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The cause of subchondral bone cysts in osteoarthrosis: a finite element analysis.

BACKGROUND: The etiology of subchondral bone cysts in arthrotic joints is unclear. MATERIALS AND METHODS: We used two-dimensional finite element analysis to evaluate the hypothesis that subchondral bone cysts in the osteoarthrotic hip joint may be the result of microfractures caused by localized cartilage defects or a thinned layer of cartilage. We evaluated the equivalent bone stress (von Mises (VM) stress) in the cancellous bone as an indicator of potential microfractures and further development of cystic lesions. RESULTS: Cartilage defects induced stress peaks in the subchondral bone. This peak stress distribution corresponded to the clinical observation of development of acetabular and femoral subchondral cysts in a "kissing" position. A femoral subchondral bone cyst induced a stress peak at the corresponding acetabular site, whereas subchondral acetabular cysts did not increase stress in the femoral head. Acetabular cysts showed an increased level of stress at the lateral and medial border of the lesion which was much higher than the stress levels in the femoral head, indicating a tendency to faster growth. INTERPRETATION: Our study supports the theory that stress-induced bone resorption may cause development of subchondral bone cysts in osteoarthrosis.

Acetabulum↗

The mechanical behaviour of cantilever fixed partial dentures in shortened dental arch therapy: a 2-D finite element analysis.

In the present study two-dimensional finite element models of two- and three-unit cantilever fixed partial dentures were created to simulate the replacement of a maxillary second premolar in a shortened dental arch. The purpose of the study was to investigate the mechanical behaviour of the two designs of fixed partial denture using the finite element method. The results indicate that the mechanical behaviour of the three-unit fixed partial denture was more favourable than that of the two-unit fixed partial denture under similar conditions of occlusal loading. Prosthesis displacement and maximum principal stresses increased substantially when loading was limited to the pontic, in particular, in the model of two-unit fixed partial denture.

Bicuspid↗

Action of human respiratory muscles inferred from finite element analysis of rib cage.

The actions of several human respiratory muscles have been inferred from finite element analysis of the rib cage. The human model is based on anatomic and mechanical measurements in dogs and human cadavers. As in an earlier canine model, the external and internal (interosseous) intercostal muscles were found to cause, respectively, inspiratory and expiratory displacements of the rib cage, in agreement with the two-dimensional geometric analysis of Hamberger. When extended to three dimensions, Hamberger's analysis helps explain why muscles at the side of the rib cage produce changes in the anteroposterior diameter, whereas muscles at the front and back of the rib cage cause changes in the transverse diameter.

Humans↗

Processing and analysis of in vivo high-resolution MR images of trabecular bone for longitudinal studies: reproducibility of structural measures and micro-finite element analysis derived mechanical properties.

The authors have developed a system for the characterization of trabecular bone structure from high-resolution MR images. It features largely automated coil inhomogeneity correction, trabecular bone region segmentation, serial image registration, bone/marrow binarization, and structural calculation steps. The system addresses problems of efficiency and inter- and intraoperator variability inherent in previous analyses. The system is evaluated on repetitive scans of 8 volunteers for both two-dimensional (2D) apparent structure calculations and three-dimensional (3D) mechanical calculations using micro-finite element analysis. Coil correction methods based on a priori knowledge of the coil sensitivity and on low-pass filtering of the high-resolution mages are compared and found to perform similarly. Image alignment is found to cause small but significant changes in some structural parameters. Overall the automated system provides on the order of a 3-fold decrease in trained operator time over previous manual methods. Reproducibility is found to be dependent on image quality for most parameters. For 7 subjects with good image quality, reproducibility of 2-4% is found for 2D structural parameters, while 3D mechanical parameters vary by 4-9%, with percent standardized coefficients of variation in the ranges of 15-34% and 20-38% respectively.

Adult↗

An examination of the stress distribution in a soft-lined acrylic resin mandibular complete denture by finite element analysis.

PURPOSE: The aim of this study was to calculate the effect of a soft liner on stress distribution within a mandibular complete denture. Although patients have welcomed soft-lined complete dentures, early fracture is one of the main reasons for failure. To minimize and prevent prosthesis fracture, the understanding of the stress distribution within a prosthesis is important. MATERIALS AND METHODS: A 3-dimensional finite element model of a mandibular complete denture for a severely reduced residual alveolar ridge was constructed. The stress was calculated with linear static finite element analysis. The stress distribution in the soft-lined acrylic resin mandibular complete denture was compared with that of a conventional acrylic resin denture. The resulting stresses were displayed in terms of von Mises equivalent stress and the major principal stresses according to 5 different loading conditions: vertical loads in premolar, molar, and incisor regions; and oblique loads in premolar and molar regions. RESULTS: Oblique loads produced higher levels of stress in the labial notch regions than vertical loads, where tension was the primary mode of stress. Significantly reduced levels of von Mises stress were calculated in soft-liner layers under all loading conditions. Acrylic resin denture base portions, however, exhibited higher levels of von Mises stress in soft-lined complete dentures. CONCLUSION: Three-dimensional finite element analysis gave a realistic explanation of denture fractures and patient response to mandibular complete dentures with and without soft linings. Control of excess lateral occlusal contact might be helpful to reduce the probability of a fracture in soft-lined mandibular complete dentures.

Acrylic Resins↗

Influence of implant length and diameter on stress distribution: a finite element analysis.

STATEMENT OF PROBLEM: Masticatory forces acting on dental implants can result in undesirable stress in adjacent bone, which in turn can cause bone defects and the eventual failure of implants. PURPOSE: A mathematical simulation of stress distribution around implants was used to determine which length and diameter of implants would be best to dissipate stress. MATERIAL AND METHODS: Computations of stress arising in the implant bed were made with finite element analysis, using 3-dimensional computer models. The models simulated implants placed in vertical positions in the molar region of the mandible. A model simulating an implant with a diameter of 3.6 mm and lengths of 8 mm, 10 mm, 12 mm, 14 mm, 16 mm, 17 mm, and 18 mm was developed to investigate the influence of the length factor. The influence of different diameters was modeled using implants with a length of 12 mm and diameters of 2.9 mm, 3.6 mm, 4.2 mm, 5.0 mm, 5.5 mm, 6.0 mm, and 6.5 mm. The masticatory load was simulated using an average masticatory force in a natural direction, oblique to the occlusal plane. Values of von Mises equivalent stress at the implant-bone interface were computed using the finite element analysis for all variations. Values for the 3 most stressed elements of each variation were averaged and expressed in percent of values computed for reference (100%), which was the stress magnitude for the implant with a length of 12 mm and diameter of 3.6 mm. RESULTS: Maximum stress areas were located around the implant neck. The decrease in stress was the greatest (31.5%) for implants with a diameter ranging from of 3.6 mm to 4.2 mm. Further stress reduction for the 5.0-mm implant was only 16.4%. An increase in the implant length also led to a decrease in the maximum von Mises equivalent stress values; the influence of implant length, however, was not as pronounced as that of implant diameter. CONCLUSIONS: Within the limitations of this study, an increase in the implant diameter decreased the maximum von Mises equivalent stress around the implant neck more than an increase in the implant length, as a result of a more favorable distribution of the simulated masticatory forces applied in this study.

Alveolar Process↗

[Establishment of two-dimensional magnetic field finite element analysis model of cup-yoke-type magnetic attachment].

OBJECTIVE: The purpose of this study was to establish two-dimensional magnetic field finite element analysis model of cup-yoke-type magnetic attachment for optmizing the design of magnetic attachments. METHODS: Because the magnetic field of cup-yoke-type magnetic attachment is stable axial-symmetrical, the authors only analyzed two-dimensional magnetic field of 1/2 section. The Maxwell stress between magnet and keeper was integral analyzed using the finite element method, and the attractive force between magnetic attachments was obtained. RESULTS: Compared the value of calculated attractive force with that of examined, the authors found that the procedure veritably reflected influencing trend of variable factors on attractive force, and the value of former one was 10% less than the later one. CONCLUSION: This procedure can be used in magnetic field calculation of cup-yoke-type magnetic attachments.

Computer Simulation↗

[Metacarpophalangeal prosthesis modeling. Comparison of stress factors in a normal and a prosthetic metacarpophalangeal joint using finite element analysis].

INTRODUCTION: Prosthetic replacement of the metacarpophalangeal joints of long fingers is a problematical technique for the surgeon. The aim of the present study was to examine and compare, by means of finite element analysis, stress distribution in a normal metacarpophalangeal joint and to compare this with the findings in a similar joint with a prosthesis in order to better determine the risk of aseptic loosening, and also to examine possible solutions to limit these risks. METHOD: Finite element modelling was carried out using Abaqus software. Various criteria were taken into account including anatomical data, stress distribution, mechanical characteristics of the materials used, and different positions of the phalanx. RESULTS: A comparison of the results showed two significant stress distribution factors, i.e., a reduction of normal stress in the cortical bone of the finger fitted with a prosthesis; and the appearance of a flexion moment which completely modified the stress distribution throughout the metacarpal and therefore also in the opposite phalanx. DISCUSSION: To reduce the risk of aseptic loosening, two solutions were proposed: a) to reduce Young's module. The problem which arises, as in the case of total hip prosthesis, is that of finding a material with a Young's module which is closer to that of cortical bone, and which at the same time has a high elastic limit and breakage point and good biocompatibility; b) to reduce the inertia of the prosthesis, which seems the more likely of the two propositions, as it is based on the results of the modelling. The inertia of the prosthesis on stress distribution can be reduced by modifying two parameters, namely by producing a hollow section and shortening the structure of the prosthesis.

Elasticity↗

The effect of malalignment on stresses in polyethylene component of total knee prostheses--a finite element analysis.

OBJECTIVE: To investigate the effects of malalignment on stresses in tibial polyethylene component of total knee prostheses. DESIGN: A three-dimensional finite element analysis was used to calculate the contact stress and von Mises stress in the tibial polyethylene component subjected to a compressive load, and the malalignment situations were simulated. BACKGROUND: Many biomechanical studies to investigate the stresses in tibial polyethylene component were assumed at the ideal contact alignment. The effect of malalignment on stresses in tibial polyethylene component was not investigated extensively. METHODS: Three-dimensional finite element models of the tibiofemoral joint of knee prostheses for three different designs were constructed. Three malalignment conditions including the medial translation (0.25, 0.5 and 1.0 mm), internal rotation (1 degree, 3 degree and 5 degree), and varus tilt (1 degree, 3 degree and 5 degree) of the femoral component relative to the tibial component were simulated. A compression load of 3000 N was applied to the tibiofemoral joint at 0 degree of flexion. The maximum contact stress and von Mises stress in the tibial component were compared to investigate the effects of malalignment. RESULTS: In comparing with the neutral position, the greatest increase of maximum contact stress were 67.6%, 14.3% and 145.9% and the greatest increase of maximum von Mises stress were 92.5%, 22.7% and 120.6% in maltranslation, internal rotation and varus tilt simulations, respectively. CONCLUSION: The greatest increase of contact stress and von Mises stress was occurred in the high conformity flat-on-flat design of knee prosthesis under the severest malalignment condition. The high conformity curve-on-curve design of knee prosthesis has the minimal risk of polyethylene wear under the malalignment conditions. RELEVANCE: This study revealed the importance of malalignment effect on stresses in tibial polyethylene component. Polyethylene wear in surface replacement total knees will be minimal when a high conformity curve-on-curve knee design is used and the rotational line between the femoral and tibial components has the least effect on polyethylene wear but varus/valgus malalignment, even with the best designed prosthesis will still accelerate wear.

Bone Malalignment↗

A mimic osseointegrated implant model for three-dimensional finite element analysis.

The purpose of this study was to develop a new three-dimensional (3D) mimic model of an osseointegrated implant for finite element analysis (FEA) and to evaluate stress distributions in comparison with a model commonly used in most studies as a control. Based on the 3D computer graphic data obtained by serial in vivo bucco-lingual peri-implant bone structure at 75 microm interval in monkey, a mimic FEA model with trabecular structure and a control model with uniform cancellous bone were constructed. A vertical load of 143 N was applied at the top of the implant and induced stress was evaluated at the peri-implant bone. In the mimic model, stress was distributed at both cortical and cancellous bones (1-5 MPa) in bucco-lingual central planes, but concentrated at the cortical crest (3-7 MPa) in the mesio-distal central plane. In contrast, the control model presented stress concentration at the cortical crest around the implant (5-14 MPa), with less stress (0-1 MPa) at the peri-implant cancellous bone in both planes. The findings, that stress distribution at the peri-implant bone were quite different between the mimic and control models, suggest the need to carefully interpret stress distribution in previous studies with models of uniform cancellous peri-implant bone.

Animals↗

Modifications to the mechanical behavior of the wrist after fracture of the scaphoid. Modeling by finite element analysis.

Although based on their long-term clinical evolution there appeared to be no doubt that fractures of the scaphoid modify the mechanical behavior of the carpus, the mechanisms of these modifications have not yet been investigated. This study based on finite element analysis provides insight into the sequence behind the onset of arthritis of the wrist, highlighting the existence of pressure peaks at the nonunion and at the midcarpal interface (scaphoid-capitate and lunate-capitate). This evidence explains the clinical evolution of nonunions of the scaphoid. Our study indirectly demonstrates the role played by the scaphoid within the wrist as a force transmission column. The use of finite element analysis for the modeling of simple or complex osteoarticular systems may prove to be a highly useful tool for the understanding of these mechanisms.

Biomechanical Phenomena↗

A two-dimensional finite element analysis of a bioprosthetic heart valve.

A finite element scheme has been developed using total Lagrangian techniques for the two-dimensional analysis of bioprosthetic heart valve leaflets undergoing large deformation. Two models of a leaflet, namely a radial and a circumferential slice, have been analysed. The attachment of the slice to the stent was simulated by progressive contact on a circular former and the coaptation of the leaflets in the centre of a heart valve by a straight line of contact. For the circumferential model, different initial configurations have been considered. The prolapse pressure under which the heart valve closes has been shown to be small in comparison with the normal pressure a heart valve sustains. The regions of the valve that are most heavily stressed are subjected to a strong component of bending. The amount is sensitive to the details of the boundary conditions and to the initial configuration of the valve. These observations are likely to be significant in the use of this kind of stress analysis to improve the design of this type of valve.

Bioprosthesis↗

Arc-length technique for nonlinear finite element analysis.

Nonlinear solution of reinforced concrete structures, particularly complete load-deflection response, requires tracing of the equilibrium path and proper treatment of the limit and bifurcation points. In this regard, ordinary solution techniques lead to instability near the limit points and also have problems in case of snap-through and snap-back. Thus they fail to predict the complete load displacement response. The arc-length method serves the purpose well in principle, received wide acceptance in finite element analysis, and has been used extensively. However modifications to the basic idea are vital to meet the particular needs of the analysis. This paper reviews some of the recent developments of the method in the last two decades, with particular emphasis on nonlinear finite element analysis of reinforced concrete structures.

Journal Article↗

Effect of bone distribution on vertebral strength: assessment with patient-specific nonlinear finite element analysis.

Three-dimensional quantitative computed tomographic (QCT) studies of the lumbar spine were extended with finite element analysis (FEA) to include bone distribution in assessment of vertebral body strength. Fifty-nine FEA models were created from data from 43 patients, 28 with no evidence of osteoporosis and 15 with previous vertebral fractures. Simulated loads were applied to the vertebral models to estimate vertebral strength. Yield strength in the models from patients with osteoporosis was 0.22-1.05 MPa (average, 0.57 MPa +/- 0.26 [mean +/- standard deviation]), compared with 0.80-2.79 MPa (1.46 +/- 0.52, P less than .001) in patients with normal bone. Yield strength of vertebrae in patients with osteoporosis uniformly fell below approximately 1.0 MPa, with minimal overlap between patients with osteoporosis and those with normal bone compared with the overlap in bone mineral content and trabecular mineral density. Reproducibility of the FEA technique was 12.1% in a subgroup of patients with normal bone. A constant relationship between cortical and trabecular contributions was observed in patients with osteoporosis but not in control patients.

Adult↗

Three-dimensional finite-element analysis of functional stresses in different bone locations produced by implants placed in the maxillary posterior region of the sinus floor.

STATEMENT OF PROBLEM: Implants placed in the posterior maxilla have lower success rates compared to implants placed in other oral regions. Inadequate bone levels have been suggested as a reason for this differential success rate. PURPOSE: The purpose of this study was to determine the amount and localization of functional stresses in implants and adjacent bone locations when the implants were placed in the posterior maxilla in proximity to the sinus using finite element analysis (FEA). MATERIAL AND METHODS: A 3-dimensional finite element model of a maxillary posterior section of bone (Type 3) was used in this study. Different bony dimensions were generated to perform nonlinear calculations. A single-piece 4.1x10-mm screw-shaped dental implant system (ITI solid implant) was modeled and inserted into atrophic maxillary models with crestal bone heights of 4, 5, 7, 10, or 13 mm. In some models the implant penetrated the sinus floor. Cobalt-Chromium (Wiron 99) was used as the crown framework material placed onto the implant, and porcelain was used for occlusal surface of the crown. A total average occlusal force (vertical load) of 300 N was applied at the palatal cusp (150 N) and mesial fossa (150 N) of the crown. The implant and superstructure were simulated in finite element software (Pro/Engineer 2000i program). RESULTS: For the porcelain superstructure for bone levels, maximum von Mises stress values were observed on the mesial fossae and palatal cusp. For the bone structure, the maximum von Mises stress values were observed in the palatal cortical bone adjacent to the implant neck. There was no stress within the spongy bone. High stresses occurred within the implants for all bone levels. CONCLUSION: The maximum von Mises stresses in the implants were localized in the neck of implants for 4- and 5-mm bone levels, but for 7-, 10-, and 13-mm bone levels more even stresses occurred within the implants.

Bite Force↗

Double-Axis Maxillary Skeletal Expander Suggests Higher Expansion Efficiency in Early Activation: A Finite Element Analysis.

INTRODUCTION: Conventional single-axis maxillary skeletal expanders (MSE) have some drawbacks, such as limited control over maxillary expansion and possible asymmetric expansion between the anterior nasal spine (ANS) and posterior nasal spine (PNS). This report introduces a double-axis maxillary skeletal expander (DAMSE) concept to overcome these drawbacks and enhance the efficiency of maxillary skeletal expansion. MATERIALS AND METHODS: Five different DAMSE designs were compared with a conventional single-axis MSE. Finite element analysis was performed to analyse their expansion efficiency, stress magnitude and distribution occurring in a simplified bone model. RESULTS: DAMSE outperformed the single-axis MSE and provided better control over ANS and PNS expansion. During early activation, the highest expansion efficiency (31.7%) was achieved by DAMSE Model V, 13% more efficient than the single-axis MSE. This efficiency was increased to 100.8% by combining the DAMSE Model V with midpalatal suture surgery. However, with the simplified bone model, the current study could not demonstrate that DAMSE can resolve the issue of asymmetric expansion between ANS and PNS. CONCLUSIONS: An appropriately designed DAMSE can be a promising tool for maxillary expansion treatment. DAMSE offers more efficient treatment than the conventional single-axis MSE while maintaining similar levels of patient comfort and invasiveness.

Finite Element Analysis↗

Titanium basal joint arthroplasty: a finite element analysis and clinical study.

PURPOSE: To define the mechanics and determine the clinical outcome of titanium implant arthroplasty in trapeziometacarpal arthritis. METHODS: For the finite element analysis (FEA) a 2-dimensional FEA mesh of the titanium arthroplasty was constructed with 8-node quadrilateral elements and analyzed. Flexion-extension displacement of the metacarpal was analyzed. For the clinical study, between 1996 and 2003, 47 patients (50 thumbs) with Eaton stage 3 trapeziometacarpal arthritis were treated with titanium basal joint arthroplasty. The average follow-up period was 2 years. Disabilities of the Arm, Shoulder, and Hand questionnaire answers and grip and pinch measurements were obtained before surgery and at the final follow-up evaluation. Failure was defined strictly as the point when revision to the standard soft-tissue interposition arthroplasty became inevitable. RESULTS: In the FEA the titanium implant showed pistoning behavior with maximum stress concentration in the midmetacarpal shaft of 1.92 MPa. The convex sphere of the implant rotates and lifts out of the trapezial crater with a high stress concentration of 0.51 MPa at the radial and ulnar corner of the trapezium. In the clinical study treatment failed in 10 of the patients before 9 months. All were converted successfully to a standard ligament reconstruction tendon interposition. The remaining 80% of the patients showed significant improvement in Disabilities of the Arm, Shoulder, and Hand questionnaire scores albeit with continued weakness at the 2-year follow-up evaluations. The reconstructed thumbs never attained the strength of the contralateral thumbs; even in the success group residual swelling was not uncommon with any increase in activity level. CONCLUSIONS: Anecdotal quotations show success rates for titanium implant arthroplasty for basal joint arthritis to be as high as 97%. Our results are quite to the contrary in that high failure rates were common early in the follow-up period. Our FEA results are confirmed by the clinical study. Titanium implant arthroplasty may have a role in low-demand patients with good bone stock; however, we have stopped offering titanium hemiarthroplasty to patients at our institution.

Arthritis↗

Effect of root canal size and external root surface morphology on fracture susceptibility and pattern: a finite element analysis.

The aim of the study was to determine the extent to which canal size, radius of curvature and proximal root concavity influence fracture susceptibility and pattern. A standardized cross-section of the mid-root region of a mandibular incisor was created by averaging the dimensions of 10 extracted teeth, and then the basic finite element analysis (FEA) model was created. By varying canal diameter, shape, and proximal concavity, these factors could be examined for roles in fracture susceptibility and pattern. The factors all interact in influencing fracture susceptibility and pattern, with dentin thickness not the only determining factor. The removal of dentin does not always result in an increased fracture susceptibility.

Dental Pulp Cavity↗