Development and validation of a digital twin of the human lower jaw under impact loading by using non-linear finite element analyses.

Mandibular fractures are one of the most frequently observed injuries within craniofacial region mostly due to tumor-related problems and traumatic events, often related to non-linear effects like impact loading. Therefore, a validated digital twin of the mandible is required to develop the best possible patient-specific treatment. However, there is a need to obtain a fully compatible numerical model that can reflect the patients' characteristics, be available and accessible quickly, require an acceptable level of modeling efforts and knowledge to provide accurate, robust and fast results at the same time under highly non-linear effects. In this study, a validated simulation methodology is suggested to develop a digital twin of mandible, capable of predicting the non-linear response of the biomechanical system under impact loading, which then can be utilized to design treatment strategies even for multiple fractures of the mandibular system. Using Computed Tomography data containing cranial (skull) images of a patient, a 3-dimensional mandibular model, which consists cortical and cancellous bones, disks and fossa is obtained with high accuracy that is compatible with anatomical boundaries. A Finite Element Model (FEM) of the biomechanical system is then developed for a three-level validation procedure including (A) modal analysis, (B) dynamic loading and (C) impact loading. For the modal analysis stage: Free-free vibration modes and frequencies of the system are validated against cadaver test results. For the dynamic loading stage: Two different regions of the mandible are loaded, and maximum stress levels of the system are validated against finite element analyses (FEA) results, where the first loading condition (i) transfers a 2000 N force acting on the symphysis region and, the second loading condition (ii) transfers a 2000 N force acting on the left body region. In both cases, equivalent muscle forces dependent on time are applied. For the impact loading stage: Thirteen different human mandibular models with various tooth deficiencies are used under the effects of traumatic impact forces that are generated by using an impact hammer with different initial velocities to transfer the impulse and momentum, where contact forces and fracture patterns are validated against cadaver tests. Five different anatomical regions are selected as the impact site. The results of the analyzes (modal, dynamic and impact) performed to validate the digital twin model are compared with the similar FEA and cadaver test results published in the literature and the results are found to be compatible. It has been evaluated that the digital twin model and numerical models are quite realistic and perform well in terms of predicting the biomechanical behavior of the mandible. The three-level validation methodology that is suggested in this research by utilizing non-linear FEA has provided a reliable road map to develop a digital twin of a biomechanical system with enough confidence that it can be utilized for similar structures to offer patient-specific treatments and can help develop custom or tailor-made implants or prosthesis for best compliance with the patient even considering the most catastrophic effects of impact related trauma.

Push-out bond strengths of two fiber post types bonded with different dentin bonding agents.

The aim of this study was to evaluate the regional push-out bond strengths for two fiber-reinforced post types using three different dentin bonding agents. Sixty single-rooted extracted human first premolar teeth were sectioned below the cemento-enamel junction, and the roots were endodontically treated. Following standardized post space preparations, the roots were divided into two fiber-post groups (Glassix and Carbopost), and further divided into three subgroups of 10 specimens each for the bonding systems self-etching dentin bonding agents (Clearfil SE Bond and Optibond all-in-one), and total-etching dentin bonding agent (XP Bond). A dual-cure resin luting cement (Maxcem) was then placed in the post spaces and posts were then seated into the root canals polymerized through the cervical portion. The roots were then cut into 3-mm thick sections. Push-out tests were performed at a crosshead speed of 0.5 mm/min. The data were analyzed with multivariate ANOVA (alpha = 0.05). The morphology of interface between different dentin bonding agents from the cervical sections were analyzed with SEM. Glass fiber-reinforced posts demonstrated significantly higher push-out bond strengths than carbon fiber-reinforced posts (p < 0.001). Bond strength values decreased significantly from the cervical to the apical root canal regions (p < 0.001). Self-etching dentin adhesive Clearfil SE Bond and total-etching dentin adhesive XP Bond demonstrated similar bond strengths values and this was significantly higher compared with the Optibond all-in-one in cervical root canal region. In conclusion, in all root segments, the glass fiber-reinforced posts provided significantly increased post retention than the carbon fiber-reinforced posts, regardless of the adhesive used.

Evaluation of microhardness, surface roughness, and wear behavior of different types of resin composites polymerized with two different light sources.

The microhardness, surface roughness and wear resistance of different types of resin composites, polymerized by a Quartz Tungsten Halogen (QTH) or Light Emitting Diode (LED) light curing units (LCU) were evaluated in this in vitro study. Cylindrical blocks were prepared from composites (8 mm in diameter, and 2 mm in thickness) and polymerized by a LED or a QTH LCU. Vickers hardness was measured on the top and bottom surfaces of the specimens. Surface roughness was measured with a surface profilometer on the top of the specimens. For the wear test, specimens were tested in a conventional pin-on-disc tribology machine under 15 N loads. The statistical analyses were performed by one-way analysis of variance (ANOVA) and t-tests, including the Bonferroni correction. Nanocomposite material Clearfil Majesty Posterior showed the highest hardness values in all polymerization types at the top and bottom surfaces (p < 0.05). Microhybrid Clearfil APX and hybrid Quixfil composites demonstrated the greatest surface roughness. Wear resistance of Clearfil Majesty Posterior was found to be the highest among the other tested resin composites. The results indicated that Clearfil Majesty Posterior demonstrated higher microhardness, less surface roughness, and higher wear resistance when compared with the other tested materials for both polymerization types.