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The effect of heel-pad thickness and loading protocol on measured heel-pad stiffness and a standardized protocol for inter-subject comparability.

BACKGROUND: Heel-pad stiffness is an important parameter in clinical assessments of the lower limb and is usually quantified by the slope of the force-deformation curve. However, the data produced is affected by the geometry of the heel, thus making inferences about tissue behaviour difficult. METHOD: With the use of finite element analysis the aim of this study is to explore the possibility of expressing heel-pad stiffness in terms of stress-strain data. An axisymmetric, non-linear and time-dependent representation of the heel was created. The material model, incorporating non-linearity and viscoelasticity, was based on a series of experiments involving healthy, cadaveric specimens and loading at different loading rates (0, 175 and 350 mm/s). The conditions of an in vivo study were then replicated and stress-strain data of the model were compared. Good agreement was achieved (error <5%) at higher strains (>0.2). Probe diameter, loading rate and heel-pad thickness were then varied and heel-pad stiffness, expressed in terms of both force-deformation and stress-strain characteristics, reported. FINDINGS: In terms of the force-deformation characteristics, thin heels are consistently stiffer than thick heels. In terms of stress-strain characteristics, thicker heels are stiffer than thin heels using small probes whereas thinner heels are stiffer than thick heels using large probes. It was possible to predict stress-strain data of the heel-pad that are least-dependent of heel-pad thickness using large probes and slow-rising loads. INTERPRETATION: It is suggested that stress-strain curves derived from large probes under slow loads would provide the most robust and standardized measure of heel-pad stiffness.

Biomechanical Phenomena↗

The effectiveness of a new algorithm on a three-dimensional finite element model construction of bone trabeculae in implant biomechanics.

More validity of finite element analysis (FEA) in implant biomechanics requires element downsizing. However, excess downsizing needs computer memory and calculation time. To evaluate the effectiveness of a new algorithm established for more valid FEA model construction without downsizing, three-dimensional FEA bone trabeculae models with different element sizes (300, 150 and 75 micron) were constructed. Four algorithms of stepwise (1 to 4 ranks) assignment of Young's modulus accorded with bone volume in the individual cubic element was used and then stress distribution against vertical loading was analysed. The model with 300 micron element size, with 4 ranks of Young's moduli accorded with bone volume in each element presented similar stress distribution to the model with the 75 micron element size. These results show that the new algorithm was effective, and the use of the 300 micron element for bone trabeculae representation was proposed, without critical changes in stress values and for possible savings on computer memory and calculation time in the laboratory.

Algorithms↗

Improvement of the reliability of ceramic hip joint implants.

The aim of this article is to present the optimization of a proof test procedure of ceramic hip joint ball heads. The proof test rejects defective samples in the production line before being implanted into human body. Thereby on every ceramic ball head a static load is applied, which is somewhat higher than the maximum physiological load. The magnitude of the applied load should not damage the samples which are free of flaws in the high stress area. The configuration of the proof test influences the stress distribution in the ball head, which should be similar to the physiological case. To determine the stress distribution, a non-linear finite element (FE) analysis was performed and the results were validated by measurements. With an iterative approach based on FE calculations the proof test configuration was optimized in such a way that the stress distribution in the ball head is similar to the stress distribution in vivo. In this study all ball heads showed very high fatigue resistance after being proof tested and fulfilled the requirements of the FDA (Food and Drug Administration, USA) described in the Guidance Document for the Preparation of Premarket Notifications for Ceramic Ball Hip System. The probability of a fracture of an implanted ceramic ball head can be decreased by the presented optimized proof test procedure. Latter can thus improve the reliability of ceramic hip joint ball heads. The study was supported by the KTI (Commission for Technology and Innovation, Switzerland).

Computer-Aided Design↗

The effect of interfacial parameters on cup-bone relative micromotions. A finite element investigation.

Achieving stability is a prerequisite for allowing bone to grow into the porous surface of non-cemented acetabular cups. The purpose of this study is to estimate the effects of interfacial characteristics on relative cyclical micromotion between cup and bone during gait in the immediate postoperative phase. The technique used is finite element analysis. Six models with different interfacial characteristics are created in order to study the effects of fixation technique. These include representation of a 1 mm press-fit, 2 mm press-fits (with and without an initial polar gap) and exact-fit conditions (with and without additional screw fixation). Although direct validation of the model has not been performed, the calculated micromotions under a static load of 1112 N are compared with appropriate experimental data. Generally, the model tends to underestimate micromotion and this underestimate is significant in the case of relative surface-normal micromotion in polar regions for models with low- and no-interference. The most likely cause of this significant underestimate is a failure of the model to accurately represent penetration of rough contacting surfaces under compression. Other types of micromotion, although low, are within standard deviations reported by Kwong et al. (1994 Journal of Arthroplasty 9, 163-170). Quasi-static joint contact and muscle forces, representative of the stance phase of gait are then applied and maximum micromotions are found to occur consistently prior to toe off: this being the point of maximum force. With regard to the press-fit simulations, good cup-bone contact in the superior region of the interface is required for stability and the greatest micromotions occur in the models with the larger interference and larger polar gaps. In contrast to the press-fit models, muscle activity in exact-fit models influences the calculations. Specifically, the early activity of m.semimembranosus modelled causes opening of the peripheral seal. Taken together it is found that polar gaps reduce the stability of the model and lack of pre-compresssion in the periphery allows this region of the interface to be opened up.

Acetabulum↗

Methods and evaluations of MRI content-adaptive finite element mesh generation for bioelectromagnetic problems.

In studying bioelectromagnetic problems, finite element analysis (FEA) offers several advantages over conventional methods such as the boundary element method. It allows truly volumetric analysis and incorporation of material properties such as anisotropic conductivity. For FEA, mesh generation is the first critical requirement and there exist many different approaches. However, conventional approaches offered by commercial packages and various algorithms do not generate content-adaptive meshes (cMeshes), resulting in numerous nodes and elements in modelling the conducting domain, and thereby increasing computational load and demand. In this work, we present efficient content-adaptive mesh generation schemes for complex biological volumes of MR images. The presented methodology is fully automatic and generates FE meshes that are adaptive to the geometrical contents of MR images, allowing optimal representation of conducting domain for FEA. We have also evaluated the effect of cMeshes on FEA in three dimensions by comparing the forward solutions from various cMesh head models to the solutions from the reference FE head model in which fine and equidistant FEs constitute the model. The results show that there is a significant gain in computation time with minor loss in numerical accuracy. We believe that cMeshes should be useful in the FEA of bioelectromagnetic problems.

Algorithms↗

New implant designs for fracture fixation in osteoporotic bone.

Screws are one of the limiting factors for fixation of implants, particularly in poor bone quality. A class of new implants with an implant-bone-interface optimized regarding load transition by increasing the peripheral area might improve the anchorage of implants in osteoporotic bone. However, the shape of these implants requires new technologies for insertion. The goal of the work presented here was to analyze the relevant parameters regarding implant geometry and to demonstrate the effect of new procedures for their insertion. The investigation was divided into three parts: 1) implant design optimisation, 2) efficiency of cortical bone ablation, and 3) implant insertion technology. Finite element analysis (FEA) was performed to investigate the influence of the number of lobes, the radius of the outer curvature and additional milling to remove any sharp changes of section around the lobe. Opening of the cortical bone with an Er:YAG laser was studied using calf cortex from 2 to 7 mm thickness. The effect of a) pulse energy and pulse duration, b) cortical thickness, c) wet or dry boundary conditions on volume and geometry of ablated bone, time required to penetrate the cortical bone and local bone tissue damage was quantified. Pneumatic and ultrasound based insertion were compared in the third experiment. The cortical bone was prepared in the following ways: a) no opening, b) predrilling of three holes (1 mm diameter each) and c) exact pre-cutting of the whole contour. Increasing the radius of the outer curvature from 2 to 5 mm reduces the peak stresses during loading in all planes in the implant as well as in the adjacent cortical bone by about 30-40%. An increase in the number of lobes from two to three decreases the mean peak stress by about 46% (alpha < 0.001) and the range between the minimal and maximal peak stresses for different loading directions by about 83%. Penetration of cortical bone with an Er:YAG laser was possible up to a cortical thickness of 6 mm with fewer than 100 pulses. The ablation rate per pulse increased more with increasing duration than with increasing energy. Signs of bone damage such as melting were only visible when high pulse energies and durations were used. Insertion of the prototype was possible with all devices, but only when the whole contour was cut out of the cortical bone. However, the use of the ultrasound vibrator led to heating up of the tissue fluid and subsequently to water evaporation and tissue damage. Insertion of the prototype was possible with both pneumatic vibrators, but only when the whole contour was cut out of the cortical bone. New implant designs may lead to reduced stress peaks in the surrounding bone and might be inserted with the help of new insertion technologies, namely laser cutting of cortical bone and pneumatic vibration. Further studies are required to optimize these technologies prior to clinical use.

Animals↗

Presurgical finite element simulation of scoliosis correction.

For surgical correction of scoliotic spinal deformity, internal fixation systems apply lateral and distractive corrective forces. In order to gain maximal correction, a finite--element analysis of the spinal deformity correction technique has been carried out preoperatively, after first employing the spinal deformity correction finite--element model to determine the in vivo spinal stiffness. The presurgical analysis also gives us an appreciation of how the parameters of deformity, stiffness and corrective forces jointly contribute to the value of the correction index. The paper presents the methodology and clinical application. It also summarizes the results for ten patients, whereby the efficacy of presurgical analysis is assessed by comparing the corrective index values by presurgical simulation with the surgical results for equivalent levels of corrective forces.

Adolescent↗

3D FEA of cemented steel, glass and carbon posts in a maxillary incisor.

OBJECTIVES: A comparative study on the stress distribution in the dentine and cement layer of an endodontically treated maxillary incisor has been carried out by using Finite Element Analysis (FEA). The role of post and cement rigidity on reliability of endodontic restorations is discussed. METHODS: A 3D FEM model (13,272 elements and 15,152 nodes) of a central maxillary incisor is presented. A chewing static force of 10 N was applied at 125 degree angle with the tooth longitudinal axis at the palatal surface of the crown. Steel, carbon and glass fiber posts have been considered. The differences in occlusal load transfer ability when steel, carbon and glass posts, fixed to root canal using luting cements of different elastic moduli (7.0 and 18.7 GPa) are discussed. RESULTS AND SIGNIFICANCE: The more stiff systems (steel and carbon posts) have been evaluated to work against the natural function of the tooth. Maximum Von Mises equivalent stress values ranging from 7.5 (steel) to 5.4 and 3.6 MPa (respectively, for carbon posts fixed with high and low cement moduli) and to 2.2 MPa (either for glass posts fixed with high and low cement moduli) have been observed under a static masticatory load of 10 N. A very stiff post works against the natural function of the tooth creating zones of tension and shear both in the dentine and at the interfaces of the luting cement and the post. Stresses in static loading do not reach material (dentine and cement) failure limits, however, they significantly differ leading to different abilities of the restored systems to sustain fatigue loading. The influence of the cement layer elasticity in redistributing the stresses has been observed to be less relevant as the post flexibility is increased.

Bite Force↗

A finite element model of the bovine claw under static load for evaluation of different flooring conditions.

AIM: To create a computer-based finite element (FE) model of the bovine claw and to use finite element analysis (FEA) to estimate stress and deformation of a physiologically-shaped model claw under static load, to visualise potential material weakness and to evaluate the effect of different flooring conditions. METHODS: Model geometry was derived using digitalised images from a recently trimmed, sound, hind claw from a 4-year-old Austrian Fleckvieh cow. Material properties of bovine claw horn were defined from preliminary investigations and recently established material data, using a modulus of elasticity from 200 to 600 N/mm2. Meshing of the model was performed with 42,127 elements based on 116,141 nodes. Loading of the model was defined at 756 N per claw on a hard and soft surface. RESULTS: The FE model of the bovine claw under a load of 756 N showed only minimal deformation, most of which took place at the axial wall. Highest stresses were evident in the proximal axial wall, the outer edge of the weight-bearing surface and under the heels. The claw-floor contact image showed a pressure distribution resembling the distal rim of the claw wall. On the hard surface, the maximum stresses were three times higher than those on the soft surface. CONCLUSIONS AND CLINICAL RELEVANCE: FEA allowed visualisation of the effects that loading on different floor surfaces have on the biomechanics of the claw. Uneven preparation of the claw sole resulted in high stresses at and close to irregularities of the sole. Consequences were more severe on harder flooring. The model supports the hypothesis that mechanical factors play a substantial role in the pathogenesis of claw lesions.

Animals↗

Evaluation of a reinforced slot design for CEREC system to restore extensively compromised premolars.

OBJECTIVES: The structural stability and adhesive strength of a large-cavity premolar with a CEREC restoration is a frequent problem in long-term use. This study sought to determine whether an additional reinforced slot could increase tooth/ceramic retention using finite element (FE) analysis and fracture testing. METHODS: The cavity was designed in a typical MODL restoration failure shape when the lingual cusp has been lost. Two FE restored-tooth models with different cavity designs were created using image processing, contour stacking, and mesh generation. Interfacial (normal and shear) stresses were then calculated with and without the slot design for restored teeth under lateral and axial forces and different interfacial conditions (bonded and de-bonding). For validation, a fracture experiment was performed with and without reinforced slot designs for large ceramic CEREC restorations. RESULTS: The maximum stresses at the buccal wall increased when a lateral occlusal force acted on the restored tooth with a slot design. Conversely, the interfacial stresses decreased when the restored tooth received a uniform axial occlusal force. After de-bonding on the buccal tooth/ceramic interface, the stresses increased by an average factor of three over those obtained with a bonded interface. The fracture forces were consistent with the tendencies predicted in FE analyses. CONCLUSIONS: An additional reinforced slot for the CEREC restoration of a large cavity could increase retention when a restored tooth receives an axial occlusal load. However, the benefits of a slot seem to be doubtful for a premolar often subjected to a lateral load.

Analysis of Variance↗

Stress distribution in bone: single-unit implant prostheses veneered with porcelain or a new composite material.

The purpose of this study was to simulate dynamic and static occlusal loading on one unit fixed, implant-supported prostheses veneered with porcelain and with GRADIA in a 3-dimensional finite element model of the human mandible to analyze and compare the resultant stresses in the superstructures and in the supporting bone. Calculation and visualization of stress, deformation, and displacement of complex structures under simulated forces were evaluated by finite element analysis (FEA) using ANSYS. The device employed was from the OSTEOFIX Dental Implant System (Oulu, Finland), and the veneering materials used were standard dental porcelain and GC GRADIA (Tokyo, Japan), a new composite material. Two different loading conditions were considered: static and transitional or impact, each delivered in three different directions: horizontal (Fh) at 0 degrees , vertical (Fv) at 90 degrees , and oblique (Fo) at 120 degrees . The proportion of the force: magnitude was fh:fv:fo = 1:3.5:7. A vertical load of 500 N, a horizontal load of 143 N, and an oblique load of 1000 N were applied. The results showed that the highest stresses in the bone-implant interface occurred in the region of cortical bone adjacent to the first thread of implants in all models and varied within 6.5%. Maximum stresses and displacements were higher (7%) in those models with statically loaded implants as compared with those that had been dynamically loading. The direction of loading played a major role in determining stress levels and they varied at up to 85%. It was shown that with dynamic loads, the peak of 1.568 mm was registered in the model with the GRADIA veneering material. This displacement was 6.5% higher than that found with the Vita VMK 68 veneers. These results suggest that the implant superstructure-fixed single crown veneering materials-porcelain and GRADIA played minor influences to the displacements and stresses in the implant supported bone with a 1% variance. One of the reasons for this element resulting in so minor a contribution to stress relief was the relatively small volume of the veneers as compared with the far greater volume and stiffness of the superstructures and implants. One of the advantages of GC GRADIA is that it reduces impact force under dynamic load up to a 6.5%.

Bite Force↗

Tissue stresses and strain in trabeculae of a canine proximal femur can be quantified from computer reconstructions.

A quantitative assessment of bone tissue stresses and strains is essential for the understanding of failure mechanisms associated with osteoporosis, osteoarthritis, loosening of implants and cell- mediated adaptive bone-remodeling processes. According to Wolff's trajectorial hypothesis, the trabecular architecture is such that minimal tissue stresses are paired with minimal weight. This paradigm at least suggests that, normally, stresses and strains should be distributed rather evenly over the trabecular architecture. Although bone stresses at the apparent level were determined with finite element analysis (FEA), by assuming it to be continuous, there is no data available on trabecular tissue stresses or strains of bones in situ under physiological loading conditions. The objectives of this project were to supply reasonable estimates of these quantities for the canine femur, to compare trabecular-tissue to apparent stresses, and to test Wolff's hypothesis in a quantitative sense. For that purpose, the newly developed method of large-scale micro-FEA was applied in conjunction with micro-CT structural measurements. A three-dimensional high-resolution computer reconstruction of a proximal canine femur was made using a micro-CT scanner. This was converted to a large-scale FE-model with 7.6 million elements, adequately refined to represent individual trabeculae. Using a special-purpose FE-solver, analyses were conducted for three different orthogonal hip-joint loading cases, one of which represented the stance-phase of walking. By superimposing the results, the tissue stress and strain distributions could also be calculated for other force directions. Further analyses of results were concentrated on a trabecular volume of interest (VOI) located in the center of the head. For the stance phase of walking an average tissue principal strain in the VOI of 279 strain was found, with a standard deviation of 212 microstrain. The standard deviation depended not only on the hip-force magnitude, but also on its direction. In more than 95% of the tissue volume the principal stresses and strains were in a range from zero to three times the averages, for all hip-force directions. This indicates that no single load creates even stress or strain distributions in the trabecular architecture. Nevertheless, excessive values occurred at few locations only, and the maximum tissue stress was approximately half the value reported for the tissue fatigue strength. These results thus indicate that trabecular bone tissue has a safety factor of approximately two for hip-joint loads that occur during normal activities.

Animals↗

A comparative study of flexible (Polyactive) versus rigid (hydroxylapatite) permucosal dental implants. II. Histological aspects.

Of the many materials that are applied in dental implantology, most have a high Young's modulus. In the concept of osseointegration, which is generally preferred, chewing forces are therefore directly transmitted from rigid implant materials to the relatively flexible surrounding bone. Polyactive is an elastomeric polyethylene-oxide polybutylene-terephthalate (PEO:PBT) copolymer, with a low modulus of elasticity, that exhibits bone-bonding characteristics. Previous finite-element analysis emphasized the benefit of the application of flexible implant materials. To assess the validity of this finite element model, one dense and two porous types of flexible Polyactive permucosal dental implants and one rigid hydroxylapatite (HA) implant were clinically tested in a beagle dog study and were compared during 30 weeks of loading. In an earlier report, it was concluded that dense Polyactive implants function clinically adequately and resemble the mobility of natural teeth. In the current study, the amount of bone contact was quantitatively assessed. Polyactive implants showed a statistically significantly higher bone contact, as compared to the HA implants, probably due to a significant water uptake and a subsequent increase in the volume of the denser Polyactive. Morphological analysis, based on back-scatter electron microscopy and light microscopy, revealed little remodelling activity of the bone surrounding the Polyactive implants. Few remodelling lacunae were seen and de novo bone formation was rarely observed. At some locations, a continuity between calcification zones with the polymer surface and the surrounding interfacial bone was observed, indicating the occurrence of bone-bonding. Also, the bone surrounding the HA implants showed little remodelling activity, although large resorption lacunae were observed, in which HA particles were present. Based on the observations of this study, flexible bone bonding implants might be more capable of transferring stresses to the surrounding bone and are therefore promising alternatives to "routine' rigid implants.

Alveolar Process↗

Influence of occlusal forces on stress distribution in preloaded dental implant screws.

STATEMENT OF PROBLEM: Abutment and prosthetic loosening of single and multiple screw-retained, implant-supported fixed partial dentures is a concern. PURPOSE: The purpose of this study was to investigate stress distribution of preloaded dental implant screws in 3 implant-to-abutment joint systems under simulated occlusal forces. MATERIAL AND METHODS: Three abutment-to-implant joint systems were simulated by using the 3-dimensional finite element analysis method: (1) Branemark external hexagonal screw-retained abutment, (2) ITI 8-degree Morse tapered cemented abutment, and (3) ITI 8-degree Morse tapered plus internal octagonal screw-retained abutment. A thermal load and contact analysis method were used to simulate the preload resulting from the manufacturers' recommended torques in implant screw joint assemblies. The simulated preloaded implants were then loaded with 3 simulated static occlusal loads (10 N; horizontal, 35 N; vertical, 70 N; oblique) on the crown position onto the implant complex. RESULTS: Numeric and graphical results demonstrated that the stresses increased in both the abutment and prosthetic screws in the finite element models after simulated horizontal loading. However, when vertical and oblique static loads were applied, stresses decreased in the external hexagonal and internal octagonal plus 8-degree Morse tapered abutment and prosthetic screws with the exception of the prosthetic screw of ITI abutment after 70-N oblique loading. Stresses increased in the ITI 8-degree Morse tapered cemented abutment after both vertical and oblique loads. CONCLUSION: Although an increase or decrease was demonstrated for the maximum calculated stress values in preloaded screws after occlusal loads, these maximum stress values were well below the yield stress of both abutment and prosthetic screws of 2 implant systems tested. The results imply that the 3 implant-to-abutment joint systems tested may not fail under the simulated occlusal forces.

Bite Force↗

Porcelain veneers: dentin bonding optimization and biomimetic recovery of the crown.

PURPOSE: The purpose of this study was to investigate the biomimetic principle in porcelain veneer reconstruction, or in other words, to assess the extent to which the restoration can mimic the biomechanics and structural integrity of the original tooth. Using an optimized luting procedure, porcelain veneers are expected to present such features even when bonded to an extensive dentin surface. METHODS AND MATERIALS: Dentin-bonded porcelain veneers were assessed using functional and cyclic thermal loads with respect to two parameters: coronal stiffness (investigated using experimental strain gauges and finite element analysis) and morphology of the tooth-restoration interface (scanning electron microscope evaluation). Two different application modes of the same dentin-bonding agent, Optibond FL, were evaluated: a traditional method (dentin adhesive applied when proceeding to luting the veneer) and an alternative method (dentin adhesive applied to dentin and cured before taking the impression for the veneer). RESULTS: In the finite element model, the crown compliance increased by a factor of 2.16 after facial enamel removal and returned to 96% of its original value after the placement of the veneer. The finite element values showed a good correlation with strain gauge experimental results (one-sample t test, P > 0.35 after facial enamel removal and P > 0.19 after veneer placement). The dentin adhesive application mode was not critical to the recovery of tooth stiffness (analysis of variance, P = 0.10). However, qualitative scanning electron microscope observations demonstrated that the traditional dentin adhesive application was associated with bonding failures between the hybrid layer and the overlying resin, whereas unbroken and continuous interfaces were obtained with the new method using the same dentin adhesive. CONCLUSION: The results of this study definitely favor the biomimetic behavior of porcelain veneers bonded to teeth using an optimized application mode of dentin adhesives, because this treatment modality proved to restore both the mechanical behavior and microstructure of the intact tooth.

Analysis of Variance↗

Parametric stress analysis of bonded "combination-materials" type of orthodontic brackets.

The finite element analysis method and a two-dimensional idealization were used to conduct a detailed parametric study of the stresses in and displacement of models of bonded edgewise "combination-materials" type of orthodontic brackets when subjected to loading and constraint conditions that are deemed to be the same as those that exist in vivo. A "combination-materials" type bracket is herein defined as one in which different materials are used in fabricating the main body and the archwire slot. The present study was conducted in three parts. In Part 1, 16 model cases were analyzed, involving 4 different combinations of materials (for the main body of the bracket and its archwire slot) and 4 different overall bracket configurations (comprising main body, base and slot). The focus of Part 2 was the model bracket configuration that was, on the basis of Part 1 results, deemed to show the "optimum performance". In this part, the parameter investigated was the value of the modulus of elasticity of the adhesive, Eadh. In Part 3, the concept of an efficiency index of the bonded bracket-archwire system, eta, was introduced and explained. The dependence of eta on stated characteristics of a rectangular archwire, for the "optimum performance" model, was explored. Part 1 results led to the conclusion that the "optimum performance" model has equally angulated buccal and lingual edges and the main body and archwire slot are fabricated from glass fiber-reinforced polycarbonate and stainless steel, respectively. Part 2 results showed that, for the aforementioned "optimum performance" model, the longitudinal displacement of the archwire slot is fairly insensitive to Eadh. Part 3 results showed that eta is intimately related to each of the wire characteristics studied (namely cross-sectional dimensions, "interbracket distance" and modulus of rigidity of the material).

Adhesives↗

[Effect of the number of splinted abutments on stress distribution of support tissue]

OBJECTIVE:This study applied an SJ-1 bolt attachment partial denture to restorate distal extension edentulous areas.Finite element analysis (FEA) was used to monitor induced around abutment supporting tissues under the different number of splinted abutments.METHODS:Finite element analysis. RESULTS:The result demonstrate that the reduction of the number of splinted unit from three to two resulted in an insignificant increase of stress records,whereas reduction of the number from two to one resulted in a significant increase of stress nine times greater than the three unit splint values.CONCLUSION:Hence,at least two teeth on each side should be splinted when SJ 1 bolt(extracoronal) distal extension attachment prostheses are used.

Journal Article↗

[Theoretical analysis of changes in femoral stresses after total hip arthroplasty].

Changes in bone stress in the proximal femur following implantation can be estimated with the use of composite beam theory. The aim of this study was to construct the mathematical analytical models for predicting the degree of stress shielding and to test the validity of the predictions using finite element simulation. To define the periprosthetic bone stress values, the proximal femur was divided into eleven equidistant cross sections, then each section was divided into four quadrants corresponding to the anterior, posterior, medial and lateral aspects of the femur. Bone stress values were calculated by both mathematical analytical models and finite element analysis, then linear regression analyses produced slopes and R-values that show numerical and finite element results corresponding well to intact femur and both the types of fixation with/without cement. And the results also showed that femoral bone stress shielding by both the prostheses occurred in most periprosthetic zones. The most serious regions occurred in the proximal medial quadrant. This study has succeeded in creating the mathematical analytical models to predict the bone, cement and prostheses stress values, and thus can help us to evaluate the mechanical behavior of total hip replacement, to further understand the distinction between different fixation, and to make advances in implant design, surgical technique and long-term results.

Arthroplasty, Replacement, Hip↗