Search

Purpose: Reconstruction plates are frequently used to treat mandibular segmental defects. The aim of this study is to compare the biomechanical performance of a 3-dimensional-printed self-designed titanium alloy reconstruction plate with that of the traditional reconstruction plate in mandible reconstruction. The analyzed parameters of the self-designed reconstruction plate, including plate length (100 mm and 125 mm), plate thickness (2.1, 2.4, and 2.7 mm), and bone mass (100, 75, and 50%), were also evaluated.Methods: An artificial mandible with anatomical geometry was used to develop the self-designed reconstructed plate. Both in vitro experiments and finite element simulations were performed for the biomechanical comparison of the self-designed and traditional reconstruction plates. In finite element analysis, 3 major muscle forces of mandible movement were set as the loading condition, and the displacement of the condyle was fixed in all directions as the boundary condition.Results: The biomechanical performances (stresses in the plate and strains in bone) of the self-designed reconstruction plate were superior to those of the traditional plate. Factorial analysis indicated that plate length and thickness had significant effects on decreasing stresses of the plate and mandibular bone.Conclusions: The self-designed reconstruction plate might have a benefit to reduce the stresses/strains in plate itself and surrounding bone. [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]

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]

The quality of maxillary bone is generally lower than that of mandibular bone; consequently, complete arch immediate implant-loading treatment is not as predictable in the maxillary as in the mandibular arch. The All-on-4 concept has proven to be an effective and successful treatment protocol. However, the survival rate of All-on-4 implants in the maxilla is lower than of those in the mandible. In this report, 2 anterior wide-diameter implants were used with the All-on-4 concept for a maxillary rehabilitation to provide biomechanical benefits with better primary stability while still achieving a functional and esthetic result. The clinical challenges of using wide-diameter implants in the anterior region are also discussed and should be considered during treatment planning. [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]

A cathodic-arc evaporation system with plasma-enhanced duct equipment was used to deposit TiZrN, TiZrCN, and TiZr/a-C coatings. Reactive gases (N 2 and C 2 H 2 ) activated by the Ti and Zr plasma in the evaporation process was used to deposit the TiZrCN and TiZr/a-C coatings with different C and nitrogen contents. The crystalline structures and bonding states of coatings were analyzed by X-ray diffraction and X-ray photoelectron spectroscopy. The microbial activity of the coatings was evaluated against Staphylococcus aureus (Gram-positive bacteria) and Actinobacillus actinomycetemcomitans (Gram-negative bacteria) by in vitro antibacterial analysis using a fluorescence staining method employing SYTO9 and a bacterial-viability test on an agar plate. The cell compatibility and morphology related to CCD-966SK cell-line human skin fibroblast cells on the coated samples were also determined using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay, reverse-transcriptase-polymerase chain reaction, and scanning electron microscopy. The results suggest that the TiZrCN coatings not only possess better antibacterial performance than TiZrN and TiZr/a-C coatings but also maintain good compatibility with human skin fibroblast cells. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effect of clenching tasks on the stress and stability of a temporomandibular joint (TMJ) condylar prosthesis, as well as on the stress and strain in the whole mandible and bone surrounding three screws. Three-dimensional finite element models of the mandible and a TMJ condylar prosthesis using three screws were established. Six static clenching tasks were simulated in this study: incisal clench (INC), intercuspal position (ICP), right unilateral molar clench (RMOL), left unilateral molar clench (LMOL), right group function (RGF), and left group function (LGF). Based on the simulation of the six clenching tasks, none of the inserted screws or the TMJ condylar prosthesis were broken. In addition, the stability of the TMJ condylar prosthesis was sufficiently high for bone ongrowth. For the whole mandibular bone, the maximum von Mises stress and von Mises strain observed in the cortical bone and cancellous bone were yielded by the ICP and RMOL, respectively. For the bone surrounding the inserted screws, the maximum von Mises stress and von Mises strain in both the cortical bone and cancellous bone were yielded by the LMOL. Clenching tasks had significant effects on the stress distribution of the TMJ condylar prosthesis, as well as on the stress and strain distribution of the whole mandible and the bone surrounding the inserted screws. [ABSTRACT FROM AUTHOR]

The surface characteristics of biomaterials play an important role in their interaction with biological systems. Tantalum (Ta) oxides and their coatings have been proved to increase their applications in the biomedical fields such as medical devices and dental implants by improving their osseointegration and corrosion resistance. In this study, Ta and amorphous tantalum oxide coatings were deposited by using magnetron sputtering. A hydrophilic crystalline β-Ta 2 O 5 coating was obtained by rapid thermal annealing of the deposited tantalum oxide coating at 700 °C. In this study, Staphylococcus aureus and Actinobacillus actinomycetemcomitans ( A. actinomycetemcomitans ) are Gram-positive and Gram-negative bacteria, respectively, that exhibit physiological commensalism on the human skin and oral areas. Both bacteria were chosen as the model for in vitro anti-bacterial analyses by a fluorescence staining method employing Syto9. The cytocompatibility of human skin fibroblast cells (CCD-966SK) on the coatings was also determined using an MTT assay. It showed that the amorphous tantalum oxide coatings possessed good antibacterial performance, while the hydrophilic crystalline tantalum oxide coatings exhibited outperformed human skin fibroblast cellular biocompatibility. [ABSTRACT FROM AUTHOR]

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. [Copyright &y& Elsevier]

Abstract: Experiment with rapid prototyping technique and validation finite element model was performed to evaluate the biomechanical behavior of an immediately loaded mandibular implant. Also, 18 finite element models of six implant designs and three surface roughnesses with anisotropic bone material properties were analyzed to compare the bone stresses and the sliding at the bone–implant interface under a vertical or lateral force of 130N. The results show that bone stress (strain) of an immediately loaded implant is heavily dependent on the implant design and surface roughness. Improving the initial interfacial interlocking using a threaded implant has a higher priority than using cylindrical or step designs with a rough surface for an immediately loaded implant. [Copyright &y& Elsevier]

Abstract: 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=A×(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=1.26×10−3×(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. [Copyright &y& Elsevier]

Background/purpose: Knowledge of root canal anatomy is important for dental practice and for identifying features of anthropological significance. Three-rooted permanent mandibular molars are considered an anatomical variant of the Mongoloid race. This study aimed to determine the prevalence of three-rooted primary mandibular first molars in Taiwanese subjects.Methods: Vertical bite-wing radiographs of 227 subjects, which had been obtained previously in the Department of Pediatric Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan, from January 2004 to December 2007, were screened retrospectively. Images of 121 subjects [54 boys and 67 girls; mean age (range), 5.8 (2.4-10.4) years] who had bilateral primary mandibular first molars were studied. The sex, symmetry and frequency of occurrence of three-rooted primary mandibular first molars were recorded and statistically analyzed.Results: The overall prevalence of subjects with three-rooted primary mandibular first molars was 5.0% (6/121), and 83.0% of the molars were unilateral. The prevalence of teeth that showed an extra root among all teeth examined was 2.9% (7/242). Such prevalence did not differ significantly between the right and left sides of the mandible, bilateral and unilateral, or with sex.Conclusion: The data presented here indicate that approximately 5% of Taiwanese subjects had a threerooted mandibular primary first molar and 80% of such teeth occurred unilaterally. Dentists should take into account the prevalence of these three-rooted variants in primary mandibular first molars among Taiwanese patients during their daily endodontic and exodontic procedures. [ABSTRACT FROM AUTHOR]

Abstract: This study determined the prevalence of permanent three-rooted mandibular first molars and their morphology among a Taiwanese population by using cone-beam computed tomography (CBCT). Images from 744 patients were screened to obtain 123 samples for this study. All permanent mandibular first molars were evaluated in axial sections from the pulpal floor to the apices of the roots to determine the number of roots. The interorifice distances from the distolingual (DL) canal to the mesiobuccal (MB) and distobuccal (DB) canals were also estimated. The prevalence of permanent three-rooted mandibular first molars was 33.33%, with a bilateral incidence of a symmetrical distribution of 53.65%. There was a significantly greater incidence of three-rooted teeth on the right side of the mandible than on the left, but gender did not show a significant relationship with this variant prevalence.The mean interorifice distances from the DL canal to the DB, MB, and ML canals of the permanent three-rooted mandibular molars were 2.7, 4.4, and 3.5 mm, respectively. The high prevalence of the DL root in permanent mandibular first molars among the Taiwanese (Chinese) population and estimations of the interorifice distance of such teeth might be useful for successful endodontic treatments. [Copyright &y& Elsevier]

Abstract: Objectives: This study investigated the surrounding bone stress and the implant–bone interfacial sliding of implant designs and implant sizes of immediately loaded implant with maxillary sinus augmentation by using three-dimensional (3D) non-linear finite element (FE) analysis. Methods: Twenty-four FE models including four implant designs (cylindrical, threaded, stepped and step-thread implants) and three implant dimensions (standard, long and wide threaded implants) with a bonded and three levels of frictional contact of implant–bone interfaces were analyzed. The maxillary model was constructed from computer tomography (CT) images of a human skull and all 3D implant models were created via the computer-aided design (CAD) software. Results: The use of threaded implants decreased the bone stress and sliding distance obviously about 30% as compared with non-threaded (cylindrical and stepped) implants. Increasing the implant''s length or diameter reduced the bone stress by 13–26%. Employing a immediately loaded implant with smooth machine surface (μ =0.3, μ represents frictional coefficient) increased the bone stress by 28–63% as compared with the osseointegrated (bonded interfaces) implants. Roughening the implant surface (μ >0.3) did not reduced the bone stress, however it did decrease the interfacial sliding between implant and bone. Conclusions: For an immediately loaded implant placed with sinus augmentation, using threaded implant could decrease both the bone stress and implant–bone sliding distance which may improve the implant initial stability and long-term survival. Rough surface of implants shows no benefit to reduce the bone stress but they could lower the interfacial sliding. On the contrary, employing long or wide implants decrease the bone stress but they cannot diminish the interfacial sliding. [Copyright &y& Elsevier]

Background/purpose: Preparing a continuous tapering conical shape and maintaining the original shape of a canal are obligatory in root canal preparation. The purpose of this study was to compare the shaping performance in simulated curved canal resin blocks of the same novice dental students using hand-prepared and engine-driven nickel-titanium (NiTi) rotary ProTaper instruments in an endodontic laboratory class.Methods: Twenty-three fourth-year dental students attending China Medical University Dental School prepared 46 simulated curved canals in resin blocks with two types of NiTi rotary systems: hand and motor ProTaper files. Composite images were prepared for estimation. Material removed, canal width and canal deviation were measured at five levels in the apical 4 mm of the simulated curved canals using AutoCAD 2004 software. Data were analyzed using Wilcoxon's rank-sum test.Results: The hand ProTaper group cut significantly wider than the motor rotary ProTaper group in the outer wall, except for the apical 0 mm point. The total canal width was cut significantly larger in the hand group than in the motor group. There was no significant difference between the two groups in centering canal shape, except at the 3 mm level.Conclusion: These findings show that the novice students prepared the simulated curved canal that deviated more outwardly from apical 1 mm to 4 mm using the hand ProTaper. The ability to maintain the original curvature was better in the motor rotary ProTaper group than in the hand ProTaper group. Undergraduate students, if following the preparation sequence carefully, could successfully perform canal shaping by motor ProTaper files and achieve better root canal geometry than by using hand ProTaper files within the same teaching and practicing sessions. [ABSTRACT FROM AUTHOR]

In this study, amorphous tantalum oxide coatings were deposited onto the Ti substrate with and without plasma electrolytic oxidation (PEO)-pretreatment by using a high-powered impulse magnetron sputtering system. The antibacterial tests were conducted using Syto9 fluorescent dyes to study the antibacterial performance of Gram-positive (Staphylococcus aureus) and Gram-negative (Actinobacillus actinomycetemcomitans) bacteria. In vitro studies, the cell cytotoxicity and cell viability were evaluated with soft-tissue derived human skin fibroblasts and hard-tissue derived human osteosarcoma cells. The results of the antibacterial experiments revealed that both the Ta 2 O 5 and PEO-pretreated Ta 2 O 5 samples had superior antibacterial properties compared to the uncoated Ti samples. Cell viability analyses showed that the Ta 2 O 5 films with and without PEO pretreatment exhibited better cell growth compared to the Ti specimens in human skin fibroblasts and human osteosarcoma cells. The cell viability of PEO-pretreated Ta 2 O 5 films even two-fold higher than the Ti specimens in human osteosarcoma cells. In addition, no cytotoxicity was detected in both the Ta 2 O 5 and PEO-pretreated Ta 2 O 5 films. It concluded that porous Ta 2 O 5 film pretreated with PEO procedure possessed both great biocompatibility and antibacterial abilities. It might have highly potential to be a candidate for the surface materials of dental or orthopedic implants. • Amorphous Ta 2 O 5 are deposited by high-powered impulse magnetron sputtering. • The plasma electrolytic oxidation-pretreated Ta 2 O 5 has the highest hydrophilicity. • The Ta 2 O 5 coatings showed good antibacterial properties. • The cell viability of human skin fibroblasts is the highest for the Ta 2 O 5 coatings. • The MG-63 cell viability is the highest for the porous PEO-pretreated Ta 2 O 5 coatings. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the correlation between the initial stability of a dental implant, quantified as the implant stability quotient (ISQ), and the bone-implant contact percentage ( BIC%). Study Design: Dental implants were inserted into specimens comprising an artificial cortical shell representing cortical bone and foam bone representing cancellous bone with 4 elastic moduli. Each specimen with an implant was subjected to microcomputed tomography (micro-CT) scanning, from which the 2D and 3D BIC% values were calculated. The values of the Spearman correlation coefficient (r) were calculated between the ISQ and the 2D and 3D BIC% values. Results: Increasing the elasticity of the specimen enhanced the ISQ. There was statistically significant correlation between the ISQ and 3D BIC% values (r = 0.85, P < .0001). However, the correlation between ISQ and 2D BIC% values was not statistically significance (r = 0.42, P = .062). Conclusions: The initial implant stability was strongly positively correlated with the 3D BIC%. [Copyright &y& Elsevier]

Objective: This study evaluated the effect of bone quality on the stability of and stress in the artificial temporomandibular joint (TMJ) condylar prosthesis as well as on the stress and strain distributions in the bone. Study design: Three-dimensional finite element models of the mandible and an artificial TMJ condylar prosthesis using 3 screws were established. Four types of bone were modeled by varying the elastic modulus of cancellous bone. Results: Increasing the bone quality from type IV to type I reduced the maximum relative micromotion between implant and bone, maximum von Mises stresses in the implant and surrounding cortical bone, and maximum von Mises strain in the surrounding cancellous bone by 17.5%, 10.5%, 12.0%, and 39.4%, respectively. Conclusion: The bone quality of the mandible has only a minor effect on the stability of and stress in an artificial TMJ implant and cortical bone, but it greatly affects the microstrain in cancellous bone. [Copyright &y& Elsevier]

Abstract: Tantalum is considered a highly biocompatible metal with high corrosion resistance. Metal-doped amorphous carbon films are gaining interest as an effective surface modifier for medical devices. In this study, tantalum (Ta), TaC/amorphous carbon (a-C), and Ta-containing amorphous hydrogenated carbon films (Ta-C:H) were synthesized using a twin-gun magnetron sputtering system to improve biological properties and explore potential applications for surgical implants or devices. Reactive C2H2, activated by the tantalum plasma in the magnetron sputtering process, was used to deposit the Ta-C:H coatings. The deposited TaC/a-C coatings, in which TaC was embedded in the amorphous carbon matrix as a nanocomposite film, exhibited favorable cell viability of the human osteosarcoma cell line (MG-63), similar to uncoated titanium. Among the examined materials, Ta-C:H coatings exhibited the highest biocompatibility for WS1 human fetal skin fibroblast cells derived from soft tissues and demonstrated the highest biological performance. [Copyright &y& Elsevier]

Abstract: One of the major causes of loosening of cementless acetabular cup implants is insufficient initial stability. This study used three-dimensional finite element models of the pelvis and acetabular components to investigate the effects of the number of screws, bone quality, and friction coefficient of the acetabular cup on the initial stability under normal walking. A commercially available hemispherical acetabular cup with five screw holes was used as the default model. The stiffness of the pelvis and the friction coefficient of the cup were systematically varied, within a realistic range, to assess the initial stability of the acetabular cup. The simulations showed that the inserted screws provide only a localized reduction in the relative micromotion between the cup and pelvis therefore inserting several screw closed together might not be useful. Changes in the pelvic stiffness have a non-linear effect on the initial stability of acetabular cup and the subchondral bone provides good support for fixation of the cementless cup. The friction coefficient of the acetabular cup plays a limited role, comparing with the factor of bone quality, in resisting relative micromotion in the cup–pelvis interface. [Copyright &y& Elsevier]

Abstract: One of the major causes inducing loosening in the cementless acetabular cup implanting is its insufficient initial stability. In this study, three-dimensional finite element models of the pelvis and acetabular components were developed to investigate the relationship between relative micromotion, initial stability, and screw fixation under six daily activity loadings. A commercial available hemispheric cup with five screw holes was used as the target acetabular cup. The simulation results showed that if screws were placed closed together, when the screw number increased from 1 to 5, the peak micromotion decreased less than 14%, from 126.5 to 108.8μm, while the stable region, micromotion less than 28μm, enlarged only by 40%, from 46.1% to 64.7%. However, if the screw could be placed near the cup rim, a single rim screw, 202.1μm micromotion, could provide better stability than that of four dome screws, 209.6μm micromotion, placed closed together. To conclude, multiple cup screws should be placed near cup rim and as separate as possible to enlarge the stable region and reduce the peak micromotion between cup and acetabulum. [Copyright &y& Elsevier]

This study reports a method for controlling loads on an in vivo dental implant and its application for the investigation of early loading versus delayed loading of dental implants. The method was developed for the purpose of studying an ongoing hypothesis that amounts to bone loss around dental implants are related to mechanical-mediated adaptation of the alveolar bone. Using a customized intra-oral hydraulic system, the daily loading over a dental implant has been completed and recorded for six Sinclair swine. Each pig had a 5-month duration implant loading. During the experiments (loading), no analgesic treatment was supplied. The mean of the in vivo daily loadings was confirmed through an in vitro bench test after each animal was euthanized. Variations of the averaged loading input among the six animals were smaller than 10%. Preliminary data produced by the model suggests that cervical bone loss is less for early loading than for delayed loading. The current system is expected to provide a useful load control model for the study of alveolar bone adaptation around dental implants in relation to various loadings. [Copyright &y& Elsevier]