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Background: Dental cone beam computed tomography (CBCT) is commonly used to evaluate cancellous bone density before dental implant surgery. However, to our knowledge, no measurement approach has been standardized yet. This study aimed to evaluate the relationship between three different regions of interest (ROI) methods on cancellous bone density at the dental implant site using dental CBCT images. Methods: Patients' dental CBCT images (n = 300) obtained before dental implant surgery were processed using Mimics (Materialise, Leuven, Belgium). At the potential implant sites, the rectangle, cylinder, and surrounding cylinder ROI methods were used to measure bone density. Repeated measures one-way analysis of variance was performed to compare the three ROI methods in terms of measurement results. Pearson correlation analysis was performed to identify the likely pair-wise correlations between the three ROI methods. Results: The density value obtained using the surrounding cylinder approach (grayscale value [GV],523.56 ± 228.03) was significantly higher than the values obtained using the rectangle (GV, 497.04 ± 236.69) and cylinder (GV,493 ± 231.19) ROI methods in terms of results. Furthermore, significant correlations were noted between the ROI methods (r > 0.965; p < 0.001). Conclusions: The density measured using the surrounding cylinder method was the highest. The choice of method may not influence the trends of measurement results. Trial registration: This study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH111-REC3-205. Informed consent was waived by the Institutional Review Board of China Medical University Hospital, CMUH111-REC3-205, owing to the retrospective nature of the study. [ABSTRACT FROM AUTHOR]

Residual alveolar ridge resorption often occurs after tooth extraction, which causes issues requiring further prothesis rehabilitation. A treatment concept referred to as all-on-four, involving fixed dentures supported with four implants, was recently developed. The current study aimed to determine the effect of changing bone atrophy and implant length in all-on-four treatments on stress and strain in the surrounding bone of the implant. A three-dimensional finite element method was used in this research. The stress analysis was conducted with von Mises stress values. Two types of synthetic jawbone models with mild and moderate atrophy were used. Furthermore, two different implant lengths with a similar implant design and diameter were selected, and they were classified into eight models. Then, the bone model was assessed via a computed tomography (CT) scan and was transformed into a virtual model in Geomagic and SolidWorks with implant rebuilding. After modifying bone atrophy, the von Mises stresses in the surrounding bone of the implant were as follows: mild type 2 < mild type 3 < moderate type 3 < moderate type 4. The bone quantity change rate increased more than when bone conditions were limited. Compared with changes in implant lengths, the stresses in the peri-implant surrounding bone were generally higher in the 9 mm implant length group than in the 11.5 mm group. However, the results did not significantly differ. In conclusion, the von Mises stress and strain increased in the models with moderate atrophy and low-density trabecular bone. Hence, bone atrophy and its presurgical diagnosis in long-term implant prognosis are crucial. [ABSTRACT FROM AUTHOR]

Dental implant surgery involves the insertion of a dental implant into the alveolar bone; the success of the surgery depends on the initial stability of the implant. The objective of this study was to examine the effects of dental implant insertion approaches in clinical surgery and in accordance with the standards of American Society for Testing and Materials on initial implant stability. Three insertion approaches were used for dental implant placement (Branemark Systems NobelSpeedy Groovy, Nobel Biocare AB, Gothenburg, Sweden) in two types of artificial bone—good bone (GB) and poor bone (PB). The three insertion approaches were as follows: (1) continuous rotation insertion (CRI): using a torque testing machine to continuously screw in an implant to completion and (2 and 3) intermittent rotation insertion (IRI)_90 and IRI_80: using CRI to bury an implant to 90% and 80% of its full length followed by IRI to complete the implantation, respectively. The maximum insertion torque value (ITV), periotest value (PTV), and implant stability quotient (ISQ) were measured and compared. The results indicated that bone quality and insertion approach both affected implant stability. Insertion approaches affected all three implant stability indicators differently in the GB and PB groups (p = 0.008). In GB groups, the insertion approach primarily affected ITV, whereas in PB groups, it primarily affected PTV. The effect of the insertion approach was less apparent for ISQ. Overall, in both the GB and PB groups, the implant stability for IRI_80 was greater than that for IRI_90, and the implant stability for IRI_90 was greater than that for CRI. Future in vitro studies should adopt an insertion approach that complies with the clinical practice for dental implant surgery. Dentists should adjust the timing for IRI in dental implant surgery to achieve greater initial dental implant stability. [ABSTRACT FROM AUTHOR]

Objective. This study evaluated the biomechanical effects of a metallic orthodontic mini-implant (OMI) covered with various types of angled revolving cap on the peri-OMI bone and the canine periodontal ligament (PDL) by finite element (FE) analyses. Materials and Methods. Three-dimensional FE models included comprised cortical bone and cancellous bone of the maxilla, and the OMIs were created. The forces (0.98 N) pulled in both the canine hook and the revolving cap, pulling towards each other in both directions as loading conditions. The upper surface of the maxilla was fixed as a boundary condition. Results. The bone stresses were increasing in the models by using OMI covered with a revolving cap as compared with that in the conventional model (in which only the OMI was placed). However, no obvious differences in bone stresses were observed among the models with various types of angled revolving cap. The minimum principal strain in the canine PDL was highest for condition 180T, followed by condition 180L. However, the maximum differences in the values between each experimental model and the conventional model were around 5%. Conclusion. This study showed no obvious effects in decreasing or increasing stress/strain in bone and PDL by using various types of angled revolving cap covered metallic mini-implant in orthodontic treatment of canine retraction. [ABSTRACT FROM AUTHOR]

Background/purpose: Impact of the implant shape on the biomechanical performance of all-on-four treatment of dental implant is still unclear. This study evaluated the all-on-four treatment with four osseointegrated implants in terms of the biomechanical effects of implant design and loading position on the implant and surrounding bone by using both in vitro strain gauge tests and three-dimensional (3D) finite element (FE) analyses.Methods: Both in vitro and 3D FE models were constructed with placing NobelSpeedy and NobelActive implants as well as a titanium framework in an edentulous jawbone based on the concept of all-on-four treatment. Three types of loads were applied: at the central incisor area (loading position 1) and at the molar regions with (loading position 2) and without (loading position 3) the denture cantilever. For the in vitro tests, the principal bone strains were recorded by rosette strain gauges and statistically evaluated using Wilcoxon's rank-sum test. The 3D FE simulations analyzed the peak von-Mises stresses in the implant and surrounding cortical bone.Results: The peak stress and strain in the surrounding bone were typically 36-62% (3D FE analysis) and 47-57% (in vitro test) (p < 0.001)higher for loading position 3 than for loading positions 1 and 2. Between those two implant designs, the bone strains and bone stresses did not differ significantly.Conclusion: For all-on-four treatment with four osseointegrated dental implants, altering the implant design does not appear to affect the biomechanical performance of the entire treatment, especially in terms of the stresses and strains in the surrounding bone. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate and compare the biomechanical behavior of internal fixation techniques in bilateral sagittal split ramus osteotomies (BSSROs) for mandibular setback. Artificial polyurethane mandibles were used in this study. The distal segment of the mandible was repositioned in an 8-mm setback position. All mandibles were divided into three groups: Group 1 had a straight plate with a four-hole monocortical fixation, Group 2 had a curved plate with a four-hole monocortical fixation, and Group 3 had a three–inverted L-type bicortical screw fixation. Vertical loads were applied on the incisal edge by a material testing system. The resistance force at 1, 3, 5, and 10 mm of displacement was analyzed. From the experimental results, Group 1 showed significantly lower results than Groups 2 and 3. No significant difference was observed between Groups 2 and 3 at 1, 3, and 5 mm of displacement. However, at 10 mm of displacement, the resistance force of Group 3 was greater than that of Group 2. For BSSROs, this study concluded that curved plate fixation exhibited the same rigidity as the inverted-L bicortical screw fixation did at ≤5 mm displacement. [ABSTRACT FROM AUTHOR]

We used the finite-element method (FEM) to investigate the effects of jawbone model integrity and the material properties of the periodontal ligament (PDL) on orthodontic tooth movement. Medical imaging software and computer-aided design software were used to create finite-element models of a partial and complete mandibles based on dental cone beam computed tomography images of the human skull. Additionally, we exerted an orthodontic force on the canine crown in the direction of an orthodontic miniscrew under a lower molar root to compare the von Mises strain on the canine PDL in three models: a partial mandible model under orthodontic force (Model 1), a complete mandible model under orthodontic force (Model 2), and a complete mandible model under orthodontic force with clench occlusion in the intercuspal position (ICP; Model 3). Additionally, in the complete mandible model under orthodontic force with ICP occlusion, we analyzed the effects of a PDL with a low (Model 4), moderate (Model 5), and high (Model 6) linear elastic modulus and a PDL a bilinear elastic modulus (Model 7). The simulation results for mandible integrity indicated that the maximum von Mises strains on the canine PDL for Models 1, 2, and 3 were 0.461, 0.394, and 1.811, respectively. Moreover, for the models with different PDL material properties, the maximum von Mises strains on the canine PDLs for Models 4, 5, 6, and 7 were 6.047, 2.594, 0.887, and 1.811, respectively. When the FEM was used to evaluate tooth movement caused by orthodontic force, the transformation of a complete mandible model into a partial mandible model or alteration of the elastic modulus of the PDL influenced the biomechanical responses of the PDL. Additionally, the incorporation of daily ICP occlusion resulted in a larger effect. [ABSTRACT FROM AUTHOR]

The objective of this study was to develop a geometrical calibration method applicable to the 2.5D prototype Periapical Radiography System and estimate component position errors. A two-steel-ball phantom with a precisely known position was placed in front of a digital X-ray sensor for two-stage calibration. In the first stage, the following three parameters were estimated: (1) r, the distance between the focal spot and the rotation axis of the X-ray tube; (2) ψ, the included angle between the straight line formed by the X-ray tube's focal spot and rotation axis and the straight line of the orthogonal sensor; and (3) L4, the distance between the rotation axis and the plane where the two steel balls were positioned. In the second stage, the steel balls' positions were determined to calculate the positions of the X-ray tube on the x, y, and z axes. Computer simulation was used to verify the accuracy of the calibration method. The results indicate that for the calibration approach proposed in this study, the differences between the estimated errors and setting errors were smaller than 0.15% in the first and second stages, which is highly accurate, verifying its applicability to accurate calibration of the 2.5D Periapical Radiography System. [ABSTRACT FROM AUTHOR]

Dental implants designed with platform switching have been used clinically to reduce crestal bone resorption. The aim of this study was to determine the biomechanical effects of loading types, diameter of platform, and implant diameter in bone strain around immediately loaded implants with platform switching concept. Platform-switching features of dental implants with various diameters of implant body and implant platform (named as RP5.0, RP4.3, and NP3.5) were inserted into artificial bone blocks. The initial implant stability was confirmed using a Periotest device before the loading test. Rosette strain gauges were placed on the alveolar region around the implants, and peak values of the bone strain during a 190-N vertical load or 30-degree lateral load were measured by a data acquisition system. The Kruskal-Wallis test and post-hoc pairwise comparisons were performed as statistical analyses. The median Periotest values of the RP5.0, RP4.3, and NP3.5 implants ranged from −6.59 to −7.34. The RP5.0 implant always showed the lowest bone strain around the implant, regardless of whether a vertical or lateral load was applied. Relative to the RP4.3 and NP3.5 implants, the RP4.3 implant produced a higher bone strain (by approximately 8%) under a vertical load but a lower bone strain (by approximately 25%) under a lateral load. This study confirmed that using a wider implant could relieve the bone strain around an immediately loaded implant with platform switching concept especially under lateral loading. [ABSTRACT FROM AUTHOR]

This study used available or purchased equipment and an image reconstruction system developed by the college of dentistry to establish a basic self-assembled micro-computed tomography (micro-CT) system. Such a system would be suitable for teaching dental radiology to dental students. Specifically, it could help students to understand the principles governing dental cone-beam computed tomography (CBCT) and provide graduate students with a system for scanning small samples (e.g., individual teeth) during the early stages of research. The self-assembled micro-CT system was constructed using a portable dental X-ray tube, an intraoral digital X-ray detector, a high-precision rotation stage, related bracket accessories, and a notebook computer. Reconstructed images and three-dimensional models of the maxillary right third molar were produced using the self-assembled micro-CT system and an advanced commercially available micro-CT system (Skyscan 2211). Subsequently, the reconstructed images and 3D models produced using the two systems were compared by two senior dentists to determine whether considerable visual differences could be observed. Finally, the signal-to-noise ratio (SNR) was used for quantitative analysis and to compare the systems. Although the self-assembled micro-CT system produced image boundaries that were not as sharp as those of Skyscan 2211, the images were nonetheless remarkably similar. In addition, the two micro-CT systems produced 3D models that were almost identical in appearance and root canal shape. Quantitative analysis revealed that Skyscan 2211 had produced a SNR that was superior to that of the self-assembled micro-CT system, with the difference ranging from 36.77% to 136.22%; enamel, which has a higher density, exhibited lower SNR differences, whereas dentin, which has a lower density, exhibited higher SNR differences. The self-assembled micro-CT system with a resolution of 36 μm was created using a portable dental X-ray tube and an intraoral digital X-ray detector. Although the scanning time was relatively long (~30 min to scan images of a tooth), the images were adequate in the preliminary stage of experiments. More importantly, students were afforded the opportunity to observe the process of assembling and disassembling each component of a micro-CT scanner and thereby achieve a more comprehensive understanding of the principles governing micro-CT and dental CBCT. [ABSTRACT FROM AUTHOR]

Background/purpose: This study investigated the effects of three three-dimensional (3D) bone-to-implant contact (BIC) parameters-potential BIC area (pBICA), BIC area (BICA), and 3D BIC percentage (3D BIC%; defined as BICA divided by pBICA)-in relation to the implant diameter on primary implant stability, as well as their correlations were also evaluated.Methods: Dental implants with diameters of 3.75, 4, 5, and 6 mm and artificial bone specimens were scanned by microcomputed tomography to construct 3D models for calculating pBICA, BICA, and 3D BIC%. Indexes of the primary implant stability including the insertion torque value (ITV), Periotest value (PTV), and implant stability quotient (ISQ) were measured after implants with various diameters were placed into bone specimens. The Kruskal-Wallis test, Wilcoxon rank-sum test with Bonferroni adjustment, and Spearman correlations were all performed as statistical and correlation analyses.Results: The implant diameter significantly influenced pBICA and BICA, but not 3D BIC%. ITV and PTV were more sensitive to implant diameter than was ISQ. The coefficients of determination were high (>0.92) for the correlations between pBICA (or BICA) and indexes of the primary implant stability.Conclusion: This study revealed how the implant diameter and the three-dimensional (3D) BIC influence the primary stabilities of dental implant. ITV and PTV were more sensitively influenced by the implant diameter than ISQ. The pBICA and BICA seem to be more important than 3D BIC % for using wider implant in treatment plan, since those two parameters are highly predictive of variations in the primary stability of dental implant. [ABSTRACT FROM AUTHOR]

Background: Intermittent parathyroid hormone (PTH) can be used to treat osteoporosis of the spine and hip. However, whether it can be used to treat osteoporosis of the mandible is unclear. The purpose of this study was to explore the influence of applying intermittent PTH to ovariectomized rats on the trabecular bone microarchitecture of the mandible and femoral head.Methods: Eighteen female rats were divided into three groups: the healthy group, ovariectomized (OVX) group, and OVX + PTH group. The OVX group and OVX + PTH group had an OVX at 8 weeks of age. The OVX + PTH group received intermittent PTH therapy for 12 weeks. The mandibles and femurs of all rats were removed at 20 weeks and were then scanned using microcomputed tomography (micro-CT).Results: From the micro-CT analysis, the trabecular bone microarchitecture of the mandible and femoral head are offered as follows: (1) The bone volume fraction and trabecular thickness in the OVX group were lower than those in the healthy group. (2) The bone volume fraction and trabecular thickness in the OVX + PTH group approximated those in the healthy group.Conclusion: The conclusions of this study regarding the trabecular bone microarchitecture of the mandible and femoral head are offered as follows: (1) The BV/TV and TbTh in the OVX group were lower than those in the healthy group. (2) The BV/TV and TbTh in the OVX + PTH group approximated those in the healthy group, therefore, intermittent PTH displayed high efficacy for treating femoral or mandibular deterioration of bone microstructure resulting from loss of ovarian function. Osteoporosis of the femur or mandible in the rats was ameliorated by intermittent PTH therapy. [ABSTRACT FROM AUTHOR]

Background/purpose: Small-diameter dental implants are associated with a higher risk of implant failure. This study used both three-dimensional finite-element (FE) simulations and in-vitro experimental tests to analyze the stresses and strains in both the implant and the surrounding bone when using one-piece (NobelDirect) and two-piece (NobelReplace) small-diameter implants, with the aim of understanding the underlying biomechanical mechanisms.Methods: Six experimental artificial jawbone models and two FE models were prepared for one-piece and two-piece 3.5-mm diameter implants. Rosette strain gauges were used for in-vitro tests, with peak values of the principal bone strain recorded with a data acquisition system. Implant stability as quantified by Periotest values (PTV) were also recorded for both types of implants. Experimental data were analyzed statistically using Wilcoxon's rank-sum test. In FE simulations, the peak value and distribution of von-Mises stresses in the implant and bone were selected for evaluation.Results: In in-vitro tests, the peak bone strain was 42% lower for two-piece implants than for one-piece implants. The PTV was slightly lower for one-piece implants (PTV = -6) than for two-piece implants (PTV = -5). In FE simulations, the stresses in the bone and implant were about 23% higher and 12% lower, respectively, for one-piece implants than those for two-piece implants.Conclusion: Due to the higher peri-implant bone stresses and strains, one-piece implants (NobelDirect) might be not suitable for use as small-diameter implants. [ABSTRACT FROM AUTHOR]

Background: the clinical application of orthopedic or dental implants improves the quality of the lives of patients. However, the long-term use of implants may lead to implant loosening and related complications. The purpose of this study is to deposit titanium (Ti)-niobium (Nb)-zirconium (Zr)-tantalum (Ta) alloys on the surface of Ti-6Al-4V to increase structural strength and biocompatibility for the possible future application of implants. Materials and methods: Ti, Nb, Zr, and Ta served as the materials for the surface modification of the titanium alloy. TiNbZr and TiNbZrTa coatings were produced using cathodic arc evaporation, and a small amount of nitrogen was added to produce TiNbZrTa(N) film. Annealing and oxidation were then conducted to produce TiNbZrTa-O and TiNbZrTa(N)-O coatings. In this study, biological tests and finite element analyses of those five alloy films, as well as uncoated Ti-6Al-4V, were performed. Human osteosarcoma cells (MG-63) and mouse fibroblast cells (L-929) were used to analyze cytotoxicity, cell viability, and cell morphology, and the bone differentiation of MG-63 was evaluated in an alkaline phosphatase experiment. Furthermore, for measuring the gene expression level of L-929, reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was conducted. The three-dimensional (3D) computational models of the coated and uncoated sample films were constructed using images of transmission electron microscopy and computer-aided design software and, then, the stress distributions of all models were evaluated by finite element analysis. Result: the cytotoxicity test revealed that the surface treatment had no significant cytotoxic effects on MG-63 and L-929 cells. According to the results of the cell viability of L-929, more cell activity was observed in the surface-treated experimental group than in the control group; for MG-63, the cell viability of the coated samples was similar to that of the uncoated samples. In the cell morphology analysis, both MG-63 and L-929 exhibited attached filopodia and lamellipodia, verifying that the cells were well attached. The alkaline phosphatase experiment demonstrated that the surface treatment did not affect the characteristics of early osteogenic differentiation, whereas RT-qPCR analysis showed that surface treatment can promote better performance of L-929 cells in collagen, type I, α1, and fibronectin 1. Finally, the results of the finite element analysis revealed that the coated TiNb interlayer can effectively reduce the stress concentration inside the layered coatings. Conclusions: TiNbZrTa series films deposited using cathodic arc evaporation had excellent biocompatibility with titanium alloys, particularly in regard to soft tissue cells, which exhibited an active performance. The finite element analysis verified that the TiNb interlayer can reduce the stress concentration inside TiNbZrTa series films, increasing their suitability for application in biomedical implants in the future. [ABSTRACT FROM AUTHOR]

Dental implant surgery is a common treatment for missing teeth. Its survival rate is considerably affected by host bone quality and quantity, which is often assessed prior to surgery through dental cone-beam computed tomography (CBCT). Dental CBCT was used in this study to evaluate dental implant sites for (1) differences in and (2) correlations between cancellous bone density and cortical bone thickness among four regions of the jawbone. In total, 315 dental implant sites (39 in the anterior mandible, 42 in the anterior maxilla, 107 in the posterior mandible, and 127 in the posterior maxilla) were identified in dental CBCT images from 128 patients. All CBCT images were loaded into Mimics 15.0 to measure cancellous bone density (unit: grayscale value (GV) and cortical bone thickness (unit: mm)). Differences among the four regions of the jawbone were evaluated using one-way analysis of variance and Scheffe's posttest. Pearson coefficients for correlations between cancellous bone density and cortical bone thickness were also calculated for the four jawbone regions. The results revealed that the mean cancellous bone density was highest in the anterior mandible (722 ± 227 GV), followed by the anterior maxilla (542 ± 208 GV), posterior mandible (535 ± 206 GV), and posterior maxilla (388 ± 206 GV). Cortical bone thickness was highest in the posterior mandible (1.15 ± 0.42 mm), followed by the anterior mandible (1.01 ± 0.32 mm), anterior maxilla (0.89 ± 0.26 mm), and posterior maxilla (0.72 ± 0.19 mm). In the whole jawbone, a weak correlation (r = 0.133, p = 0.041) was detected between cancellous bone density and cortical bone thickness. Furthermore, except for the anterior maxilla (r = 0.306, p = 0.048), no correlation between the two bone parameters was observed (all p > 0.05). Cancellous bone density and cortical bone thickness varies by implant site in the four regions of the jawbone. The cortical and cancellous bone of a jawbone dental implant site should be evaluated individually before surgery. [ABSTRACT FROM AUTHOR]

Assessing bone quality and quantity at the location of dental implants before dental implantation is crucial. In recent years, dental cone-beam computed tomography (dental CBCT) has often been used to assess bone quality and quantity prior to dental implant. However, the effect of scanning resolution on the prediction of trabecular bone microarchitectural parameters (TBMPs) remains unclear. The objective of this study was to examine how dental CBCT with various scanning resolution differs with regard to predicting TBMPs. This study used micro-computed tomography (micro-CT) with 18 μm resolution and dental CBCT with 100 μm and 150 μm resolutions on 28 fresh bovine vertebrae cancellous bone specimens. Subsequently, all images were input into the ImageJ software to measure four TBMPs: bone volume total volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular separation (Tb.Sp). One-way analysis of variance and Tukey's test were subsequently used to assess the differences between three scanning modes for the four TBMPs. In addition, correlations between measurement results obtained from micro-CT and dental CBCT with two resolutions were measured. The experimental results indicated that significant differences in four TBMPs were observed between micro-CT and dental CBCT (p < 0.05). The correlation coefficients between BV/TV, Tb.N, and Tb.Sp obtained from micro-CT and from dental CBCT with 100 μm resolution (0.840, 0.739, and 0.820, respectively) were greater than the correlation coefficients between BV/TV, Tb.N, and Tb.Sp obtained from micro-CT and from dental CBCT with 150 μm resolution (0.758, 0.367, and 0.724, respectively). The experimental results revealed that the TBMPs measured with dental CBCT with two resolutions differed from ideal values, but a higher resolution could provide more accurate prediction results, particularly for BV/TV, Tb.N, and Tb.Sp. [ABSTRACT FROM AUTHOR]

Pure titanium (Ti) and titanium alloys are widely used as artificial implant materials for biomedical applications. The excellent biocompatibility of Ti has been attributed to the presence of a natural or artificial surface layer of titanium dioxide. Zinc oxide and tantalum oxide thin films are recognized due to their outstanding antibacterial properties. In this study, high power impulse magnetron sputtering (HiPIMS) was used for the deposition of tantalum oxide and zinc-doped Ta(Zn)O thin films on Ti with rough and porous surface, which was pretreated by plasma electrolytic oxidation (PEO). Surface morphology, antibacterial property as well as cell biocompatibility were analyzed. The antibacterial effect was studied individually for the Gram-positive and Gram-negative bacteria Staphylococcus aureus (S. aureus) and Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans). The deposited Ta (Zn)O coating was composed of amorphous tantalum oxide and crystalline ZnO. The antibacterial results on the tantalum oxide and Ta(Zn)O coated Ti indicated a significant inhibition of both S. aureus and A. actinomycetemcomitans bacteria when compared with the uncoated Ti samples. The deposited Ta(Zn)O showed the best antibacterial performance. The Ta(Zn)O coated Ti showed lower level of the cell viability in MG-63 cells compared to other groups, indicating that Zn-doped Ta(Zn)O coatings may restrict the cell viability of hard tissue-derived MG-63 cells. However, the biocompatibility tests demonstrated that the tantalum oxide and Ta(Zn)O coatings improved cell attachment and cell growth in human skin fibroblasts. The cytotoxicity was found similar between the Ta2O5 and Ta(Zn)O coated Ti. By adopting a first PEO surface modification and a subsequent HiPIMS coating deposition, we synthetized amorphous tantalum oxide and Ta(Zn)O coatings that improved titanium surface properties and morphologies, making them a good surface treatment for titanium-based implants. [ABSTRACT FROM AUTHOR]

In finite element (FE) simulations, the peak bone stresses were higher when loading with a cantilever extension (CE) than when loading without a CE by 33–49% in the cortical bone. In the in vitro experiments, the highest values of principal strain were all within the range of the minimum principal strain, and those peak bone strains were 40–58% greater when loading with a CE than when loading without a CE (p < 0.001). This study investigated how varying the implanted position and angulation of anterior implants in the All-on-Four treatment influenced the biomechanical environment in the alveolar bone around the dental implants. Ten numerical simulations of FE models and three in vitro samples of All-on-Four treatment of dental implants were created to investigate the effects of altering the implanted position and angulation type of anterior implants. A single load of 100 N was applied in the molar region in the presence or absence of a CE of the denture. The 3D FE simulations analyzed the von-Mises stresses in the surrounding cortical bone and trabecular bone. For the in vitro tests, the principal bone strains were recorded by rosette strain gauges and statistically evaluated using the Mann–Whitney U test and the Kruskal–Wallis test. Loading in the presence of a CE of the denture induced the highest bone stress and strain, which were 53–97% greater in the FE simulation and 68–140% in the in vitro experiments (p < 0.008) than when loading without a CE. The bone stresses in the FE models of various implanted positions and angulation types of anterior implants were similar to those in the model of a typical All-on-Four treatment. In vitro tests revealed that the bone strains were significantly higher in the samples with various angulation types of anterior implants (p < 0.008). In the All-on-Four treatment of dental implants, the bone stress and strain were higher when the load was applied to the CE of dentures. Altering the position or angulation of the anterior dental implant in the All-on-Four treatment has no benefit in relieving the stress and strain of the bone around the dental implant. [ABSTRACT FROM AUTHOR]

Patients with oral cancer often have to undergo the surgery for mandibular excision. Once the bone in the cancerous area is removed, not only the facial area but also chewing function of the patient is needed to be repaired by clinicians. In recent years, the rapid growth of three-dimensional (3D) metal printing technology has meant that higher-quality facial reconstructions are now possible, which could even restore chewing function. This study developed 3D-printed titanium (Ti)-alloy reconstruction implant for a prosthesis designed for mandibular segmental osteotomy defects, and 3D finite element (FE) analysis was conducted to evaluate its biomechanical performance. The analyzed parameters in the FE models were as follows: (1) two prosthesis designs, namely a prosthesis retaining the residual mandibular bone (for patients with mild oral cancer) and a prosthesis with complete mandibular resection (for patients with severe oral cancer); (2) two lengths of prosthesis, namely 20 and 25 mm; and (3) three thicknesses of prosthesis, namely 0.8, 1, and 1.5 mm. A 45° lateral bite force (100 N) was applied to the top of the prosthesis as the loading condition. The results revealed that for the two prosthesis designs, the prosthesis retaining the residual mandibular bone showed higher stress on the prosthesis and cortical bone compared with the prosthesis with complete mandibular resection. Regarding the two prosthesis lengths, no fixed trend of prosthesis stress was found, but stress in the cortical bone was relatively high for a prosthesis length of 20 mm compared with that of 25 mm. For the three prosthesis thicknesses, as the thickness of the prosthesis decreased, the stress in the prosthesis decreased but the stress in the cortical bone increased. These findings require confirmation in future clinical investigations. [ABSTRACT FROM AUTHOR]

Titanium dioxide and vanadium oxides have been applied extensively in industrial and medical fields. The objective of this study was to develop various composite structures of titanium and vanadium oxide (Ti-V-O) coatings on pure titanium through high-temperature annealing and laser texturing oxidation, separately; additionally, surface morphologies, tribological and hydrophilic properties, and antibacterial and biocompatibility abilities of these Ti-V-O coatings were evaluated. TiV alloy thin films were deposited on pure titanium and then annealed to form Ti-V-O coatings through thermal oxidation and laser texturing oxidation. Ball-on-disc wear tests and contact angle tests were conducted to evaluate the tribological properties and wettability of the coatings, respectively. The antibacterial activity of the coatings was estimated by SYTO9 nucleic acid staining with Staphylococcus aureus (Gram-positive bacteria). The cell cytotoxicity of the coatings was analyzed following the ISO 10995-5:2009 standard with human skin fibroblast cells. The Ti-V-O coatings, subjected to annealing at 700 °C, demonstrated higher hardness (Hv 1171) and a lower friction coefficient (0.6). The highest hardness (Hv 2711) and the lowest friction coefficient (0.52) were obtained for the Ti-V-O after laser surface texturing oxidation at 100 kHz. The oxide coating obtained from 100 kHz laser texturing oxidation exhibited the lotus effect because of its systematic textured microstructures, and displayed superhydrophobic surface properties. Compared with the unannealed TiV coating, both the samples with high-temperature annealing and laser surface texturing oxidation had excellent antibacterial properties to Staphylococcus aureus. However, the Ti-V-O thin films exhibited notable cell cytotoxicity. Although the cell viability on Ti-V-O coatings were not ideal, this study confirmed improvement in surface hardness, tribology, and antibacterial performance in Ti-V-O coatings, which may have potential for use in biomedical tools, devices, and equipment. [ABSTRACT FROM AUTHOR]

The evolution of flight in feathered dinosaurs and early birds over millions of years required flight feathers whose architecture features hierarchical branches. While barb-based feather forms were investigated, feather shafts and vanes are understudied. Here, we take a multi-disciplinary approach to study their molecular control and bio-architectural organizations. In rachidial ridges, epidermal progenitors generate cortex and medullary keratinocytes, guided by Bmp and transforming growth factor β (TGF-β) signaling that convert rachides into adaptable bilayer composite beams. In barb ridges, epidermal progenitors generate cylindrical, plate-, or hooklet-shaped barbule cells that form fluffy branches or pennaceous vanes, mediated by asymmetric cell junction and keratin expression. Transcriptome analyses and functional studies show anterior-posterior Wnt2b signaling within the dermal papilla controls barbule cell fates with spatiotemporal collinearity. Quantitative bio-physical analyses of feathers from birds with different flight characteristics and feathers in Burmese amber reveal how multi-dimensional functionality can be achieved and may inspire future composite material designs. • A cortex/medulla composite beam organization allows rachides to adapt flexibly • Polarized adhesion and keratin expression lead to hooklet barbules that form vanes • With-dermal papilla WNT signaling controls barbule shape along the feather P-D axis • 3D feathers embedded in amber show primitive vanes formed by overlapping barbules The design and developmental paradigms of flight feathers are explored using a combination of bio-physical analyses, molecular characterization, and evolutionary comparisons across a broad range of birds with different flight modes, revealing a modular architectural design that can accommodate diverse eco-spaces. [ABSTRACT FROM AUTHOR]

Background/purpose: The aim of this study was to determine the effects of age and sex on the difference between chronological age (CA) and dental age (DA) predicted using the Demirjian and Willems methods in Taiwanese children., Materials and Methods: A total of 232 periapical X-ray images were obtained from children aged 5-12 years in Taiwan. Among them, 119 were boys, and 113 were girls. DA was calculated on the basis of the X-ray images of permanent teeth by using the aforementioned methods. The children were stratified by age (5-9 years [early mixed dentition period] vs. 10-12 years [late mixed dentition period]) and sex (boys vs. girls). Statistical analyses were performed to investigate potential age- and sex-based differences in the correlation between CA and DA., Results: No significant difference was observed between the mean CA and DA predicted using the Willems method in children with late mixed dentition and in girls. However, the correlation between CA and DA was stronger in children with early mixed dentition than in those with late mixed dentition and also stronger in boys than in girls., Conclusion: For children in mid-Taiwan, age and sex influence the development of permanent teeth. In addition, the correlation between DA and CA is relatively strong for boys in the early mixed dentition period., Competing Interests: The authors have no conflicts of interest relevant to this article., (© 2024 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.)

Background/purpose: Clear aligners are popular orthodontic tools because of their relatively aesthetic appearance and convenience of use. Nevertheless, bodily tooth movements still present challenges. This study evaluated various configurations of attachments placed on the mandibular canine in terms of the efficiency of canine bodily movement and correction of tipping., Materials and Methods: A finite element model of the mandible was constructed to investigate the effects of various attachment configurations on the overall bodily movement and undesirable tipping of a mandibular canine. Canine movements were categorized into four types, namely tipping and bodily movements in the mesial and distal directions. The size and shape of the attachments were fixed, but their placement and orientation were varied. Five and seven attachment configurations were evaluated for their influence on tipping and bodily movements, respectively., Results: Attachment configuration significantly influenced mandibular canine tipping. The mesial occlusal-distal cervical and mesial occlusal-mesial cervical configurations had notable effects on mesial tipping, and the mesial occlusal-mesial cervical configuration excelled in distal tipping by increasing strain by 33.1%. The mesial occlusal-mesial cervical attachment configuration consistently had superior efficiency in facilitating both mesial and distal bodily movements of the canine., Conclusion: The mesial occlusal-mesial cervical attachment configuration excelled in all four types of canine movement. Irrespective of the attachment configuration, canines tend to move overall with slight tipping due to skeletal resistance and their center of rotation. The attachment configuration is crucial to the success of clear aligner treatment and must be carefully considered in clinical practice., Competing Interests: The authors have no conflicts of interest relevant to this article., (© 2024 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.)

Clinically, a reconstruction plate can be used for the facial repair of patients with mandibular segmental defects, but it cannot restore their chewing function. The main purpose of this research is to design a new three-dimensionally (3D) printed porous titanium mandibular implant with both facial restoration and oral chewing function reconstruction. Its biomechanical properties were examined using both finite element analysis (FEA) and in vitro experiments. Cone beam computed tomography images of the mandible of a patient with oral cancer were selected as a reference to create 3D computational models of the bone and of the 3D-printed porous implant. The pores of the porous implant were circles or hexagons of 1 or 2 mm in size. A nonporous implant was fabricated as a control model. For the FEA, two chewing modes, namely right unilateral molar clench and right group function, were set as loading conditions. Regarding the boundary condition, the displacement of both condyles was fixed in all directions. For the in vitro experiments, an occlusal force (100 N) was applied to the abutment of the 3D-printed mandibular implants with and without porous designs as the loading condition. The porous mandibular implants withstood higher stress and strain than the nonporous mandibular implant, but all stress values were lower than the yield strength of Ti-6Al-4V (800 MPa). The strain value of the bone surrounding the mandibular implant was affected not only by the shape and size of the pores but also by the chewing mode. According to Frost's mechanostat theory of bone, higher bone strain under the porous implants might help maintain or improve bone quality and bone strength. The findings of this study serve as a biomechanical reference for the design of 3D-printed titanium mandibular implants and require confirmation through clinical investigations.

Background: the clinical application of orthopedic or dental implants improves the quality of the lives of patients. However, the long-term use of implants may lead to implant loosening and related complications. The purpose of this study is to deposit titanium (Ti)-niobium (Nb)-zirconium (Zr)-tantalum (Ta) alloys on the surface of Ti-6Al-4V to increase structural strength and biocompatibility for the possible future application of implants., Materials and Methods: Ti, Nb, Zr, and Ta served as the materials for the surface modification of the titanium alloy. TiNbZr and TiNbZrTa coatings were produced using cathodic arc evaporation, and a small amount of nitrogen was added to produce TiNbZrTa(N) film. Annealing and oxidation were then conducted to produce TiNbZrTa-O and TiNbZrTa(N)-O coatings. In this study, biological tests and finite element analyses of those five alloy films, as well as uncoated Ti-6Al-4V, were performed. Human osteosarcoma cells (MG-63) and mouse fibroblast cells (L-929) were used to analyze cytotoxicity, cell viability, and cell morphology, and the bone differentiation of MG-63 was evaluated in an alkaline phosphatase experiment. Furthermore, for measuring the gene expression level of L-929, reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was conducted. The three-dimensional (3D) computational models of the coated and uncoated sample films were constructed using images of transmission electron microscopy and computer-aided design software and, then, the stress distributions of all models were evaluated by finite element analysis., Result: the cytotoxicity test revealed that the surface treatment had no significant cytotoxic effects on MG-63 and L-929 cells. According to the results of the cell viability of L-929, more cell activity was observed in the surface-treated experimental group than in the control group; for MG-63, the cell viability of the coated samples was similar to that of the uncoated samples. In the cell morphology analysis, both MG-63 and L-929 exhibited attached filopodia and lamellipodia, verifying that the cells were well attached. The alkaline phosphatase experiment demonstrated that the surface treatment did not affect the characteristics of early osteogenic differentiation, whereas RT-qPCR analysis showed that surface treatment can promote better performance of L-929 cells in collagen, type I, α1, and fibronectin 1. Finally, the results of the finite element analysis revealed that the coated TiNb interlayer can effectively reduce the stress concentration inside the layered coatings., Conclusions: TiNbZrTa series films deposited using cathodic arc evaporation had excellent biocompatibility with titanium alloys, particularly in regard to soft tissue cells, which exhibited an active performance. The finite element analysis verified that the TiNb interlayer can reduce the stress concentration inside TiNbZrTa series films, increasing their suitability for application in biomedical implants in the future.

Purpose: Leeway space is clinically crucial in pediatric dentistry because it is utilized to resolve tooth crowding and allow the first molars to drift mesially to establish a Class I molar relationship in the later stages of mixed dentition. This study investigated leeway space in the mixed dentition of Taiwanese children of different sexes and ages., Materials and Methods: The digital panoramic dental films of 182 lower arches of 119 boys and 63 girls aged 5-10 years were analyzed in this retrospective study. The mesiodistal crown widths of the primary canines and first and second molars and the permanent canines and first and second premolars were measured using medical imaging software. Differences in leeway space were statistically analyzed., Results: The average leeway space was 1.29 ± 1.48 mm on each side of the lower arch. The leeway space of children aged 5-6 years was significantly greater than that of children aged 7-8 years. No gender difference in crown width was discovered, except with regard to the primary first molar. Although no gender difference in leeway space was observed, permanent teeth affected leeway space more for girls than for boys., Conclusion: In Taiwanese children, although leeway space does not differ by sex, age affects leeway space. However, permanent tooth size has an influence on the leeway space of girls.

The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.

Background: The influences of potential bone-to-implant contact (BIC) area (pBICA), BIC area (BICA), and three dimensional (3D) BIC percentage (3D BIC%; defined as BICA divided by pBICA) in relation to the implant length on initial implant stability were studied. Correlations between these parameters were also evaluated., Methods: Implants with lengths of 8.5, 10, 11.5, and 13 mm were placed in artificial bone specimens to measure three indexes of the initial implant stability: insertion torque value (ITV), Periotest value (PTV), and implant stability quotient (ISQ). The implants and bone specimens were also scanned by microcomputed tomography, and the obtained images were imported into Mimics software to reconstruct the 3D models and calculate the parameters of 3D bone-to-implant contact including pBICA, BICA, and 3D BIC%. The Kruskal-Wallis test, Wilcoxon rank-sum test with Bonferroni adjustment, and Spearman correlations were applied for statistical and correlation analyses., Results: The implant length affected ITV more than PTV and ISQ, and significantly affected pBICA, BICA, and 3D BIC%. A longer implant increased pBICA and BICA but decreased 3D BIC%. The Spearman coefficients were high (>0.78) for the correlations between the three 3D BIC parameters and the three indexes of the initial implant stability., Conclusions: pBICA, BICA, and 3D BIC% are useful when deciding on treatment plans related to various implant lengths, since these 3D BIC parameters are predictive of the initial implant stability.

Background: Intermittent parathyroid hormone (PTH) can be used to treat osteoporosis of the spine and hip. However, whether it can be used to treat osteoporosis of the mandible is unclear. The purpose of this study was to explore the influence of applying intermittent PTH to ovariectomized rats on the trabecular bone microarchitecture of the mandible and femoral head., Methods: Eighteen female rats were divided into three groups: the healthy group, ovariectomized (OVX) group, and OVX + PTH group. The OVX group and OVX + PTH group had an OVX at 8 weeks of age. The OVX + PTH group received intermittent PTH therapy for 12 weeks. The mandibles and femurs of all rats were removed at 20 weeks and were then scanned using microcomputed tomography (micro-CT)., Results: From the micro-CT analysis, the trabecular bone microarchitecture of the mandible and femoral head are offered as follows: (1) The bone volume fraction and trabecular thickness in the OVX group were lower than those in the healthy group. (2) The bone volume fraction and trabecular thickness in the OVX + PTH group approximated those in the healthy group., Conclusion: The conclusions of this study regarding the trabecular bone microarchitecture of the mandible and femoral head are offered as follows: (1) The BV/TV and TbTh in the OVX group were lower than those in the healthy group. (2) The BV/TV and TbTh in the OVX + PTH group approximated those in the healthy group, therefore, intermittent PTH displayed high efficacy for treating femoral or mandibular deterioration of bone microstructure resulting from loss of ovarian function. Osteoporosis of the femur or mandible in the rats was ameliorated by intermittent PTH therapy.

Background: Before extracting impacted lower third molars, dentists must first identify the spatial relationship between the inferior alveolar nerve (IAN) and an impacted lower third molar to prevent nerve injury from the extraction. Nevertheless, the current method for describing the spatial relationship between the IAN and an impacted lower third molar is deficient. Therefore, the objectives of this study were to: (1) evaluate the relative position between impacted lower third molars and the IAN; and (2) investigate the relative position between impacted lower third molars and the IAN by using a cylindrical coordinate system., Methods: From the radiology department's database, we selected computed tomography images of 137 lower third molars (from 75 patients) requiring removal and applied a Cartesian coordinate system by using Mimics, a medical imaging software application, to measure the distribution between impacted mandibular third molars and the IAN. In addition, the orientation of the lower third molar to the IAN was also measured, but by using a cylindrical coordinate system with the IAN as the origin., Results: According to the Cartesian coordinate system, most of the IAN runs through the inferior side of the third molar (78.6 %), followed by the lingual side (11.8 %), and the buccal side (8.9 %); only 0.7 % is positioned between the roots. Unlike the Cartesian coordinate system, the cylindrical coordinate system clearly identified the relative position, r and θ, between the IAN and lower third molar., Conclusions: Using the cylindrical coordinate system to present the relationship between the IAN and lower third molar as (r, θ) might provide clinical practitioners with a more explicit and objective description of the relative position of both sites. However, comprehensive research and cautious application of this system remain necessary.