Patient-specific modeling of facial soft tissue based on radial basis functions transformations of a standard three-dimensional finite element model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>An important purpose of orthodontic treatment is to gain the harmonic soft tissue profile. This article describes a novel way to build patient-specific models of facial soft tissues by transforming a standard finite element (FE) model into one that has two stages: a first transformation and a second transformation, so as to evaluate the facial soft tissue changes after orthodontic treatment for individual patients.</p><p><b>METHODS</b>The radial basis functions (RBFs) interpolation method was used to transform the standard FE model into a patient-specific one based on landmark points. A combined strategy for selecting landmark points was developed in this study: manually for the first transformation and automatically for the second transformation. Four typical patients were chosen to validate the effectiveness of this transformation method.</p><p><b>RESULTS</b>The results showed good similarity between the transformed FE models and the computed tomography (CT) models. The absolute values of average deviations were in the range of 0.375 - 0.700 mm at the lip-mouth region after the first transformation, and they decreased to a range of 0.116 - 0.286 mm after the second transformation.</p><p><b>CONCLUSIONS</b>The modeling results show that the second transformation resulted in enhanced accuracy compared to the first transformation. Because of these results, a third transformation is usually not necessary.</p>

Individualized three-dimensional finite element model of facial soft tissue and preliminary application in orthodontics / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To get individualized facial three-dimensional finite element (FE) model from transformation of a generic one to assist orthodontic analysis and prediction of treatment-related morphological change of facial soft tissue.</p><p><b>METHODS</b>A generic three-dimensional FE model of craniofacial soft and hard tissue was constructed based on a volunteer's spiral CT data. Seven pairs of main peri-oral muscles were constructed based on a combination of CT image and anatomical method. Individualized model could be obtained through transformation of the generic model based on selection of corresponding anatomical landmarks and radial basis functions (RBF) method. Validation was analyzed through superimposition of the transformed model and cone-beam CT (CBCT) reconstruction data. Pre- and post-treatment CBCT data of two patients were collected, which were superimposed to gain the amount of anterior teeth retraction and anterior alveolar surface remodeling that could be used as boundary condition. Different values of Poisson ratio ν and Young's modulus E were tested during simulation.</p><p><b>RESULTS</b>Average deviation was 0.47 mm and 0.75 mm in the soft and hard tissue respectively. It could be decreased to a range of +0.29 mm and -0.21 mm after a second transformation at the lip-mouth region. The best correspondence between simulation and post-treatment result was found with elastic properties of soft tissues defined as follows. Poisson ratio ν for skin, muscle and fat being set as 0.45 while Young's modulus being set as 90.0 kPa, 6.2 kPa and 2.0 kPa respectively.</p><p><b>CONCLUSIONS</b>Individualized three-dimensional facial FE model could be obtained through mathematical model transformation. With boundary condition defined according to treatment plan such FE model could be used to analyze the effect of orthodontic treatment on facial soft tissue.</p>

Stress area of the mandibular alveolar mucosa under complete denture with linear occlusion at lateral excursion / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The rocking and instability of a loaded complete denture (CD) during lateral excursion reduce the bearing area under the denture base, causing localized high stress concentrations. This can lead to mucosal tenderness, ulceration, and alveolar bone resorption, and the linear occlusion design was to decrease the lateral force exerted on the denture and to ensure denture stability. But it is not known how the bearing areas of linear occlusal CDs (LOCDs) and anatomic occlusal CDs (AOCDs) differ. The purpose of this study was to analyze and compare the distributions of the high and low vertical stress-bearing areas in the mandibular alveolar mucosa under LOCDs and AOCDs at lateral excursion.</p><p><b>METHODS</b>Computerized tomography (CT) and finite element analysis were used to establish three-dimensional models of an edentulous maxilla and mandible with severe residual ridge resorption. These models were composed of maxillary and mandibular bone structure, mucosa, and the LOCD or AOCD. Lateral excursion movements of the mandible were simulated and the vertical stress-bearing areas in the mucosa under both mandibular CDs were analyzed using ANSYS 7.0.</p><p><b>RESULTS</b>On the working side, the high stress-bearing (-0.07 to -0.1 MPa) area under the LOCD during lateral excursion was smaller than that under the AOCD, while the medium stress-bearing (-0.03 to -0.07 MPa) area under the LOCD was 1.33-fold that under the AOCD. The medium stress-bearing area on the non-working side under the LOCD was 2.4-fold that under the AOCD. Therefore, the overall medium vertical stress-bearing area under the LOCD was 20% larger than that under the AOCD.</p><p><b>CONCLUSIONS</b>During lateral excursion, the medium vertical stress-bearing area under a mandibular LOCD was larger and the high vertical stress-bearing area was smaller than that under an AOCD. Thus, the vertical stress under the LOCD was distributed more evenly and over a wider area than that under the AOCD, thereby improving denture stability.</p>

Stress distribution in alveolar bone around implants under implant supported overdenture with linear occlusion at lateral occlusion / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To analyze stress distribution in alveolar bone around implants of implant supported overdentures (ISO) with linear occlusion and with anatomic occlusion at lateral mandibular position, and to justify the possibility of decreased injurious force around implants in ISO with linear occlusion.</p><p><b>METHODS</b>Computerized tomography scan and finite element analysis (FEA) were used to set up two 3-D FEA models of maxillae and mandible with severe residual ridge resorption. The mucosa, linear and anatomic occlusal ISO with bar attachments, and two implants inserted between mandibular foramina were also established in the models. With the condition of imitating the loading of masseter muscles, these models were loaded to simulate the stress distributions in alveolar bone around implants under ISO at lateral occlusion position.</p><p><b>RESULTS</b>At lateral occlusion, the stress distributions in alveolar bone around implants under ISO with anatomic occlusion were mainly on the lingual and distal sides of the working side implants. However, stress distributions under ISO with linear occlusion were on the distal sides of bilateral implants. Both the stress peaks of ISOs with linear occlusion and with the anatomic one appeared in the working side. In anatomic occlusion model, sigma(z): -6.47 MPa and 6.81 MPa, sigma(1): -4.20 MPa and 7.20 MPa (negative value: compressive stress, positive value: tensile stress); in linear occlusion model, sigma(z): -4.86 MPa and 3.04 MPa, sigma(1): -3.48 MPa and 5.33 MPa.</p><p><b>CONCLUSIONS</b>At lateral occlusion, when comparing the ISO with two different occlusion schemes, stress peak in alveolar bone around implants in the linear occlusion model was lower than that in the anatomic occlusion model at equal loading situation. Stress in the alveolar bone under ISO with linear occlusion distributed more evenly than that under ISO with anatomic occlusion.</p>