and boundary conditions corresponding to the central occlusion were applied on all the models. The results showed that the stress distributions of the patient’s TMJs were not the same as those of asymptomatic subjects. The stress distributions and deformations of the disc, condylar and temporal cartilage were changed at different periods after SSRO. The biomechanical parameters of TMJ were improved after SSRO. And the postoperative results showed that appropriate functional training could help to avoid TMJ diseases. Therefore SSRO could improve the stress distributions of the TMJ and relieve the symptoms of temporomandibular disorder (TMD).     

Hyperbaric oxygen therapy treatment for the fixation of implant prosthesis in oncology patients irradiated

doi: 10.1111/j.1741‐2358.2012.00636.x Hyperbaric oxygen therapy treatment for the fixation of implant prosthesis in oncology patients irradiated Objectives: This study aimed to present a clinical report of an irradiated oncologic patient who underwent hyperbaric oxygen therapy to be rehabilitated with implant‐supported prosthesis. Materials and Methods: A 67‐year‐old man was admitted at Oral Oncology Center (FOA‐UNESP) presenting a lesion on the mouth floor. After clinical evaluation, incisional biopsy and histopathological exam, a grade II squamous cell carcinoma was diagnosed. The patient was subjected to surgery to remove the lesion and partial glossectomy. Afterwards, the radiotherapy, in the left/right cervicofacial area of the supraclavicular fossa, was conducted. After 3 years of the surgery, the patient was submitted to hyperbaric oxygen therapy. Then, four implants were installed in patient’s mandible. Five months later, an upper conventional complete denture and lower full‐arch implant‐supported prosthesis were fabricated. Conclusion: The treatment resulted in several benefits such as improving his chewing efficiency, swallowing and speech, less denture trauma on the mucosa and improving his self‐esteem.     

Resonance frequency analysis of overdenture retainer implants with immediate loading

doi: 10.1111/j.1741‐2358.2011.00488.x
Resonance frequency analysis of overdenture retainer implants with immediate loading Objective: To evaluate 16 patients of both sexes with lower overdenture and upper complete dentures, by analysing the resonance frequency of the initial and late stability of implants used to retain the overdenture under immediate loading. Background: Oral rehabilitation treatment with complete dentures using implants has been increasingly more common among the specialists in the oral rehabilitation area. This is an alternative for obtaining retention and stability in treatments involving conventional complete dentures, where two implants are enough to retain the overdenture satisfactorily. Materials and methods: The Osstell? Mentor device was used for the analysis in the initial period (primary stability), 3 and 15 months after the installation of the lower overdenture (secondary stability). The statistical analysis was performed with the repeated measures model (p < 0.01). Results: The implant stability quotients were observed to increase after 15 months of the rehabilitating treatment. Conclusion: The use of overdentures over two lower implants should become the treatment of choice for individuals who have a fully edentulous mandible.     

Serum superoxide dismutase,a potential predictor for radiation pneumonitis following chemoradiotherapy in non-small cell lung cancer patients

Purpose: To explore serum superoxide dismutase (SOD) for predicting radiation pneumonitis (RP) in non-small cell lung cancer patients following chemoradiotherapy.

Methods: Serum levels for SOD were measured by enzyme-linked immunosorbent assays prior to radiation therapy (Pre-RT) and post 40 Gy/4 weeks during the treatment (Pos-RT).

Results: SOD concentrations after delivery of 40 Gy/4 weeks was associated with the development of RP. The best predictive ability of SOD was observed for a cut-off value of 56 unit/ml, with a sensitivity of 0.80 (95% CI 0.28–0.99), and a specificity of 0.67 (95% CI 0.43–0.65) (p = 0.040).

Conclusion: Serum SOD may be a potential predictor for RP, which need to be further verified.     

Validation of a musculo-skeletal model of the mandible and its application to mandibular distraction osteogenesis

Mandibular distraction osteogenesis will lead to a change in muscle coordination and load transfer to the temporomandibular joints (TMJ). The objective of this work is to present and validate a rigid-body musculo-skeletal model of the mandible based on inverse dynamics for calculation of the muscle activations, muscle forces and TMJ reaction forces for different types of clenching tasks and dynamic tasks. This approach is validated on a symmetric mandible model and an application will be presented where the TMJ reaction forces during unilateral clenching are estimated for a virtual distraction patient with a shortened left ramus. The mandible model consists of 2 rigid segments and has 4 degrees-of-freedom. The model was equipped with 24 hill-type musculotendon actuators. During the validation experiment one subject was asked to do several tasks while measuring EMG activity, bite force and kinematics. The bite force and kinematics were used as input for the simulations of the same tasks after which the estimated muscle activities were compared with the measured muscle activities. This resulted in an average correlation coefficient of 0.580 and an average of the Mean Absolute Error of 0.109. The virtual distraction model showed a large difference in the TMJ reaction forces between left and right compared with the symmetric model for the same loading case. The present work is a step in the direction of building patient-specific mandible models, which can assess the mechanical effects on the TMJ before mandibular distraction osteogenesis surgery.     

Influence of different mucosal resiliency and denture reline on stress distribution in peri-implant bone tissue during osseointegration. A three-dimensional finite element analysis

doi: 10.1111/j.1741‐2358.2011.00569.x Influence of different mucosal resiliency and denture reline on stress distribution in peri‐implant bone tissue during osseointegration. A three‐dimensional finite element analysis Objective: The aim of this study was to evaluate the influence of mucosal properties and relining material on the stress distribution in peri‐implant bone tissue during masticatory function with a conventional complete denture during the healing period through finite element analysis. Materials and Methods: Three‐dimensional models of a severely resorbed mandible with two recently placed implants in the anterior region were created and divided into the following situations: (i) conventional complete denture and (ii) relined denture with soft lining material. The mucosal tissue properties were divided into soft, resilient and hard. The models were exported to mechanical simulation software; two simulations were carried out with a load at the lower right canine (35 N) and the lower right first molar (50 N). Data were qualitatively evaluated using Maximum Principal Stress, in MPa, given by the software. Results: All models showed stress concentrations in the cortical bone corresponding to the cervical part of the implant. The mucosal properties influenced the stress in peri‐implant bone tissue showing a different performance according to the denture base material. The simulations with relined dentures showed lower values of stress concentration than conventional ones. Conclusions: It seems that the mucosal properties and denture reline have a high influence on the stress distribution in the peri‐implant bone during the healing period.     

Elders with implant overdentures: a 22-year clinical report

doi: 10.1111/j.1741‐2358.2012.00628.x Elders with implant overdentures: a 22‐year clinical report Objective: To report on the long‐term survival and prosthodontic maintenance of two edentulous adults with mandibular overdentures supported by hydroxyapatite (HA)‐coated implants. Background: Mandibular implant overdentures are a successful treatment option with positive impact on the quality of life of elderly edentulous adults. Long‐term survival of the implants requires continued rigorous prosthodontic maintenance. Clinical report: Two elderly edentulous adults with mandibular overdentures supported by 2 HA‐coated implants were presented for prosthodontic rehabilitation after 22 years of placement. The implants were osseo‐integrated and surviving at presentation based on accepted criteria. The mandibular implant overdentures suffered recurrent loss of retention and stability. Prosthodontic treatment involving the replacement of defective attachment systems and construction of new sets of mandibular implant overdentures opposing complete maxillary dentures is presented. Conclusion: The long‐term survival of mandibular 2‐implant overdentures requires continued prosthodontic maintenance. A conservative approach in the rehabilitation of two older edentulous adults with mandibular 2‐implant overdentures was described including proper selection of attachment systems.     

Advanced material modelling in numerical simulation of primary acetabular press-fit cup stability

Primary stability of artificial acetabular cups, used for total hip arthroplasty, is required for the subsequent osteointegration and good long-term clinical results of the implant. Although closed-cell polymer foams represent an adequate bone substitute in experimental studies investigating primary stability, correct numerical modelling of this material depends on the parameter selection.

Material parameters necessary for crushable foam plasticity behaviour were originated from numerical simulations matched with experimental tests of the polymethacrylimide raw material. Experimental primary stability tests of acetabular press-fit cups consisting of static shell assembly with consecutively pull-out and lever-out testing were subsequently simulated using finite element analysis.

Identified and optimised parameters allowed the accurate numerical reproduction of the raw material tests. Correlation between experimental tests and the numerical simulation of primary implant stability depended on the value of interference fit. However, the validated material model provides the opportunity for subsequent parametric numerical studies.     

Dietary correlates of temporomandibular joint morphology in the great apes

Behavioral observations of great apes have consistently identified differences in feeding behavior among species, and these differences have been linked to variation in masticatory form. As the point at which the mandible and cranium articulate, the temporomandibular joint (TMJ) is an important component of the masticatory apparatus. Forces are transmitted between the mandible and cranium via the TMJ, and this joint helps govern mandibular range of motion. This study examined the extent to which TMJ form covaries with feeding behavior in the great apes by testing a series of biomechanical hypotheses relating to specific components of joint shape using linear measurements extracted from three‐dimensional coordinate data. Results of these analyses found that taxa differ significantly in TMJ shape, particularly in the mandibular fossa. Chimpanzees have relatively more anteroposteriorly elongated joint surfaces, whereas gorillas tend to have relatively anteroposteriorly compressed joints. Orangutans were most commonly intermediate in form between Pan and Gorilla, perhaps reflecting a trade‐off between jaw gape and load resistance capabilities. Importantly, much of the observed variation among taxa reflects differences in morphologies that facilitate gape over force production. These data therefore continue to emphasize the unclear relationship between mandibular loading and bony morphology, but highlight the need for further data regarding food material properties, jaw gape, and ingestive/food processing behaviors. Am J Phys Anthropol, 2013. © 2012 Wiley Periodicals, Inc.     

Assessment of the risk of perforation of the mandibular canal by implant drill using density and thickness parameters

Gerodontology 2009; doi: 10.1111/j.1741‐2358.2009.00362.x
Assessment of the risk of perforation of the mandibular canal by implant drill using density and thickness parameters Objective: The objective of this study was to investigate whether the resistance of the bone surrounding the mandibular canal had sufficient density and thickness to avoid perforation by drills when preparing the bed of the implant. Background: Damage to the inferior alveolar nerve (IAN) is more common than expected. This injury may lead to serious complications ranging from mild paresthesia to total anaesthesia of the lower jaw. Materials and methods: The CT images of 99 patients, whose ages ranged between 20 and 79 years, and who applied for an implant application to the posterior aspect of the mandible were included in this study. Results: The overall average bone thickness in the premolar and molar regions was 0.8717 ± 0.1818 and 0.8556 ± 0.1756 mm, respectively, whereas the bone density in the premolar and molar regions was 649.18 ± 241.42 and 584.44 ± 222.73 Hounsfield Units (HU), respectively (p < 0.001). Conclusion: It was determined that the average density and thickness of the bone that surrounds the mandibular canal was not sufficient to resist the implant drill. It can be concluded that the risk of injury to the IAN may be minimised by accurately determining the bone mass on the canal prior to the implant procedure, and avoiding excessive force when approaching the canal.     

Modeling the debonding process of osseointegrated implants due to coupled adhesion and friction

Cementless implants have become widely used for total hip replacement surgery. The long-term stability of these implants is achieved by bone growing around and into the rough surface of the implant, a process called osseointegration. However, debonding of the bone–implant interface can still occur due to aseptic implant loosening and insufficient osseointegration, which may have dramatic consequences. The aim of this work is to describe a new 3D finite element frictional contact formulation for the debonding of partially osseointegrated implants. The contact model is based on a modified Coulomb friction law by Immel et al. (2020), that takes into account the tangential debonding of the bone-implant interface. This model is extended in the direction normal to the bone-implant interface by considering a cohesive zone model, to account for adhesion phenomena in the normal direction and for adhesive friction of partially bonded interfaces. The model is applied to simulate the debonding of an acetabular cup implant. The influence of partial osseointegration and adhesive effects on the long-term stability of the implant is assessed. The influence of different patient- and implant-specific parameters such as the friction coefficient \(\mu _\text {b}\), the trabecular Young’s modulus \(E_\text {b}\), and the interference fit \(I\!F\) is also analyzed, in order to determine the optimal stability for different configurations. Furthermore, this work provides guidelines for future experimental and computational studies that are necessary for further parameter calibration.

     

Convergence and functional evolution of longirostry in crocodylomorphs

During the Mesozoic, Crocodylomorpha had a much higher taxonomic and morphological diversity than today. Members of one particularly successful clade, Thalattosuchia, are well‐known for being longirostrine: having long, slender snouts. It has generally been assumed that Thalattosuchia owed their success in part to the evolution of longirostry, leading to a feeding ecology similar to that of the living Indian gharial, Gavialis. Here, we compare form and function of the skulls of the thalattosuchian Pelagosaurus and Gavialis using digital reconstructions of the skull musculoskeletal anatomy and finite element models to show that they had different jaw muscle arrangements and biomechanical behaviour. Additionally, the relevance of feeding‐related mandibular traits linked to longirostry in the radiation of crocodylomorph clades was investigated by conducting an evolutionary rates analysis under the variable rates model. We find that, even though Pelagosaurus and Gavialis share similar patterns of stress distribution in their skulls, the former had lower mechanical resistance. This suggests that compared to Gavialis, Pelagosaurus was unable to process large, mechanically less tractable prey, instead operating as a specialized piscivore that fed on softer and smaller prey. Secondly, innovation of feeding strategies was achieved by rate acceleration of functional characters of the mandible, a key mechanism for the diversification of certain clades like thalattosuchians and eusuchians. Different rates of functional evolution suggest divergent diversification dynamics between teleosaurids and metriorhynchids in the Jurassic.     

Structure and properties of a personalized bio-fixed implant prepared with selective laser melting

Abstract

Personalized bio-fixed implants require good modeling efficiency, matching, and stress distribution for optimal function. We performed three-dimensional reconstruction of the tibial implant using reverse and positive methods, performed finite element analysis, and then used the optimized model structure and the optimal node arrangement of the finite element method to design a biomechanical tibia implant. Next, we used selective laser melting equipment for direct manufacturing and then determined the mechanical properties of the completed implant unit structure. The results indicated that the finite element method allows good modeling, the strain performance is equivalent to that of material produced using the traditional modeling method, and the resulting product has a more even stress distribution. The porous structure of the material formed by SLM showed a good forming effect within 3?mm of the pillar, had less powder adhesive on the surface, and lacked obvious dross, suggesting the utility of this method for preparation of personalized bio-fixed implants.     

Free body analysis,beam mechanics,and finite element modeling of the mandible of Alligator mississippiensis

The mechanical behavior of mammalian mandibles is well‐studied, but a comprehensive biomechanical analysis (incorporating detailed muscle architecture, accurate material properties, and three‐dimensional mechanical behavior) of an extant archosaur mandible has never been carried out. This makes it unclear how closely models of extant and extinct archosaur mandibles reflect reality and prevents comparisons of structure–function relationships in mammalian and archosaur mandibles. We tested hypotheses regarding the mechanical behavior of the mandible of Alligator mississippiensis by analyzing reaction forces and bending, shear, and torsional stress regimes in six models of varying complexity. Models included free body analysis using basic lever arm mechanics, 2D and 3D beam models, and three high‐resolution finite element models of the Alligator mandible, incorporating, respectively, isotropic bone without sutures, anisotropic bone with sutures, and anisotropic bone with sutures and contact between the mandible and the pterygoid flange. Compared with the beam models, the Alligator finite element models exhibited less spatial variability in dorsoventral bending and sagittal shear stress, as well as lower peak values for these stresses, suggesting that Alligator mandibular morphology is in part designed to reduce these stresses during biting. However, the Alligator models exhibited greater variability in the distribution of mediolateral and torsional stresses than the beam models. Incorporating anisotropic bone material properties and sutures into the model reduced dorsoventral and torsional stresses within the mandible, but led to elevated mediolateral stresses. These mediolateral stresses were mitigated by the addition of a pterygoid‐mandibular contact, suggesting important contributions from, and trade‐offs between, material properties and external constraints in Alligator mandible design. Our results suggest that beam modeling does not accurately represent the mechanical behavior of the Alligator mandible, including important performance metrics such as magnitude and orientation of reaction forces, and mediolateral bending and torsional stress distributions. J.Morphol. 2011. © 2011 Wiley‐Liss, Inc.     

Negative effects of agrocin 84-encoding Agrobacterium plasmids on symbiotic properties of Rhizobium meliloti

Two plasmids, pAgK84::Tn5-Mob from Agrobacterium radiobacter carrying genes for the production of agrocin 84, and RP4-4 from E. coli were inserted either separately or together into a strain of Rhizobium meliloti. Each of these plasmid-containing R. meliloti transconjugants was less effective than the wild type strain in their ability to fix nitrogen in Medicago tornata. The pAgK84::Tn5-Mob-containing transconjugant was significantly less effective than that containing RP4-4. The transconjugant strains were inferior to the wild type strain in their ability to nodulate seedlings and to compete for nodulation.     

Edge activators and a polycationic polymer enhance the formulation of porous voriconazole nanoagglomerate for the use as a dry powder inhaler

Purpose: Voriconazole has both low aqueous solubility and stability. We hypothesize that designing voriconazole in the form of a nano powder inhaler at a geometric diameter within 1–5?μm will enhance its stability and solubility. Therefore, we prepared nanoagglomerates of voriconazole which will collapse in the lungs to reform the nanoparticles.

Method: The nanoparticles were formulated using both stearic acid and sodium deoxycholate as edge activators. Osmogenic polycation polyethyleneimine (PEI) was used to form agglomerates of controllable size.

Results: Voriconazole nanoparticles and agglomerates showed a significant higher cumulative drug release than the pure powder (p?R^2?=^?0.95. Small-sized particles were formed (353?nm), while their zeta potential was ?30.7?mV. The agglomerates were 2.7?μm in size and their zeta potential was ?20.9?mV. The formation of porous agglomerates was confirmed using a transmission electron microscope. Cascade impactor was used to evaluate the aerodynamic properties of the nanoparticles and the agglomerates. The aerodynamic characterization of the nanoparticles and the agglomerates resulted in a significant smaller mass median aerodynamic diameter (MMAD) (p?p?p?p?Conclusion: The results suggest that using the combination of edge activators and diluted polycationic polymer solution provides porous voriconazole nanoagglomerates in a respirable range, which is proved successful in enhancing both the deposition and the dissolution of water insoluble-drugs in the lung.     

Using the finite element method to model the biomechanics of the asymmetric mandible before, during and after skeletal correction by distraction osteogenesis

An approach was developed to evaluate the load transfer mechanism in the temporomandibular joint (TMJ) area before, during and after mandibular ramus elongation by distraction osteogenesis (DO). In a concerted approach using computer tomography, magnetic resonance imaging (MRI), and finite element analysis, three-dimensional numerical models based on a young male patient, with a dento-facial deformity were generated. The magnitude and direction of the muscle forces acting on the mandible were assessed using both values derived from the muscles volume and cross-section as retrieved from the MRI-scan data-sets and taken from the literature. The resistance of the soft tissue envelope towards elongation during the DO-phase was also included. The finite element analyses showed that before skeletal correction by DO the load transfer was asymmetrical with high peak stresses in the affected joint. Following ramus elongation a more symmetrical loading in TMJs was predicted. The reaction forces in the TMJs during DO were low.