Novel and simplified optimisation pathway using response surface and design of experiments methodologies for dental implants based on the stress of the cortical bone.

Dental implants are widely used as a long-term treatment solution for missing teeth. A titanium implant is inserted into the jawbone, acting as a replacement for the lost tooth root and can then support a denture, crown or bridge. This allows discreet and high-quality aesthetic and functional improvement, boosting patient confidence. The use of implants also restores normal functions such as speech and mastication. Once an implant is placed, the surrounding bone will fuse to the titanium in a process known as osseointegration. The success of osseointegration is dependent on stress distribution within the surrounding bone and thus implant geometry plays an important role in it. Optimisation analyses are used to identify the geometry which results in the most favourable stress distribution, but the traditional methodology is inefficient, requiring analysis of numerous models and parameter combinations to identify the optimal solution. A proposed improvement to the traditional methodology includes the use of Design of Experiments (DOE) together with Response Surface Methodology (RSM). This would allow for a well-reasoned combination of parameters to be proposed. This study aims to use DOE, RSM and finite element models to develop a simplified optimisation analysis method for dental implant design. Drawing on data and results from previous studies, two-dimensional finite element models of a single Branemark implant, a multi-unit abutment, two prosthetic screws, a prosthetic crown and a region of mandibular bone were built. A small number of combinations of implant diameter and length were set based on the DOE method to analyse the influence of geometry on stress distribution at the bone-implant interface. The results agreed with previous studies and indicated that implant length is the critical parameter in reducing stress on cortical bone. The proposed method represents a more efficient analysis of multiple geometrical combinations with reduced time and computational cost, using fewer than a third of the models required by the traditional methods. Further work should include the application of this methodology to optimisation analyses using three-dimensional finite element models.

Properties of PMMA end cap holders affect FE stiffness predictions of vertebral specimens.

Bone cement is often used, in experimental biomechanics, as a potting agent for vertebral bodies (VB). As a consequence, it is usually included in finite element (FE) models to improve accuracy in boundary condition settings. However, bone cement material properties are typically assigned to these models based on literature data obtained from specimens created under conditions which often differ from those employed for cement end caps. These discrepancies can result in solids with different material properties from those reported. Therefore, this study aimed to analyse the effect of assigning different mechanical properties to bone cement in FE vertebral models. A porcine C2 vertebral body was potted in bone cement end caps, µCT scanned, and tested in compression. DIC was performed on the anterior surface of the specimen to monitor the displacement. Specimen stiffness was calculated from the load-displacement output of the materials testing machine and from the machine load output and average displacement measured by DIC. Fifteen bone cement cylinders with dimensions similar to the cement end caps were produced and subjected to the same compression protocol as the vertebral specimen and average stiffness and Young moduli were estimated. Two geometrically identical vertebral body FE models were created from the µCT images, the only difference residing in the values assigned to bone cement material properties: in one model these were obtained from the literature and in the other from the cylindrical cement samples previously tested. The average Youngs modulus of the bone cement cylindrical specimens was 1177 ± 3 MPa, considerably lower than the values reported in the literature. With this value, the FE model predicted a vertebral specimen stiffness 3% lower than that measured experimentally, while when using the value most commonly reported in similar studies, specimen stiffness was overestimated by 150%.

Comparison of the within-reader and inter-vendor agreement of left ventricular circumferential strains and volume indices derived from cardiovascular magnetic resonance imaging.

PURPOSE: Volume indices and left ventricular ejection fraction (LVEF) are routinely used to assess cardiac function. Ventricular strain values may provide additional diagnostic information, but their reproducibility is unclear. This study therefore compares the repeatability and reproducibility of volumes, volume fraction, and regional ventricular strains, derived from cardiovascular magnetic resonance (CMR) imaging, across three software packages and between readers. METHODS: Seven readers analysed 16 short-axis CMR stacks of a porcine heart. Endocardial contours were manually drawn using OsiriX and Simpleware ScanIP and repeated in both softwares. The images were also contoured automatically in Circle CVI42. Endocardial global, apical, mid-ventricular, and basal circumferential strains, as well as end-diastolic and end-systolic volume and LVEF were compared. RESULTS: Bland-Altman analysis found systematic biases in contour length between software packages. Compared to OsiriX, contour lengths were shorter in both ScanIP (-1.9 cm) and CVI42 (-0.6 cm), causing statistically significant differences in end-diastolic and end-systolic volumes, and apical circumferential strain (all p<0.006). No differences were found for mid-ventricular, basal or global strains, or left ventricular ejection fraction (all p<0.007). All CVI42 results lay within the ranges of the OsiriX results. Intra-software differences were found to be lower than inter-software differences. CONCLUSION: OsiriX and CVI42 gave consistent results for all strain and volume metrics, with no statistical differences found between OsiriX and ScanIP for mid-ventricular, global or basal strains, or left ventricular ejection fraction. However, volumes were influenced by the choice of contouring software, suggesting care should be taken when comparing volumes across different software.

A Novel Modelling Methodology Which Predicts the Structural Behaviour of Vertebral Bodies under Axial Impact Loading: A Finite Element and DIC Study.

Cervical spine injuries (CSIs) arising from collisions are uncommon in contact sports, such as rugby union, but their consequences can be devastating. Several FE modelling approaches are available in the literature, but a fully calibrated and validated FE modelling framework for cervical spines under compressive dynamic-impact loading is still lacking and material properties are not adequately calibrated for such events. This study aimed to develop and validate a methodology for specimen-specific FE modelling of vertebral bodies under impact loading. Thirty-five (n = 35) individual vertebral bodies (VBs) were dissected from porcine spine segments, potted in bone cement and µCT scanned. A speckle pattern was applied to the anterior faces of the bones to allow digital image correlation (DIC), which monitored the surface displacements. Twenty-seven (n = 27) VBs were quasi-statically compressively tested to a load up to 10 kN from the cranial side. Specimen-specific FE models were developed for fourteen (n = 14) of the samples in this group. The material properties were optimised based on the experimental load-displacement data using a specimen-specific factor (kGSstatic) to calibrate a density to Young's modulus relationship. The average calibration factor arising from this group was calculated (K¯GSstatic) and applied to a control group of thirteen (n = 13) samples. The resulting VB stiffnesses was compared to experimental findings. The final eight (n = 8) VBs were subjected to an impact load applied via a falling mass of 7.4kg at a velocity of 3.1ms-1. Surface displacements and strains were acquired from the anterior VB surface via DIC, and the impact load was monitored with two load cells. Specimen-specific FE models were created for this dynamic group and material properties were assigned again based on the density-Young's modulus relationship previously validated for static experiments, supplemented with an additional factor (KGSdynamic). The optimised conversion factor for quasi-static loading, K¯GSstatic, had an average of 0.033. Using this factor, the validation models presented an average numerical stiffness value 3.72% greater than the experimental one. From the dynamic loading experiments, the value for KGSdynamic was found to be 0.14, 4.2 times greater than K¯GSstatic. The average numerical stiffness was 2.3% greater than in the experiments. Almost all models presented similar stiffness variations and regions of maximum displacement to those observed via DIC. The developed FE modelling methodology allowed the creation of models which predicted both static and dynamic behaviour of VBs. Deformation patterns on the VB surfaces were acquired from the FE models and compared to DIC data, achieving high agreement. This methodology is now validated to be fully applied to create whole cervical spine models to simulate axial impact scenarios replicating rugby collision events.