Comparison of the mechanical properties and mechanical damages to tendon tissue in three suspensory fixation techniques.

Background: Anterior cruciate ligament (ACL) injury is the most common traumatic injury to the knee joint. Suspensory fixation has become popular in ACL reconstruction because of its high primary stability, less invasiveness, and surgical convenience. There are two common types of suspensory fixation devices: those with fixed-length and those with adjustable-length loops. Owing to structural differences and differences in initial tensioning techniques, it is expected that mechanical property and damage to the tendons will vary from device to device; however, no literature has examined this so far. The main purpose of this study was to evaluate the damage caused to the tendon by three different suspensory fixation devices. An effective mechanical test was carried out as a prerequisite. Methods: First, the mechanical properties of simple loop device (SLD) as fixed-length loop device, first-generation, and second-generation adjustable devices (AD1 and AD2) as adjustable-length loop devices were tested (isolated device testing). Second, each device was tested using bovine extensor tendons (specimen testing). Cyclic testing included 2000 cycles; the devices were subsequently displaced until failure, and the ultimate tensile strength was determined using isolated device testing. Six samples of 3 devices were used in each testing experiment. After specimen testing, the surface structure of the tendon was evaluated quantitatively using optical coherence tomography (OCT) and our original histological scoring system. Results: During isolated device testing, SLD demonstrated the least cyclic displacement, followed by AD1 and AD2. The highest ultimate tensile strength was observed in AD2, followed by SLD and AD1. In specimen testing, the least cyclic displacement was observed in SLD, followed by AD1 and AD2. Histologically, AD1 demonstrated a significantly lower score, with damaged surface morphology, than SLD and AD2. OCT values were significantly higher, with a more disturbing tendon surface structure, in AD1 than in SLD and AD2. Conclusions: The first-generation adjustable loop device exhibited greatest graft tissue damage at the suspensory site in a clinically relevant setting. The thinner adjustable loop mechanism may have elevated graft damage by frictional stresses during loop adjustment or by repetitive tensioning stresses.

Finite-element analysis and optimization of the mechanical properties of polyetheretherketone (PEEK) clasps for removable partial dentures.

PURPOSE: Polyetheretherketone (PEEK), a high-strength, aesthetic, and non-allergic thermoplastic polymer, recently became a candidate for replacing metallic components in dental prosthesis. However, as PEEK is flexible, the need for retention presents a key challenge in terms of its clinical application. In this study, clasps prepared using PEEK were optimized and evaluated to provide the mechanical properties required by dentures. METHODS: Seventy-two three-dimensional rod-shape models, based on four thickness/width ratios, three base widths, and six taper ratios were created. These models were analyzed using finite-element methods to determine which modified clasp arm shape provided the most appropriate mechanical properties. Three shape-optimized PEEK specimens and one standard-shape Co-Cr alloy specimen were then fabricated. Constant-displacement fatigue testing was performed to calculate load values and deformations after ten years of clinical use. RESULTS: Shape optimization indicated a maximum stress concentration that was consistently located at the base of the specimen, a correlation between mean load values and thickness that was greater than that with the width, and a correlation between taper ratio and mean load values. Fatigue testing showed that although PEEK exhibited significantly lower average load values than the Co-Cr alloy, these were sufficient for clinical use. All specimens exhibited significant deformation during the first period of cycling; however, there was no significant difference in the deformation between the two materials after fatigue testing. CONCLUSIONS: PEEK exerts fewer stresses on abutments compared to standard-alloy clasps, provides adequate retention, and satisfy aesthetic demands, indicating that PEEK presents a promising alternative to conventional metal clasps.

Static and fatigue fracture resistances of pulpless teeth restored with post-cores.

OBJECTIVES: Superior restorative methods for effectively strengthening pulpless teeth need to be identified, since vertical root fractures of pulpless teeth are still a major problem in everyday clinical practice. The present study tested the null hypothesis that there were no differences in static and fatigue fracture resistances of pulpless teeth restored with different types of post-core systems. METHODS: Extracted human premolars were restored with a combination of either a fiber post or metallic post and a composite resin core. Teeth with full crown preparations without post-core restorations served as a control. A 90 degrees vertical or 45 degrees oblique static compressive load was applied to restored teeth, and fracture loads and modes of fracture were recorded. Fatigue fracture tests were conducted by applying sinusoidal cyclic loads to restored teeth from vertical or oblique directions. Fatigue limits for each restoration were calculated using the staircase approach. RESULTS: In both static and fatigue fracture testing under vertical or oblique loadings, the fracture loads of teeth restored with fiber posts were significantly greater than those of teeth restored with metallic posts. The fatigue limits of teeth restored with fiber and metallic posts were 112 kgf and 82 kgf respectively under vertical loadings and 26 kgf and 20 kgf under oblique loadings. SIGNIFICANCE: The combination of a fiber post and a composite resin core showed superior fracture resistance against both static and fatigue loadings compared to restorations using a metallic post, and is therefore recommended in restoring pulpless teeth.