3-D finite element modelling of facial soft tissue and preliminary application in orthodontics

Prediction of soft tissue aesthetics is important for achieving an optimal outcome in orthodontic treatment planning. Previously, applicable procedures were mainly restricted to 2-D profile prediction. In this study, a generic 3-D finite element (FE) model of the craniofacial soft and hard tissue was constructed, and individualisation of the generic model based on cone beam CT data and mathematical transformation was investigated. The result indicated that patient-specific 3-D facial FE model including different layers of soft tissue could be obtained through mathematical model transformation. Average deviation between the transformed model and the real reconstructed one was 0.47 ± 0.77 mm and 0.75 ± 0.84 mm in soft and hard tissue, respectively. With boundary condition defined according to treatment plan, such FE model could be used to predict the result of orthodontic treatment on facial soft tissue.     

Experiments and finite element modelling for the study of prolapse in the pelvic floor system

Pelvic prolapse affects one woman in three of all ages combined and is quite common for more than 60% of patients over 60 years of age. The treatment of this pathological problem is one of the biggest challenges to the gynaecologist today. The rate of surgical intervention failure is quite significant. The recurrence of prolapse could be related to inadequate surgical technique or the pathology or/and biomechanical deficiency of the soft tissues. The modelling and simulation of the behaviour of the pelvic cavity could be a major tool for specific evaluation of pelvic status. A first stage of this model is being developed and reported. The computer-aided design model of the organs of the pelvic floor is created using magnetic resonance image data and the ligament boundary conditions are defined. A multi-organ geometric model is thus created and studied.     

On the importance of 3D,geometrically accurate,and subject-specific finite element analysis for evaluation of in-vivo soft tissue loads

Pressure ulcers are a type of local soft tissue injury due to sustained mechanical loading and remain a common issue in patient care. People with spinal cord injury (SCI) are especially at risk of pressure ulcers due to impaired mobility and sensory perception. The development of load improving support structures relies on realistic tissue load evaluation e.g. using finite element analysis (FEA). FEA requires realistic subject-specific mechanical properties and geometries. This study focuses on the effect of geometry. MRI is used for the creation of geometrically accurate models of the human buttock for three able-bodied volunteers and three volunteers with SCI. The effect of geometry on observed internal tissue deformations for each subject is studied by comparing FEA findings for equivalent loading conditions. The large variations found between subjects confirms the importance of subject-specific FEA.     

A centric/non-centric impact protocol and finite element model methodology for the evaluation of American football helmets to evaluate risk of concussion

American football reports high incidences of head injuries, in particular, concussion. Research has described concussion as primarily a rotation dominant injury affecting the diffuse areas of brain tissue. Current standards do not measure how helmets manage rotational acceleration or how acceleration loading curves influence brain deformation from an impact and thus are missing important information in terms of how concussions occur. The purpose of this study was to investigate a proposed three-dimensional impact protocol for use in evaluating football helmets. The dynamic responses resulting from centric and non-centric impact conditions were examined to ascertain the influence they have on brain deformations in different functional regions of the brain that are linked to concussive symptoms. A centric and non-centric protocol was used to impact an American football helmet; the resulting dynamic response data was used in conjunction with a three-dimensional finite element analysis of the human brain to calculate brain tissue deformation. The direction of impact created unique loading conditions, resulting in peaks in different regions of the brain associated with concussive symptoms. The linear and rotational accelerations were not predictive of the brain deformation metrics used in this study. In conclusion, the test protocol used in this study revealed that impact conditions influences the region of loading in functional regions of brain tissue that are associated with the symptoms of concussion. The protocol also demonstrated that using brain deformation metrics may be more appropriate when evaluating risk of concussion than using dynamic response data alone.     

Implementation and validation of thoracic side impact injury prediction metrics in a human body model

This study's purpose was to implement injury metrics into the Total Human Model for Safety (THUMS) mirroring the spinal accelerometers, rib accelerometers and chest band instrumentation from two lateral post-mortem human subject sled test configurations. In both sled configurations, THUMS contacted a flat rigid surface (either a wall or beam) at 6.7 m/s. Sled A maximum simulated wall forces for the thorax, abdomen and pelvis were 7.1, 5.0 and 10.0 kN versus 5.7 ± 0.8, 3.4 ± 1.2 and 6.2 ± 2.7 kN experimentally. Sled B maximum simulated beam forces for the torso and pelvis were 8.0 and 7.6 kN versus 8.5 ± 0.2 and 7.9 ± 2.5 kN experimentally. Quantitatively, force magnitude contributed more to variation between simulated and experimental forces than phase shift. Acceleration-based injury metrics were within one standard deviation of experimental means except for the lower spine in the rigid wall sled test. These validated metrics will be useful for quantifying occupant loading conditions and calculating injury risks in various loading configurations.     

Detailed finite element modelling of deep needle insertions into a soft tissue phantom using a cohesive approach

Detailed finite element modelling of needle insertions into soft tissue phantoms encounters difficulties of large deformations, high friction, contact loading and material failure. This paper demonstrates the use of cohesive elements in high-resolution finite element models to overcome some of the issues associated with these factors. Experiments are presented enabling extraction of the strain energy release rate during crack formation. Using data from these experiments, cohesive elements are calibrated and then implemented in models for validation of the needle insertion process. Successful modelling enables direct comparison of finite element and experimental force–displacement plots and energy distributions. Regions of crack creation, relaxation, cutting and full penetration are identified. By closing the loop between experiments and detailed finite element modelling, a methodology is established which will enable design modifications of a soft tissue probe that steers through complex mechanical interactions with the surrounding material.     

The use of preserved tissue in finite element modelling of fresh ovine vertebral behaviour

The aim of this study was to investigate whether the predicted finite element (FE) stiffness of vertebral bone is altered when using images of preserved rather than fresh tissue to generate specimen-specific FE models. Fresh ovine vertebrae were used to represent embalmed (n = 3) and macerated dry-bone (n = 3) specimens and treated accordingly. Specimens were scanned pre- and post-treatment using micro-computed tomography. A constant threshold level derived from these images was used to calculate the respective bone volume fraction (BV/TV) from which the conversion factor validated for fresh tissue was used to determine material properties that were assigned to corresponding FE models. Results showed a definite change in the BV/TV between the fresh and the preserved bone. However, the changes in the predicted FE stiffness were not generally greater than the variations expected from assignment of loading and boundary conditions. In conclusion, images of preserved tissue can be used to generate FE models that are representative of fresh tissue with a tolerable level of error.     

Quantification of soft tissue balance in total knee arthroplasty using finite element analysis

Unbalanced contact force on the tibial component has been considered a factor leading to loosening of the implant and increased wear of the bearing surface in total knee arthroplasty. Because it has been reported that good alignment cannot guarantee successful clinical outcomes, the soft tissue balance should be checked together with the alignment. Finite element models of patients' lower extremities were developed to analyse the medial and lateral contact force distribution on the tibial insert. The distributions for four out of five patients were not balanced equally, even though the alignment angles were within a clinically acceptable range. Moreover, the distribution was improved by changing soft tissue release and ligament tightening for the specific case. Integration of the biomechanical modelling, image matching and finite element analysis techniques with the patient-specific properties and various dynamic loading would suggest a clinically relevant pre-operative planning for soft tissue balancing.     

Stress analysis of a complete maxillary denture under various drop impact conditions: a 3D finite element study

Complete maxillary dentures are one of the most economic and easy ways of treatment for edentulous patients and are still widely used. However, their survival rate is slightly above three years. It is presumed that the failure reasons are not only due to normal fatigue but also emerge from damage based on unavoidable improper usage. Failure types other than long-term fatigue, such as over-deforming, also influence the effective life span of dentures. A hypothesis is presumed, stating that the premature/unexpected failures may be initiated by impact on dentures, which can be related to dropping them on the ground or other effects such as biting crispy food. Thus, the behavior of a complete maxillary denture under impact loading due to drop on a rigid surface was investigated using the finite element method utilizing explicit time integration and a rate-sensitive elastoplastic material model of polymethylmethacrylate (PMMA). Local permanent deformations have been observed along with an emphasis on frenulum region of the denture, regardless of the point of impact. Contact stresses at the tooth–denture base were also investigated. The spread of energy within the structure via wave propagation is seen to play a critical role in this fact. Stress-wave propagation is also seen to be an important factor that decreases the denture's fatigue life.     

Computational modelling of the natural hip: a review of finite element and multibody simulations

Primary objective: The hip joint suffers from a high prevalence of degenerative conditions. Athough patient's well-being could be improved through early and more effective interventions, without a greater understanding of the mechanics of the hip, these developments cannot be attained. Thus, this review article summarises the current literature on this subject in order to provide a platform for future developments. To illustrate the influence computational simulations have had on the knowledge advancement in hip mechanics, we explored two methodological approaches: finite element (FE) analysis and multibody dynamics (MBD). Main outcomes and results: Notwithstanding the unique capabilities of FE and MBD, the former generally offers the micromechanics of the articulating surfaces whereas the latter the macromechanics of the skeleton, these two methodologies also provide the bulk of the literature regarding computational modelling of the musculoskeletal system. Although FE has provided significant knowledge on contact pressures and the effects of musculoskeletal geometries, in particular cartilage and bone shapes, MBD has afforded a wealth of understanding on the influence of gait patterns and muscle attachment locations on force magnitudes. Conclusions: These two computational techniques have, and will continue to, provide significant contributions towards the development of interventions. It is hoped that this article will help focus ongoing technological developments by highlighting areas of success, but also areas of under development.     

Comparative finite element modelling of aneurysm formation and physiologic inflation in the descending aorta

Abstract

Despite the general interest in aneurysm rupture prediction, the aneurysm formation has received limited attention. The goal of this study is to assess whether an aneurysm may be instigated in a healthy model of an aorta inflated by a supra-physiological pressure. The effect of two main aspects on numerical predictions has been explored: i) the geometric design and ii) the constitutive law adopted to represent the material properties. Firstly, higher values of wall stress and displacement magnitude were generated in the physiologic model compared to the cylindrical one when assigning the same material properties. Secondly, greater deformations are observed in the anisotropic model compared to the isotropic one.     

An investigation into the use and limitations of different spatial integration schemes and finite element software in head impact analyses

To understand the mechanopathogenesis of brain lesions, finite element (FE) head models are used. There is a broad range of material properties, contact interfaces and integration schemes used for the different parts in current FE head models. The effect of material behaviour and contact definitions on a head impact analysis is reported in the literature, whereas the effect of FE integration schemes is a rather unexplored domain. This paper starts with the development of a simplified head model to which small adaptations are made in the integration scheme to obtain multiple analyses that are compared using an accident reconstruction. The performed study highlighted potential hazards of different integration schemes and the significant effect they have on the simulated mechanical responses of the head. Based on a comparison between FE softwares using an impact test and patch test, it was seen that also the software could have an effect on the FE analysis results.     

Updated Lagrangian finite element formulations of various biological soft tissue non-linear material models: a comprehensive procedure and review

Simplified material models are commonly used in computational simulation of biological soft tissue as an approximation of the complicated material response and to minimize computational resources. However, the simulation of complex loadings, such as long-duration tissue swelling, necessitates complex models that are not easy to formulate. This paper strives to offer the updated Lagrangian formulation comprehensive procedure of various non-linear material models for the application of finite element analysis of biological soft tissues including a definition of the Cauchy stress and the spatial tangential stiffness. The relationships between water content, osmotic pressure, ionic concentration and the pore pressure stress of the tissue are discussed with the merits of these models and their applications.     

Finite element analysis of a hemi-pelvis: the effect of inclusion of cartilage layer on acetabular stresses and strain

An appropriate method of application of the hip-joint force and stress analysis of the pelvic bone, in particular the acetabulum, is necessary to investigate the changes in load transfer due to implantation and to calculate the reference stimulus for bone remodelling simulations. The purpose of the study is to develop a realistic 3D finite element (FE) model of the hemi-pelvis and to assess stress and strain distribution during a gait cycle. The FE modelling approach of the pelvic bone was based on CT scan data and image segmentation of cortical and cancellous bone boundaries. Application of hip-joint force through an anatomical femoral head having a cartilage layer was found to be more appropriate than a perfectly spherical head, thereby leading to more accurate stress–strain distribution in the acetabulum. Within the acetabulum, equivalent strains varied between 0.1% and 0.7% strain in the cancellous bone. High compressive (15–30 MPa) and low tensile (0–5 MPa) stresses were generated within the acetabulum. The hip-joint force is predominantly transferred from the acetabulum through the lateral cortex to the sacroiliac joint and the pubic symphysis. The study is useful to understand the load transfer within the acetabulum and for further investigations on acetabular prosthesis.     

Validation of plantar pressure simulations using finite and discrete element modelling in healthy and diabetic subjects

Plantar pressure simulation driven by integrated 3D motion capture data, using both a finite element and a discrete element model, is compared for ten healthy and ten diabetic neuropathic subjects. The simulated peak pressure deviated on average between 16.7 and 34.2% from the measured peak pressure. The error in the position of the peak pressure was on average smaller than 4.2 cm. No method was more accurate than the other although statistical differences were found between them. Both techniques are thus complementary and useful tools to better understand the alteration of diabetic foot biomechanics during gait.     

Biomechanical analysis of the Universal 2 implant in total wrist arthroplasty: a finite element study

Little is known about the mechanics of in vivo loading on total wrist prostheses where many studies have looked at the mechanics of other types of arthroplasty such as for the hip and the knee which has contributed to the overall success of these types of procedures. Currently surgeons would prefer to carry out arthrodesis on the wrist rather than consider arthroplasty as clinical data have shown that the outcome of total wrist arthroplasty is poorer than compared to the hip and knee. More research is needed on the loading mechanisms of the implants in order to enhance the design of future generation implants. This study looks at the load transfer characteristics of the Universal 2 implant using a finite element model of a virtually implanted prosthesis during gripping. The results showed that the loading on the implant is higher on the dorsal and ulnar aspect than on the volar and radial aspect of the implant. The whole load is transmitted through the radius and none through the ulna.     

Development of a geometrically accurate and adaptable finite element head model for impact simulation: the Naval Research Laboratory–Simpleware Head Model

This study demonstrates a novel model generation methodology that addresses several limitations of conventional finite element head models (FEHM). By operating chiefly in image space, new structures can be incorporated or merged, and the mesh either decimated or refined both locally and globally. This methodology is employed in the development of a highly bio-fidelic FEHM from high-resolution scan data. The model is adaptable and presented here in a form optimised for impact and blast simulations. The accuracy and feasibility of the model are successfully demonstrated against a widely used experimental benchmark in impact loading and through the investigation of potential brain injury under blast overpressure loading.     

Implication of obesity on motion,posture and internal stress of the foot: an experimental and finite element analysis

Obesity causes increased loading on the foot which can damage the soft tissue and bone ultimately leading to foot problems. Experimental and computational methods were used to analyse the chain of biomechanical changes in the lower limb due to obesity. The experimental study shows some changes in foot posture and gait where obese subjects were more likely to have pronated feet, smaller joint angles in the sagittal and frontal planes, smaller cadence, and smaller stride length. Anatomically correct finite element models generated on obese subjects showed increased and altered internal and plantar stress. Altered foot posture was identified as a key indicator of increased internal stress indicating the importance of foot posture correction.     

Pedicle screw-based posterior dynamic stabilisation of the lumbar spine: in vitro cadaver investigation and a finite element study

Pedicle screw-based dynamic constructs either benefit from a dynamic (flexible) interconnecting rod or a dynamic (hinged) screw. Both types of systems have been reported in the literature. However, reports where the dynamic system is composed of two dynamic components, i.e. a dynamic (hinged) screw and a dynamic rod, are sparse. In this study, the biomechanical characteristics of a novel pedicle screw-based dynamic stabilisation system were investigated and compared with equivalent rigid and semi-rigid systems using in vitro testing and finite element modelling analysis. All stabilisation systems restored stability after decompression. A significant decrease in the range of motion was observed for the rigid system in all loadings. In the semi-rigid construct the range of motion was significantly less than the intact in extension, lateral bending and axial rotation loadings. There were no significant differences in motion between the intact spine and the spine treated with the dynamic system (P>0.05). The peak stress in screws was decreased when the stabilisation construct was equipped with dynamic rod and/or dynamic screws.     

Finite element models of the thigh-buttock complex for assessing static sitting discomfort and pressure sore risk: a literature review

Being seated for long periods, while part of many leisure or occupational activities, can lead to discomfort, pain and sometimes health issues. The impact of prolonged sitting on the body has been widely studied in the literature, with a large number of human-body finite element models developed to simulate sitting and assess seat-induced discomfort or to investigate the biomechanical factors involved. Here, we review the finite element models developed to investigate sitting discomfort or risk of pressure sores. Our study examines finite element models from twenty-seven papers, seventeen dedicated to assessing seating discomfort and ten dedicated to investigating pressure ulcers caused by prolonged sitting. The models’ mesh composition and material properties are found to differ widely. These models share a lack of validation and generally make little allowance for anthropometric diversity.