Ming-Tzu Tsai

Effect of Screw Fixation on Temporomandibular Joint Condylar Prosthesis

PURPOSE The objective of the present study was to evaluate the effect of the number of screws on the stress and stability of the temporomandibular joint (TMJ) condylar prosthesis and on the strain distribution in the bone. MATERIALS AND METHODS Three-dimensional, finite element models of the mandible and a TMJ condylar prosthesis with fixations involving different numbers of screws in 8 configurations were established to investigate the effect of the number of fixed screws on the stress and stability of the implant and strain in cortical and cancellous bone. RESULTS The simulations showed that increasing the number of screws beyond 3 only slightly enhanced the implant stability and reduced the implant stress. The position of the inserted screws significantly affected the strain distributions in cortical and cancellous bone tissues. CONCLUSIONS The results of our study have shown that 3 staggered screws can provide optimal implant stability and bone stress and strain distributions in a TMJ condylar prosthesis.

The assessment of trabecular bone parameters and cortical bone strength: A comparison of micro-CT and dental cone-beam CT

This study compared the capabilities of micro-computed tomography (micro-CT) and dental cone-beam computed tomography (CBCT) in assessing trabecular bone parameters and cortical bone strength. Micro-CT and CBCT scans were applied to 28 femurs from 14 rats to obtain independent measurements of the volumetric cancellous bone mineral density (vCanBMD) in the femoral head, volumetric cortical bone mineral density (vCtBMD) in the femoral diaphysis, cross-sectional moment of inertia (CSMI), and bone strength index (BSI) (=CSMI×vCtBMD). Five structural parameters of the trabecular bone of the femoral head were calculated from micro-CT images. A three-point bending test was then conducted to measure the fracture load of each femur. Bivariate linear Pearson analysis was conducted to calculate the correlation coefficients (r values) of the micro-CT, dental CBCT, and three-point bending measurements. The statistical analyses showed a strong correlation between vCanBMD values obtained using micro-CT and dental CBCT (r=0.830). There were strong or moderate correlation between vCanBMD measured using dental CBCT and five parameters of trabecular structure measured using micro-CT. Additionally, the results were satisfactory regardless of whether micro-CT or dental CBCT was used to measure the femoral diaphysis vCtBMD (r=0.733 and 0.680, respectively), CSMI (r=0.756 and 0.726, respectively), or BSI (r=0.846 and 0.847, respectively) to predict fracture loads. This study has yielded a new method for using dental CBCT to evaluate bone parameters and bone strength; however, further studies are necessary to validate the use of dental CBCT on humans.

In vitro antibacterial activity and cytocompatibility of bismuth doped micro-arc oxidized titanium

Chemical manipulations of the implant surface produce a bactericidal feature to prevent infections around dental implants. Despite the successful use of bismuth against mucosal and dermis infections, the antibacterial effect of bismuth in the oral cavity remains under investigation. The aim of this study was to evaluate the antibacterial activities of bismuth compounds against Actinobacillus actinomycetemcomitans, Staphylococcus mutans, and methicillin-resistant Staphylococcus aureus (MRSA), and to investigate the antimicrobial effects of bismuth doped micro-arc oxidation (MAO) titanium via an agar diffusion test. Cell viability, alkaline phosphatase activity, and mineralization level of MG63 osteoblast-like cells seeded on the coatings were evaluated at 1, 7, and 14 days. The results demonstrate that bismuth nitrate possess superior antibacterial activity when compared with bismuth acetate, bismuth subgallate, and silver nitrate. The bismuth doped MAO coating (contained 6.2 atomic percentage bismuth) had good biological affinities to the MG63 cells and showed a higher antibacterial efficacy against Actinobacillus actinomycetemcomitans and MRSA, where the reduction rates of colony numbers is higher than that of the control group by 1.5 and 1.9 times, respectively. These in vitro evaluations demonstrate that titanium implants with bismuth on the surface may be useful for better infection control.

Effects of the 3D bone-to-implant contact and bone stiffness on the initial stability of a dental implant: micro-CT and resonance frequency analyses

This study investigated the effects of bone stiffness (elastic modulus) and three-dimensional (3D) bone-to-implant contact ratio (BIC%) on the primary stabilities of dental implants using micro-computed tomography (micro-CT) and resonance frequency analyses. Artificial sawbone models with five values of elastic modulus (137, 123, 47.5, 22, and 12.4 MPa) comprising two types of trabecular structure (solid-rigid and cellular-rigid) were investigated for initial implant stability quotient (ISQ), measured using the wireless Osstell resonance frequency analyzer. Bone specimens were attached to 2 mm fibre-filled epoxy sheets mimicking the cortical shell. ISQ was measured after placing a dental implant into the bone specimen. Each bone specimen with an implant was subjected to micro-CT scanning to calculate the 3D BIC% values. The similarity of the cellular type of artificial bone to the trabecular structure might make it more appropriate for obtaining accurate values of primary implant stability than solid-bone blocks. For the cellular-rigid bone models, the ISQ increased with the elastic modulus of cancellous bone. The regression correlation coefficient was 0.96 for correlations of the ISQ with the elasticity of cancellous bone and with the 3D BIC%. The initial implant stability was moderately positively correlated with the elasticity of cancellous bone and with the 3D BIC%.

A Comparison of Micro-CT and Dental CT in Assessing Cortical Bone Morphology and Trabecular Bone Microarchitecture

Objective The objective of this study was to evaluate the relationship between the trabecular bone microarchitecture and cortical bone morphology by using micro-computed tomography (micro-CT) and dental cone-beam computed tomography (dental CT). Materials and Methods Sixteen femurs and eight fifth lumbar vertebrae were collected from eight male Sprague Dawley rats. Four trabecular bone microarchitecture parameters related to the fifth lumbar vertebral body (percent bone volume [BV/TV], trabecular thickness [TbTh], trabecular separation [TbSp], and trabecular number [TbN]) were calculated using micro-CT. In addition, the volumetric cancellous bone grayscale value (vCanGrayscale) of the fifth lumbar vertebral body was measured using dental CT. Furthermore, four cortical bone morphology parameters of the femoral diaphysis (total cross-sectional area [TtAr], cortical area [CtAr], cortical bone area fraction [CtAr/TtAr], and cortical thickness [CtTh]) were calculated using both micro-CT and dental CT. Pearson analysis was conducted to calculate the correlation coefficients (r) of the micro-CT and dental CT measurements. Paired-sample t tests were used to compare the differences between the measurements of the four cortical bone morphology parameters obtained using micro-CT and dental CT. Results High correlations between the vCanGrayscale measured using dental CT and the trabecular bone microarchitecture parameters (BV/TV [r = 0.84] and TbTh [r = 0.84]) measured using micro-CT were observed. The absolute value of the four cortical bone morphology parameters may be different between the dental CT and micro-CT approaches. However, high correlations (r ranged from 0.71 to 0.90) among these four cortical bone morphology parameters measured using the two approaches were obtained. Conclusion We observed high correlations between the vCanGrayscale measured using dental CT and the trabecular bone microarchitecture parameters (BV/TV and TbTh) measured using micro-CT, in addition to high correlations between the cortical bone morphology measured using micro-CT and dental CT. Further experiments are necessary to validate the use of dental CT on human bone.

Predicting Cortical Bone Strength from DXA and Dental Cone-Beam CT

Objective This study compared the capabilities of dual-energy X-ray absorptiometry (DXA) and dental cone-beam computed tomography (CBCT) for predicting the cortical bone strength of rat femurs and tibias. Materials and Methods Specimens of femurs and tibias obtained from 14 rats were first scanned with DXA to obtain the areal bone mineral density (BMD) of the midshaft cortical portion of the bones. The bones were then scanned using dental CBCT to measure the volumetric cortical bone mineral density (vCtBMD) and the cross-sectional moment of inertia (CSMI) for calculating the bone strength index (BSI). A three-point bending test was conducted to measure the fracture load of each femur and tibia. Bivariate linear Pearson analysis was used to calculate the correlation coefficients (r values) among the CBCT measurements, DXA measurements, and three-point bending parameters. Results The correlation coefficients for the associations of the fracture load with areal BMD (measured using DXA), vCtBMD (measured using CBCT), CSMI (measured using CBCT), and BSI were 0.585 (p = 0.028) and 0.532 (p = 0.050) (for the femur and tibia, respectively), 0.638 (p = 0.014) and 0.762 (p = 0.002), 0.778 (p = 0.001) and 0.792 (p<0.001), and 0.822 (p<0.001) and 0.842 (p<0.001), respectively. Conclusions CBCT was found to be superior to DXA for predicting cortical bone fracture loads in rat femurs and tibias. The BSI, which is a combined index of densitometric and geometric parameters, was especially useful. Further clinical studies are needed to validate the predictive value of BSI obtained from CBCT and should include testing on human cadaver specimens.

A new method to evaluate the elastic modulus of cortical bone by using a combined computed tomography and finite element approach

This study attempted to estimate the elastic modulus of cortical specimens directly from the computed tomography (CT) number (CT). Cubic specimens of fresh bovine femora were tested under compressive loading. The corresponding three-dimensional mesh models of these specimens were established with the aid of CT images. The elastic modulus of each element was determined using the following transfer formula: E=Ax(CT)(B). The A and B were determined by matching the simulation results with the experimental force-displacement curves. An optimization approach was used to match the entire specimen sets between simulations and experiments. The results indicated that the elastic modulus of cortical bone can be effectively estimated using a power relationship (E=1.26 x 10(-3) x (CT)(1.93)) directly from the CT number. This procedure eliminates the need to determine the bone density, and therefore reduces the computational time required to define mechanical properties in finite element methods.

Biological characteristics of the MG-63 human osteosarcoma cells on composite tantalum carbide/amorphous carbon films.

Tantalum (Ta) is a promising metal for biomedical implants or implant coating for orthopedic and dental applications because of its excellent corrosion resistance, fracture toughness, and biocompatibility. This study synthesizes biocompatible tantalum carbide (TaC) and TaC/amorphous carbon (a-C) coatings with different carbon contents by using a twin-gun magnetron sputtering system to improve their biological properties and explore potential surgical implant or device applications. The carbon content in the deposited coatings was regulated by controlling the magnetron power ratio of the pure graphite and Ta cathodes. The deposited TaC and TaC/a-C coatings exhibited better cell viability of human osteosarcoma cell line MG-63 than the uncoated Ti and Ta-coated samples. Inverted optical and confocal imaging was used to demonstrate the cell adhesion, distribution, and proliferation of each sample at different time points during the whole culture period. The results show that the TaC/a-C coating, which contained two metastable phases (TaC and a-C), was more biocompatible with MG-63 cells compared to the pure Ta coating. This suggests that the TaC/a-C coatings exhibit a better biocompatible performance for MG-63 cells, and they may improve implant osseointegration in clinics.

Location of the Mandibular Canal and Thickness of the Occlusal Cortical Bone at Dental Implant Sites in the Lower Second Premolar and First Molar

The objective of this study was to evaluate the location of the mandibular canal and the thickness of the occlusal cortical bone at dental implant sites in the lower second premolar and lower first molar by using dental cone-beam computed tomography (CBCT). Seventy-nine sites (47 second premolar and 32 first molar sites) were identified in the dental CBCT examinations of 47 patients. In this study, 4 parameters were measured: (1) MC—the distance from the mandibular canal to the upper border of the mandible; (2) CD—the distance from the mandibular canal to the buccal border of the mandible; (3) MD—the distance from the mandibular canal to the lingual border of the mandible; (4) TC—the thickness of the cortical bone at the occlusal side. A statistical analysis was employed to compare the size and differences between these 4 parameters at the lower second premolar and lower first molar. Regarding the MC and MD, the experimental results showed no statistical difference between the first molar and second premolar. However, the TC for the second premolar was greater than that of the first molar. Thus, careful consideration is necessary in choosing the size of and operation type for dental implants.

Cortical Bone Morphological and Trabecular Bone Microarchitectural Changes in the Mandible and Femoral Neck of Ovariectomized Rats

Objective This study used microcomputed tomography (micro-CT) to evaluate the effects of ovariectomy on the trabecular bone microarchitecture and cortical bone morphology in the femoral neck and mandible of female rats. Materials and Methods Twelve female Wister rats were divided into two groups: the control and ovariectomized groups. The rats in the ovariectomized group received ovariectomy at 8 weeks of age; all the rats were sacrificed at 20 weeks of age, and their mandibles and femurs were removed and scanned using micro-CT. Four microstructural trabecular bone parameters were measured for the region below the first mandibular molar and the femoral neck region: bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular separation (TbSp), and trabecular number (TbN). In addition, four cortical bone parameters were measured for the femoral neck region: total cross-sectional area (TtAr), cortical area (CtAr), cortical bone area fraction (CtAr/TtAr), and cortical thickness (CtTh). The CtTh at the masseteric ridge was used to assess the cortical bone morphology in the mandible. The trabecular bone microarchitecture and cortical bone morphology in the femoral necks and mandibles of the control group were compared with those of the ovariectomized group. Furthermore, Spearman’s correlation (rs) was conducted to analyze the correlation between the osteoporosis conditions of the mandible and femoral neck. Results Regarding the trabecular bone microarchitectural parameters, the BV/TV of the trabecular bone microarchitecture in the femoral necks of the control group (61.199±11.288%, median ± interquartile range) was significantly greater than that of the ovariectomized group (40.329±5.153%). Similarly, the BV/TV of the trabecular bone microarchitecture in the mandibles of the control group (51.704±6.253%) was significantly greater than that of the ovariectomized group (38.486±9.111%). Furthermore, the TbSp of the femoral necks in the ovariectomized group (0.185±0.066 mm) was significantly greater than that in the control group (0.130±0.026mm). Similarly, the TbSp of the mandibles in the ovariectomized group (0.322±0.047mm) was significantly greater than that in the control group (0.285±0.041mm). However, the TbTh and TbN trends for the mandibles and femoral necks were inconsistent between the control and ovariectomized groups. Regarding the cortical bone morphology parameters, the TtAr of the femoral necks in the ovariectomized group was significantly smaller than that in the control group. There was no significant difference in the TtAr, CtAr, or CtTh of the femoral necks between the control and ovariectomized groups, and no significant difference in the CtTh of the mandibles between the control and ovariectomized groups. Moreover, the BV/TV and TbSp of the mandibles were highly correlated with those of the femurs (rs = 0.874 and rs = 0.755 for BV/TV and TbSp, respectively). Nevertheless, the TbTh, TbN, and CtTh of the mandibles were not correlated with those of the femoral necks. Conclusion After the rats were ovariectomized, osteoporosis of the trabecular bone microarchitecture occurred in their femurs and mandibles; however, ovariectomy did not influence the cortical bone morphology. In addition, the parametric values of the trabecular bone microarchitecture in the femoral necks were highly correlated with those of the trabecular bone microarchitecture in the mandibles.