A meshless microscale bone tissue trabecular remodelling analysis considering a new anisotropic bone tissue material law

In this work, a novel anisotropic material law for the mechanical behaviour of the bone tissue is proposed. This new law, based on experimental data, permits to correlate the bone apparent density with the obtained level of stress. Combined with the proposed material law, a biomechanical model for predicting bone density distribution was developed, based on the assumption that the bone structure is a gradually self-optimising anisotropic biological material that maximises its own structural stiffness. The strain and the stress field required in the iterative remodelling process are obtained by means of an accurate meshless method, the Natural Neighbour Radial Point Interpolation Method (NNRPIM). Comparing with other numerical approaches, the inclusion of the NNRPIM presents numerous advantages such as the high accuracy and the smoother stress and strain field distribution. The natural neighbour concept permits to impose organically the nodal connectivity and facilitates the analysis of convex boundaries and extremely irregular meshes. The viability and efficiency of the model were tested on several trabecular benchmark patch examples. The results show that the pattern of the local bone apparent density distribution and the anisotropic bone behaviour predicted by the model for the microscale analysis are in good agreement with the expected structural architecture and bone apparent density distribution.     

A new numerical approach to mechanically analyse biological structures

In this work, an advanced discretization meshless technique is used to study the structural response of a human brain due to an impact load. The 2D and 3D brain geometrical models, and surrounding structures, were obtained through the processing of medical images, allowing to achieve a realistic geometry for the virtual model and to define the distribution of the mechanical properties accordingly with the medical images colour scale. Additionally, a set of essential and natural boundary conditions were assumed in order to reproduce a sudden impact force applied to the cranium. Then, a structural numerical analysis was performed using the Natural Neighbour Radial Point Interpolation Method (NNRPIM). The obtained results were compared with the finite element method (FEM) and a solution available in the literature. This work shows that the NNRPIM is a robust and accurate numerical technique, capable to produce results very close to other numerical approaches. In addition, the variable fields obtained with the meshless method are much smoother than the FEM corresponding solution.     

Data on morphometric analysis of anterior teeth from Hazaribag College of Dental Sciences and Hospital,jharkhand

It is of interest to document data on morphometric (measurement of external form) analysis of maxillary and mandibular anterior teeth collected from a dental set up using mesio-distal (MD) dimension. The mesiodistal dimensions of all permanent anterior teeth (central incisor, lateral incisor and canine) of 25 males and 25 females patients were recorded using digital vernier calipers. Data were charted and statistical analysis was done using Mann Whitney U test. Data shows sexual dimorphism for every tooth between males and females. However, dimorphism was exhibited only in maxillary and mandibular canine, mandibular central incisors, and lateral incisor. Hence,odontometric parameters offer simple, reliable and cost-effective in forensic investigation for recording gender discrimination.     

An analytical investigation into possible mechanical causes of bone remodelling

Three-dimensional finite element analyses were carried out on idealisations of two situations where bone remodelling has been reported clinically viz. the malaligned femur and a maxillary central incisor under orthodontic loading. The mechanical responses, i.e. stress, strain and change of curvature, in various directions, are presented. They are compared with the biological response, either bone resorption or bone deposition. The results are discussed in relation to three current theories of bone remodelling.     

CAD–CAM prosthetically guided bone regeneration using preformed titanium mesh for the reconstruction of atrophic maxillary arches

The protocol presented here is intended to minimise the intervention in bone reconstruction surgery when severe atrophy or deformity is present in the maxillary arches. A patient underwent augmentation of an atrophic maxillary arch using titanium mesh and particulate autogenous plus bovine demineralised bone. After computed tomography data elaboration, computer-aided design and computer-aided machining were used to plan the augmentation of bone volume to improve the implant position needed to support the final dental prosthesis. The augmented maxilla was rapidly prototyped in plastic, and the titanium mesh was tested on this model before the surgical intervention. Then, the preformed titanium mesh was implanted in the maxillary arch with bone grafting. The bone was augmented relative to the position of the implants for the definitive fixed implant-supported rehabilitation. The protocol presented here is a viable, reproducible way to determine the correct bone augmentation for the final implant-supported prosthetic rehabilitation.     

Talon cusp from two archaic period cemeteries in North America: implications for comparative evolutionary morphology

Talon cusps are rare morphological features of the anterior dentition that represent a spectrum of lingual cingulum diversity. In this paper, talon cusp prevalence is described in two Archaic period North American samples, Windover Pond (Florida) and Buckeye Knoll (Texas). Given the early date of these cemeteries (~7500 BP), these specimens represent the oldest reported cases of lingual talon cusp in the New World, and perhaps globally. Windover preserves three cases of talon cusp (representing three different individuals) affecting the permanent maxillary lateral incisors. The sample frequencies were 1.8% and 3.1% for the left and right maxillary lateral incisors, respectively. Buckeye Knoll preserves four cases of talon cusp representing three individuals. Talon cusps at this site were distributed throughout the maxillary anterior dentition, including a permanent maxillary central incisor, bilateral permanent maxillary lateral incisors, and a deciduous maxillary lateral incisor. The multicomponent nature of this site complicates sample frequency calculation with by-tooth estimates ranging from 3.6% to 25%. This paper discusses the difficulties with comparative frequency estimation, resulting from a proliferation of terminology that is discipline-specific. Understanding the evolutionary basis and significance of dental morphological variation requires an inclusive approach to the comparative literature that focuses on homology within the context of odontogenetic process.     

Parametric finite element analysis and closed-form solutions in orthodontics

The goal and clinical relevance of this work was the development of closed formulas that are correct and simple enough for a fast decision making by the orthodontist in the daily praxis. This paper performs a parametric three-dimensional finite element linear analysis on a maxillary central incisor with a root of paraboloidal shape, which is subjected to typical orthodontic force-systems. Parameters of most importance, such as the tooth mobility in translation and in pure moment rotation including orthodontic centers, as well as the stresses inside the periodontal ligament are calculated for a large variety of over four hundred different couples of root lengths and root diameters around a nominal value. Regression analysis is afterwards performed and establishes closed-form solutions, which are also explained in terms of analytical strain energy and hydrostatic stress considerations within the periodontal ligament characterised by a small compressibility. The obtained expressions include both the root length as well as the root diameter.     

Expression of matrix metalloproteinases-2 and -9 and RECK during alveolar bone regeneration in rat

MMPs are endopeptidases that play a pivotal role in ECM turnover. RECK is a single membrane-anchored MMP-regulator. Here, we evaluated the temporal and spatial expression of MMP-2, MMP-9, and RECK during alveolar bone regeneration. The maxillary central incisor of Wistar rats was extracted and the animals were killed at 1, 3, 7, 10, 14, 21, 28, and 42 days post-operatively (n = 3/period). The hemimaxillae were collected, demineralized and embedded in paraffin. Immunohistochemical analysis was performed by the immunoperoxidase technique with polyclonal antibodies. On day 1, polymorphonuclear cells in the blood clot presented mild immunolabeling for MMPs. During bone remodeling, osteoblasts facing new bone showed positive staining for gelatinases and RECK in all experimental periods. MMPs were also found in the connective tissue and endothelial cells. Our results show for the first time that inactive and/or active forms of MMP-2, MMP-9 and RECK are differentially expressed by osteogenic and connective cells during several events of alveolar bone regeneration. This may be important for the replacement of the blood clot by connective tissue, and in the formation, maturation and remodeling of new bone.     

Use of digital photographs for artificial tooth selection

Digital photography has become available to everybody. The aim of this study was to examine possibility of calculating the width of a missing central incisor using digital photographs. Digital photographs were obtained from 51 dentate subjects using a 3.1 Megapixel digital camera from various distances: 35 cm, 70 cm, 1 m and 1.5 m. For the calculation of the width of maxillary left central incisor (MLI), the following equation was used: MLI(calculated) = Photographic width of MLI x IPD / photographic IPD. Statistical analysis was made (Kolmogorov-Smirnov test, dependent sample t-test, correlation and frequencies) using SPSS 10.0 for Windows. Results revealed no significant difference between the calculated MLI (70 cm, 1 m and 1.5 m distance) and actual MLI, however calculated MLI from 35 cm distance was significantly different from the actual MLI value (p < 0.01). The highest correlation was between calculated MLI (70 cm distance) and actual MLI. However, the highest percentage of results from a distance of 70 cm also fitted within +/- 0.3 mm; +/- 0.5 mm and +/- 1 mm difference from the actual MLI values. However, the results obtained from 1 m distance were also satisfactory. The technique of use of digital photography is of proven value in calculating the width of a maxillary central incisor. The photographs using a simple digital camera should be taken from a distance from 70 cm to 1 m. Saving such photographs in a dental office may eventually be helpful for calculating dimensions of artificial teeth.     

Parametric Finite Element Analysis and Closed-formSolutions in Orthodontics

The goal and clinical relevance of this work was the development of closed formulas that are correct and simple enough for a fast decision making by the orthodontist in the daily praxis. This paper performs a parametric three-dimensional finite element linear analysis on a maxillary central incisor with a root of paraboloidal shape, which is subjected to typical orthodontic force-systems. Parameters of most importance, such as the tooth mobility in translation and in pure moment rotation including orthodontic centers, as well as the stresses inside the periodontal ligament are calculated for a large variety of over four hundred different couples of root lengths and root diameters around a nominal value. Regression analysis is afterwards performed and establishes closed-form solutions, which are also explained in terms of analytical strain energy and hydrostatic stress considerations within the periodontal ligament characterised by a small compressibility. The obtained expressions include both the root length as well as the root diameter.     

Computer aided stress analysis of long bones utilizing computed tomography

A computer aided analysis method has been developed which utilizes computed tomography (CT) and a finite element (FE) computer program to determine the stress-displacement pattern in a long bone section. The CT data file provides the geometry, the apparent density and the elastic properties for the three-dimensional FE model. A developed pre-processor generates the FE model of a human diaphyseal tibia section which is then analyzed by the SAP IV finite element program. The results obtained are sorted and displayed by a developed post-processor and compared with stresses and deformations from the literature. The model generation method was verified by applying it to a model of simple geometry and boundary conditions, then comparing the results with the analytical solution of the same problem. The convergence behavior of nodal displacements was tested as a function of mesh refinement. This method provides an automatic, versatile, non-invasive and accurate tool of long bone modeling for finite element stress analysis.     

A complete structural performance analysis and modelling of hydroxyapatite scaffolds with variable porosity

The use of hydroxyapatite (HA) scaffolds for bone regeneration is an alternative procedure to treat bone defects due to cancer, other diseases or traumas. Although the use of HA has been widely studied in the literature, there are still some disparities regarding its mechanical performance. This paper presents a complete analysis of the structural performance of porous HA scaffolds based on experimental tests, numerical simulations and theoretical studies. HA scaffolds with variable porosity were considered and fabricated by the water-soluble polymer method, using poly vinyl alcohol as pore former. These scaffolds were then characterised by scanning electron microscopy, stereo microscopy, X-ray diffraction, porosity analysis and mechanical tests. Different scaffold models were proposed and analysed by the finite element method to obtain numerical predictions of the mechanical properties. Also theoretical predictions based on the (Gibson LJ, Ashby MF. 1988. Cellular solids: structure and properties. Oxford: Pergamon Press) model were obtained. Finally the experimental, numerical and theoretical results were compared. From this comparison, it was observed that the proposed numerical and theoretical models can be used to predict, with adequate accuracy, the mechanical performance of HA scaffolds for different porosity values.     

Genetic structure of a tribal population, the Yanomama Indians. XIII. Dental microdifferentiation.

Data are presented on the frequency of the following eight dental traits in 635 Yanomama and 65 Makiritare Indians: upper central incisor rotation or winging, shoveling of maxillary incisors, maxillary molar hypocone reduction, Carabelli's trait, mandibular molar cusp number, mandibular molar cusp pattern rotation of second lower premolar, and pattern of second lower premolar cusps. Yanomama dentition is unusual in the high frequency of six cusps on the mandibular molars. There is marked dental microdifferentiation between villages; significant agreement was observed between a matrix of pairwise "dental distances" based on six morphological traits and corresponding matrices based on 11 genetic systems and on geographic location.     

An experimental and theoretical approach of elasticity and viscoelasticity of compact and spongy bone with periodic homogenization

An experimental study on samples from a fresh human femur highlighted the viscoelastic behaviour of bone. The memory aspect of the behaviour is weak compared to the elastic aspect. A theoretical and numerical approach based on the finite element method illustrates the existing bond between the structure and the micro behaviour on the one hand, and the macro behaviour on the other. The orthotropic elastic behaviour observed by various authors is shown numerically. The memory functions of compact and spongy bone are given. The numerical results illustrate the behaviour observed in the experiments.     

Maxillary expansion treatment using bone anchors: development and validation of a 3D finite element model

OBJECTIVE: Develop a finite element (FE) model of a skull to perform biomechanical studies of maxillary expansion using bone anchors (BA). MATERIALS AND METHODS: A skull model was developed and assigned material properties based on Hounsfield unit (HU) values of cone-beam computerized tomography (CBCT) images. A 3 mm diameter cylindrical BA was modelled and inserted in the palatal bone. A 4 mm transverse displacement was applied on the anchor. An evaluation on the effect on local stresses of BA implantation inclination angle was performed. RESULTS: Proper displacement results and strain-stress trends for the expansion process were present. Stress distribution patterns were similar as reported in the literature. No significant difference between BA inclination angles was found. CONCLUSION: This work leads to a better understanding and prediction of craniofacial and maxillary bone remodelling during ME with BA treatments and is a first step towards the development of patient specific treatments.     

Reconstruction using a three-dimensional orbitozygomatic skeletal model of titanium mesh plate and soft-tissue free flap transfer following total maxillectomy

The surgical strategy for maxillary reconstruction after maxillectomy has yet to be standardized. The authors developed a technique using a three-dimensional orbitozygomatic skeletal model of a titanium mesh for skeletal reconstruction after maxillectomy. From May of 1996 to September of 2000, 18 patients underwent reconstruction using the titanium mesh model in conjunction with a soft-tissue free flap following total maxillectomy for a maxillary malignancy. The soft-tissue free flap was conventional and consisted of two skin paddles to the maxillary defect. One skin paddle became the lateral nasal wall and the other was used to close the palatal defect. After modeling, the titanium mesh plate was implanted between the orbital contents and the upper edge of the free flap to lie over the front of the flap. The model was fixed to the residual zygoma laterally and to the nasal or frontal bone medially. The palatal skin paddle was anchored by three or four dermal stitches to the bottom edge of the titanium mesh to create a concave neopalate that allowed the patient to wear a denture. Thirteen of 18 patients who underwent implantation had good facial appearance and oral function. This procedure prevented lagophthalmos, facial deformity, and sagging of the palatal skin paddle caused by gravitational force. Five patients (27.8 percent) developed exposure or infection of the implant and lost the benefit of having the prosthesis. However, treatment did not require total removal of the implant. Maintaining adequate tissue volume during soft-tissue transfer on either side of the mesh plate may minimize the complication rate. Titanium mesh implantation for skeletal reconstruction after maxillectomy avoids the need for bone grafting and may be especially beneficial in fragile or aged patients.     

Disproportionate eruption of maxillary and mandibular incisors in the long-tailed ground squirrel

The surface of the maxillary and mandibular incisors of Spermophilus undulatus long-tailed ground squirrels, including those born in the current year and those that have hibernated (trapped one month or later after hibernation) is studied. The presence of daily growth increments on the incisors’ surface allows the evaluation of the eruption rate of the incisors; a specific change in the character of the growth increments corresponds to winter hibernation (hibernation zone), which serves as the time mark. Ratio between the eruption rates of the maxillary and mandibular incisors typical for rodents is found in young-of-the-year and some animals after hibernation. In these animals the eruption rate of the mandibular incisors is higher than the eruption rate of the maxillary incisors and can be taken as proportional to their length. In individuals that have hibernated and show proportional eruption of the incisors, the proportions of the total length of the incisor formed before hibernation zone are equal for the maxillary and mandibular incisors. In the individuals that also have hibernated and show the ratio between the total length of the maxillary and mandibular incisors typical for rodents, the eruption rate of the mandibular incisor is equal to or less than the eruption rate of the maxillary incisor and the proportion of the incisor formed before hibernation is greater in the mandibular incisor than in the maxillary. This disproportionate pattern of incisor eruption is not typical for rodents and is a result of inequal attrition of the maxillary and mandibular incisors, which ultimately results in the normal ratio of the total length of the maxillary and mandibular incisors.     

Le Fort I型截骨术定位平面的应用解剖学研究

目的：研究Le Fort I型截骨术与上颌牙根尖的关系,为临床合理制订截骨平面提供解剖学依据。方法：选择上颌牙槽清晰或出土后仍有牙保留的颅骨,在颅骨梨状孔下缘至上颌结节作一连线作为模拟Le Fort I型术式截骨水平,以上颌牙槽缘为标志,用游标卡尺测量每侧上颌各牙的牙槽缘至上述模拟截骨水平的距离及牙槽缘至各牙根尖端的长度,然后计算出上颌各牙根尖至Le Fort I型术式截骨线的距离。结果：上颌各牙相对的牙槽缘至Le FortI型术式截骨线的距离,从中切牙至第二磨牙逐渐缩小,右侧中切牙为21．09±1．53mm,左侧中切牙为20．96±1．64mm,右侧第二磨牙为14．94±1．52mm,左侧第二磨牙为14．95±1．59mm;上颌各牙根尖至Le Fort I型术式截骨水平的距离,从中切牙至第二磨牙也逐渐缩小,而两侧尖牙牙根尖距离Le Fort I型术式截骨线的距离右侧为4．49±1．74mm,左侧为4．69±2．14mm,第二磨牙牙根尖距离Le Fort I型术式截骨线的距离右侧为4．65±1．63mm,左侧为4．49±1．89,两侧尖牙牙根尖和第二磨牙牙根尖至Le Fort I型术式截骨水平的距离均比较接近。结论：上颌各牙根尖至LeFortI型术式截骨线的距离均在4mm以上,根据前牙中尖牙牙根尖的位置和后牙中第二磨牙牙根尖的位置,Le Fort I型术式截骨线水平在13、23（3｜3）根尖及27、27（7｜7）根尖上方4mm以上,按此平面作截骨水平较为安全,不易损伤牙根。     

Characterization of structure and properties of bone by spectral measure method

Novel mathematical method called spectral measure method (SMM) is developed for characterization of bone structure and indirect estimation of bone properties. The spectral measure method is based on an inverse homogenization technique which allows to derive information about the structure of composite material from measured effective electric or viscoelastic properties. The mechanical properties and ability to withstand fracture depend on the structural organization of bone as a hierarchical composite. Information about the bone structural parameters is contained in the spectral measure in the Stieltjes integral representation of the effective properties. The method is based on constructing the spectral measure either by calculating it directly from micro-CT images or using measurements of electric or viscoelastic properties over a frequency range. In the present paper, we generalize the Stieltjes representation to the viscoelastic case and show how bone microstructure, in particular, bone volume or porosity, can be characterized by the spectral function calculated using measurements of complex permittivity or viscoelastic modulus. For validation purposes, we numerically simulated measured data using micro-CT images of cancellous bone. Recovered values of bone porosity are in excellent agreement with true porosity estimated from the micro-CT images. We also discuss another application of this method, which allows to estimate properties difficult to measure directly. The spectral measure method based on the derived Stieltjes representation for viscoelastic composites, has a potential for non-invasive characterization of bone structure using electric or mechanical measurements. The method is applicable to sea ice, porous rock, and other composite materials.