Evaluation of the Transfemoral Bone-Implant Interface Properties Using Vibration Analysis.

Evaluating the bone-implant interface (BII) properties of osseointegrated transfemoral (TFA) implants is important for early failure detection and prescribing loads during rehabilitation. The objective of this work is to derive and validate a 1D finite element (FE) model of the Osseointegrated Prosthetic Limb (OPL) TFA system that can: (1) model its dynamic behaviour and (2) extract the BII properties. The model was validated by: (1) comparing the 1D FE formulation to the analytical and 3D FE solutions for a simplified cylinder, (2) comparing the vibration modes of the actual TFA geometry using 1D and 3D FE models, and (3) evaluating the BII properties for three extreme conditions (LOW, INTERMEDIATE, and HIGH) generated using 3D FE and experimental (where the implant was embedded, using different adhesives, in synthetic femurs) signals for additional validation. The modes predicted by the 1D FE model converged to the analytical and the 3D FE solutions for the cylinder. The 1D model also matched the 3D FE solution with a maximum frequency difference of 2.02% for the TFA geometry. Finally, the 1D model extracted the BII stiffness and the system's damping properties for the three conditions generated using the 3D FE simulations and the experimental INTERMEDIATE and HIGH signals. The agreement between the 1D FE and the 3D FE solutions for the TFA geometry indicates that the 1D model captures the system's dynamic behaviour. Distinguishing between the different BII conditions demonstrates the 1D model's potential use for the non-invasive clinical evaluation of the TFA BII properties.

Evaluating the Intracranial Pressure Biofidelity and Response Repeatability of a Physical Head-Brain Model in Frontal Impacts.

Headforms are widely used in head injury research and headgear assessment. Common headforms are limited to replicating global head kinematics, although intracranial responses are crucial to understanding brain injuries. This study aimed to evaluate the biofidelity of intracranial pressure (ICP) and the repeatability of head kinematics and ICP of an advanced headform subjected to frontal impacts. Pendulum impacts were performed on the headform using various impact velocities (1-5 m/s) and impactor surfaces (vinyl nitrile 600 foam, PCM746 urethane, and steel) to simulate a previous cadaveric experiment. Head linear accelerations and angular rates in three axes, cerebrospinal fluid ICP (CSFP), and intraparenchymal ICP (IPP) at the front, side, and back of the head were measured. The head kinematics, CSFP, and IPP demonstrated acceptable repeatability with coefficients of variation generally being less than 10%. The BIPED front CSFP peaks and back negative peaks were within the range of the scaled cadaver data (between the minimum and maximum values reported by Nahum et al.), while side CSFPs were 30.9-92.1% greater than the cadaver data. CORrelation and Analysis (CORA) ratings evaluating the closeness of two time histories demonstrated good biofidelity of the front CSFP (0.68-0.72), while the ratings for the side (0.44-0.70) and back CSFP (0.27-0.66) showed a large variation. The BIPED CSFP at each side was linearly related to head linear accelerations with coefficients of determination greater than 0.96. The slopes for the BIPED front and back CSFP-acceleration linear trendlines were not significantly different from cadaver data, whereas the slope for the side CSFP was significantly greater than cadaver data. This study informs future applications and improvements of a novel head surrogate.

Influence of surrogate scalp material and thickness on head impact responses: Toward a biofidelic head-brain physical model.

Advanced physical head models capable of replicating both global kinematics and intracranial mechanics of the human head are required for head injury research and safety gear assessment. These head surrogates require a complex design to accommodate realistic anatomical details. The scalp is a crucial head component, but its influence on the biomechanical response of such head surrogates remains unclear. This study aimed to evaluate the influence of surrogate scalp material and thickness on head accelerations and intraparenchymal pressures using an advanced physical head-brain model. Scalp pads made from four materials (Vytaflex20, Vytaflex40, Vytaflex50, PMC746) and each material with four thicknesses (2, 4, 6, and 8 mm) were evaluated. The head model attached to the scalp pad was dropped onto a rigid plate from two heights (5 and 19.5 cm) and at three head locations (front, right side, and back). While the selected materials' modulus exhibited a relatively minor effect on head accelerations and coup pressures, the effect of scalp thickness was shown to be major. Moreover, by decreasing the thickness of the head's original scalp by 2 mm and changing the original scalp material from Vytaflex 20 to Vytaflex 40 or Vytaflex 50, the head acceleration biofidelity ratings could improve by 30% and approached the considered rating (0.7) of good biofidelity. This study provides a potential direction for improving the biofidelity of a novel head model that might be a useful tool in head injury research and safety gear tests. This study also has implications for selecting appropriate surrogate scalps in the future design of physical and numerical head models.

Review of Mechanisms and Research Methods for Blunt Ballistic Head Injury.

Head injuries account for 15%-20% of all military injuries and pose a high risk of causing functional disability and fatality. Blunt ballistic impacts are one of the threats that can lead to severe head injuries. This review aims to examine the mechanisms and injury risk assessment associated with blunt ballistic head injury (BBHI). The review further discusses research methods and instrumentation used in BBHI studies, focusing on their limitations and challenges. Studies on the mechanisms of focal and diffuse brain injuries remain largely inconclusive and require further effort. Some studies have attempted to associate BBHIs with head mechanics, but more research is required to establish correlations between head mechanics and injury severity. Limited access to experimental models and a lack of instrumentation capable of measuring the mechanics of brain tissue in situ are potential reasons for the lack of understanding of injury mechanisms, injury correlations, and injury tolerance levels specific to this loading regime. Targeted research for understanding and assessing head injuries in blunt ballistic impacts is a necessary step in improving our ability to design protection systems to mitigate these injuries.

[Measurement of mesiodistal root angulation for panoramic images and the effect of buccolingual root angulation]. / Evaluation de l'angulation radiculaire mésio-distale pour les images panoramiques et l'impact de l'angulation radiculaire vestibulo-linguale.

Panoramic images were taken from an anatomically correct phantom with three different buccolingual angulations for each tooth (Original, 10 degrees buccal root torque, and 10 degrees lingual root torque). The true mesiodistal angulation of each tooth was determined with a three-dimensional coordinate measurement machine. Each tooth had at least one angle measurement that was statistically different from the other mesiodistal angles with different buccolingual orientations. Roots with buccal root orientations were projected more distally than they were in reality; and the roots lingually positioned were projected more mesially. The canine and premolars in both arches were most affected and the phenomenon was more pronounced in the maxilla than the mandible. Buccolingual orientation changes did not affect the root angulation expression on the incisor area.

Effect of buccolingual root angulation on the mesiodistal angulation shown on panoramic radiographs.

INTRODUCTION: The purpose of this study was to evaluate the effect of buccolingual root angulation on the perception of root parallelism in panoramic images. METHODS: A skull-typodont device was constructed according to cephalometric norms. The bases of the typodont were partially sectioned so that the buccolingual orientation of 4 adjacent pairs of teeth could be easily modified. Three buccolingual angulations were used for each tooth. Nine image sequences were necessary to analyze all possible buccolingual orientation combinations between adjacent teeth. The true root parallelism angulations relative to an orthodontic archwire were compared with the angulations obtained from scanned panoramic films. RESULTS: The largest root parallelism differences for adjacent teeth occurred between the maxillary canine and the first premolar. The second largest differences occurred in the mandibular canine-premolar area. No significant differences were found in the incisor area. CONCLUSIONS: The root parallelism expression in the canine-premolar region can be modified by altering the buccolingual orientation. Buccolingual orientation changes do not seem to affect the incisor area. The clinical usefulness of panoramic radiography to assess root parallelism should be approached with caution, especially in premolar extraction sites.

Argon laser vs conventional visible light-cured orthodontic bracket bonding: an in-vivo and in-vitro study.

INTRODUCTION: Many advantages of argon lasers have been reported, including high-speed orthodontic adhesive curing and less enamel demineralization. The purpose of this study was to compare bond strengths after curing with the argon laser (10 seconds) and the conventional curing light (40 seconds) in vivo and in vitro. METHODS: Four premolars from each of 23 volunteers were randomly assigned to either the argon laser group or the conventional light group for the in-vivo study. Shear bond strengths were measured after 14 days with custom-designed debonding pliers. In-vitro bond strengths were measured by using 4 premolars from each of 25 volunteers. Shear bond strength was measured after 14 days of thermocycling with the same protocol as the in-vivo study. Adhesive remnant index scores (ARI) were determined. RESULTS: No significant differences were found in bond strengths according to curing method, dental arch, or sex. In-vivo results were significantly lower (P < .05) than in-vitro results. A significant (P < .05) difference in ARI scores between the curing methods was determined; no significant correlation between mean bond strengths and ARI scores was determined. CONCLUSIONS: Bond strength for argon laser curing is comparable to conventional light curing and is sufficient for clinical applications. Although the argon laser left more adhesive on the tooth surfaces on debonding, there was no increase in enamel surface fractures.

Validity, reliability, and reproducibility of plaster vs digital study models: comparison of peer assessment rating and Bolton analysis and their constituent measurements.

INTRODUCTION: The objective of this validation study was to compare standard plaster models (the current gold standard for cast measurements) with their digital counterparts made with emodel software (version 6.0, GeoDigm, Chanhassen, Minn) for the analysis of tooth sizes and occlusal relationships--specifically the Bolton analysis and the peer assessment rating (PAR) index and their components. METHODS: Dental casts were poured from 24 subjects with 8 malocclusion types grouped according to American Board of Orthodontics categories. Measurements were made with a digital caliper to the nearest 0.01 mm from plaster models and with the software from the digital models. A paired samples t test was used to compare reliability and validity of measurements between plaster and digital methods. RESULTS: Reproducibility of digital models via the concordance correlation coefficient was excellent in most cases and good in some. Although statistically significant differences in some measurements were found for the reliability and validity of the digital models via the average mean of the absolute differences of repeated measurements, none was clinically significant. Grouping of the measurements according to the 8 American Board of Orthodontics categories produced no significant difference (Kruskal-Wallis test). No measurement associated with Bolton analysis or PAR index made on plaster vs digital models showed a clinically significant difference. The PAR analysis and its constituent measurements were not significantly different clinically between plaster and emodel media. CONCLUSIONS: Preliminary results did not indicate that digital models would cause an orthodontist to make a different diagnosis of malocclusion compared with plaster models; digital models are not a compromised choice for treatment planning or diagnosis.

Condylar shape analysis using panoramic radiography units and conventional tomography.

OBJECTIVE: The objective of this study was to compare condyle shape between lateral temporomandibular joint (TMJ) images from axially corrected tomography and 3 panoramic radiography units with TMJ-specific programs. STUDY DESIGN: The TMJ from a single dry human skull was imaged with multidirectional tomography and the following 3 panoramic radiography units: Instrumentarium OP 100, Planmeca PM 2002 CC Proline, and Soredex Orthophos DS. A curve-fitting procedure (spline curves) was used to mathematically describe condyle outlines. One sample t tests were used to compare panoramic images against the tomograms (gold standard). RESULTS: A significant difference (P < .05) in condyle shape was found between TMJ tomography images and each of the 3 panoramic images. Images from the PM 2002 CC Proline demonstrated the smallest shape difference (13.4%), followed by the OP 100 (17.5%) and the Orthophos DS (24.8%). CONCLUSION: If panoramic radiography is to be used for the initial radiographic examination of the TMJ, practitioners should be aware of the potential for shape distortion of the condyle.

Assessment of facial asymmetries from posteroanterior cephalograms: validity of reference lines.

The goal of this study was to determine the ability of various horizontal and vertical reference lines to provide measurements of dentofacial asymmetries from posteroanterior (PA) cephalograms. Ten horizontal and 15 vertical reference lines, including best-fit lines and lines most commonly used in PA analysis, were tested. A model of a dry skull was devised to create 30 asymmetric positions of the maxillomandibular complex. The true transverse and vertical asymmetries were calculated based on measurements of changes in the position of 24 dental and skeletal landmarks. A PA cephalogram was obtained for each asymmetric position. The horizontal and vertical reference lines were constructed on each PA cephalogram, and measurements of transverse and vertical asymmetries were obtained relative to the individual reference lines. Linear regression analyses were used to compare the actual asymmetries with those measured cephalometrically, relative to the individual reference lines. The adjusted R(2) values for all 10 horizontal lines indicated excellent agreement between the true asymmetries and the measured vertical asymmetries. Ten vertical lines accurately represented transverse asymmetry. Vertical lines constructed between 2 midline points, with 1 point located on the lower part of the skull, were not valid. The best-fit line and all lines constructed as perpendiculars through midpoints between pairs of orbital landmarks showed excellent validity. Crista galli-anterior nasal spine and nasion-anterior nasal spine had the lowest validity and should not be used in cephalometric analysis of asymmetries. The position of anterior nasal spine will be altered in facial asymmetry involving the maxilla.