Libor Borák

Structural and mechanical implications of PMMA implant shape and interface geometry in cranioplasty – A finite element study

This computational study investigates the effect of shape (defect contour curvature) and bone-implant interface (osteotomy angle) on the stress distribution within PMMA skull implants. Using finite element methodology, 15 configurations--combinations of simplified synthetic geometric shapes (circular, square, triangular, irregular) and interface angulations--were simulated under 50N static loads. Furthermore, the implant fixation devices were modelled and analysed in detail. Negative osteotomy configurations demonstrated the largest stresses in the implant (275 MPa), fixation devices (1258 MPa) and bone strains (0.04). The circular implant with zero and positive osteotomy performed well with maximum observed magnitudes of--implant stress (1.2 MPa and 1.2 MPa), fixation device stress (11.2 MPa and 2.2 MPa), bone strain (0.218e-3 and 0.750e-4). The results suggest that the preparation of defect sites is a critical procedure. Of the greatest importance is the angle at which the edges of the defect are sawed. If under an external load, the implant has no support from the interface and the stresses are transferred to the fixation devices. This can endanger their material integrity and lead to unphysiological strains in the adjacent bone, potentially compromising the bone morphology required for anchoring. These factors can ultimately weaken the stability of the entire implant assembly.

Finite element analysis of dental implant loading on atrophic and non-atrophic cancellous and cortical mandibular bone – a feasibility study

The first aim of this study was to assess displacements and micro-strain induced on different grades of atrophic cortical and trabecular mandibular bone by axially loaded dental implants using finite element analysis (FEA). The second aim was to assess the micro-strain induced by different implant geometries and the levels of bone-to-implant contact (BIC) on the surrounding bone. Six mandibular bone segments demonstrating different grades of mandibular bone atrophy and various bone volume fractions (from 0.149 to 0.471) were imaged using a micro-CT device. The acquired bone STL models and implant (Brånemark, Straumann, Ankylos) were merged into a three-dimensional finite elements structure. The mean displacement value for all implants was 3.1 ±1.2 µm. Displacements were lower in the group with a strong BIC. The results indicated that the maximum strain values of cortical and cancellous bone increased with lower bone density. Strain distribution is the first and foremost dependent on the shape of bone and architecture of cancellous bone. The geometry of the implant, thread patterns, grade of bone atrophy and BIC all affect the displacement and micro-strain on the mandible bone. Preoperative finite element analysis could offer improved predictability in the long-term outlook of dental implant restorations.

Finite element analysis of 6 large PMMA skull reconstructions : A multi-criteria evaluation approach

In this study 6 pre-operative designs for PMMA based reconstructions of cranial defects were evaluated for their mechanical robustness using finite element modeling. Clinical experience and engineering principles were employed to create multiple plan options, which were subsequently computationally analyzed for mechanically relevant parameters under 50N loads: stress, strain and deformation in various components of the assembly. The factors assessed were: defect size, location and shape. The major variable in the cranioplasty assembly design was the arrangement of the fixation plates. An additional study variable introduced was the location of the 50N load within the implant area. It was found that in smaller defects, it was simpler to design a symmetric distribution of plates and under limited variability in load location it was possible to design an optimal for expected loads. However, for very large defects with complex shapes, the variability in the load locations introduces complications to the intuitive design of the optimal assembly. The study shows that it can be beneficial to incorporate multi design computational analyses to decide upon the most optimal plan for a clinical case.

Micro finite element analysis of dental implants under different loading conditions

Osseointegration is paramount for the longevity of dental implants and is significantly influenced by biomechanical stimuli. The aim of the present study was to assess the micro-strain and displacement induced by loaded dental implants at different stages of osseointegration using finite element analysis (FEA). Computational models of two mandible segments with different trabecular densities were constructed using microCT data. Three different implant loading directions and two osseointegration stages were considered in the stress-strain analysis of the bone-implant assembly. The bony segments were analyzed using two approaches. The first approach was based on Mechanostat strain intervals and the second approach was based on tensile/compression yield strains. The results of this study revealed that bone surrounding dental implants is critically strained in cases when only a partial osseointegration is present and when an implant is loaded by buccolingual forces. In such cases, implants also encounter high stresses. Displacements of partially-osseointegrated implant are significantly larger than those of fully-osseointegrated implants. It can be concluded that the partial osseointegration is a potential risk in terms of implant longevity.

Evaluating Different Shapes of Cranial Fixation Mini-plates Using Finite Element Method

Medical grade 3D printing offers the possibility to manufacture patient-specific implants to treat cranial defects. The performance of the implant assembly depends on many factors, such as material, thickness, size and manufacturing accuracy. A significant factor in the stability and success of the assembly is the fixation method. Cranial implants are usually fixed to the skull by means of mini-plates. Biomechanical assessment of fixing the implant to the skull might be helpful not only for mini-plate design but might be beneficial also for the surgeons. In this study, four different mini-plate designs were analyzed and compared based on the stress-strain analysis of one cranial implant fixed at three locations by mini-plates. Computational simulations were done using Finite Element Method.

Bone Remodeling Algorithm Incorporating Various Quantities as Mechanical Stimulus and Assuming Initial Microcrack in Bone

It is widely accepted that bones have the ability to adapt to new biomechanical environment by changing their material properties, geometry and inner architecture. Bones have also an exceptional ability to self-repair, to remove microcracks and to prevent the bone damage caused by the fatigue failure. These abilities are enabled through coupled processes of bone resorption and bone formation, the processes collectively referred to as bone remodeling. Numerous studies have shown that bone remodeling is governed by combination of mechanical stimulus (strains) and its frequency, both sensed by sensor cells (osteocytes). Through mechanotransduction, the stimulus is transmitted to actor cells (osteoclasts, osteoblasts) that actually do the bone resorption or formation. Several theories have been proposed to predict bone remodeling and several finite-element-based algorithms have been introduced. The vast majority of them uses strain energy density as the mechanical stimulus. The purpose of this paper is to investigate and discuss the applicability of also other strain-based representations of the mechanical stimulus in simulations of remodeling of bone with an initial microcrack. The need for developing more reliable models is essential for both clinicians and engineers who are interested, for instance, in prediction of bone performance when various implants are involved.

Microstructural Finite-Element Analysis of Influence of Bone Density and Histomorphometric Parameters on Mechanical Behavior of Mandibular Cancellous Bone Structure

Using porous bioceramics became recently an alternative approach to increase bone density which is a key factor for successful dental implant application. These novel biomaterials should substitute missing natural trabecular structures in terms of material strength as well as deformation characteristics. However, mechanical behavior of these materials used as bone fillers are still in question. This problem is made more difficult by the fact that bone structure itself exhibits a complex mechanical behavior which is still in question as well and, therefore, appropriate analytical criteria should to be established. The purpose of this paper is to determine typical mechanical behavior of trabecular structure of mandibular cancellous bone using computational simulations which can serve as a basis for establishing such criteria. For this purpose, four bone specimens of various bone density were μCT-scanned and high-level finite element models including detailed trabecular structure were created on their basis to analyze relevant mechanical quantities for various loadings in terms of bone density and various histomorphometric parameters.

Computational Modeling of Interaction of Dental Implant with Mandible

This paper is focused on computational modeling of an interaction of dental implant with mandible bone. It describes creation of computational model including model of geometry, materials, loads and constraints. There is a comparative stress-strain analysis of the levels of cancellous bone model. Computations are performed with the use of finite element method. Results show differences between the model which includes trabecular architecture of cancellous bone tissue and the model with non-trabecular cancellous bone tissue. For better description of the processes in bone tissue and at the interface between bone tissue and implant, it is necessary to create the computational model on the highest possible level, i.e. with the trabecular bone tissue.