Complementary to experimental studies, computational biomechanics has become useful tool for the understanding of human foot biomechanics and pathomechanics. Its findings have been widely used for the evaluation of the effectiveness of surgical and conservative interventions. These models, however, were developed with a wide range of variations in terms of simplifications and assumptions on the representation of geometrical structures and material properties, as well as boundary and loading conditions. These variations may create differences in prediction accuracy, and restrict practical and clinical applications. This paper reviews the state-of-the-art technologies and challenges in computational model development, focusing on foot problem-specific models for the assessment of the effectiveness and accessibility of clinical treatments. The computational models have provided valuable biomechanical information for clinical applications but further investigations come with many challenges in terms of detailed and patient-specific models, accurate representations of tissue properties, and boundary and loading conditions. Multi-scale computational models are expected to be an efficient platform to fully address the biomechanical and biological concerns.

Computational Models of the Foot and Ankle for Pathomechanics and Clinical Applications: A Review.

Alveolar bone remodelling is vital for the success of dental implants and orthodontic treatments. However, the underlying biomechanical mechanisms, in particular the function of the periodontal ligament (PDL) in bone loading and remodelling, are not well understood. The PDL is a soft fibrous connective tissue that joins the tooth root to the alveolar bone and plays a critical role in the transmission of loads from the tooth to the surrounding bone. However, due to its complex structure, small size and location within the tooth socket it is difficult to study in vivo. Finite element analysis (FEA) is an ideal tool with which to investigate the role of the PDL, however inclusion of the PDL in FE models is complex and time consuming, therefore consideration must be given to how it is included. The aim of this study was to investigate the effects of including the PDL and its fibrous structure in mandibular finite element models. A high-resolution model of a human molar region was created from micro-computed tomography scans. This is the first time that the fibrous structure of the PDL has been included in a model with realistic tooth and bone geometry. The results show that omission of the PDL creates a more rigid model, reducing the strains observed in the mandibular corpus which are of interest when considering mandibular functional morphology. How the PDL is modelled also affects the strains. The inclusion of PDL fibres alters the strains in the mandibular bone, increasing the strains in the tooth socket compared to PDL modelled without fibres. As strains in the alveolar bone are thought to play a key role in bone remodelling during orthodontic tooth movement, future FE analyses aimed at improving our understanding and management of orthodontic treatment should include the fibrous structure of the PDL.

/pdf/inclusion-of-periodontal-ligament-fibres-in-mandibular-1sloaz9hns.pdf

Inclusion of periodontal ligament fibres in mandibular finite element models leads to an increase in alveolar bone strains.

Improving the validation of finite element models with quantitative full-field strain comparisons

Craniofacial computer-assisted surgical planning and simulation

Objective: Mini dental implants could be an alternative treatment method for prosthetic treatment of edentulous cleft palate. The aim of this study was to analyze stress distribution around the cortical bone and different plans using a varied number of mini dental implants in edentulous unilateral complete cleft palates. Materials and Methods: Three edentulous maxillary models were modified to create unilateral complete cleft palates. Mini dental implants (2.4 × 15 mm) were located as two mini implants at the premolar region, four mini implants at the premolar and molar region, and six mini implants at the first premolar, second premolar, and first molar regions in the models, respectively. Mucosa, o-ring/ball attachments, and overdentures were simulated. Vertical and horizontal loads of 100 N were applied on both the right and left molar teeth of the overdenture for each model. Maximum and minimum principal stress values and the distribution at cortical bone around the implants and cleft palates were eva...

Evaluation of Stress Distribution of Mini Dental Implant-Supported Overdentures in Complete Cleft Palate Models: A Three-Dimensional Finite Element Analysis Study.

A CT imaging system has been used to develop a finite element (FE) model of the child-specific mandible. Correspondingly, a procedure to generate FE models from digital image data has also been developed. The geometric models are extracted from the CT scan data of children using ANALYZE AVW version 3.0, and then reviewed, edited and meshed using the preprocessor of DEFORM 3D version 6.0. By utilizing a simplified material model and boundary conditions, detailed convergence tests were carried out using ABAQUS/STANDARD version 6.1. Test results show that over 52,592 linear tetrahedral elements or 37,062 degrees of freedom (DOF) are needed to model a child-specific mandible with reasonable accuracy. Results of the test series indicate that the surgical planning system is appropriate for further clinical implementation.

Medical imaging genesis for finite element-based mandibular surgical planning in the pediatric subject

For children with cleft palate, oral function is impaired. The hypothesis is that the stress and strain distribution within the affected maxilla with a cleft during functional tasks such as biting and chewing is abnormal and can significantly affect bone development in the growing child. To test this hypothesis, a three-dimensional finite element model of a pediatric subject-specific maxilla with and without unilateral cleft palate was established based upon pediatric subject-specific bony geometry. The stress and strain distribution of the maxillary alveolar region subjected to typical functional loads was analyzed. The preliminary results revealed that both Von Mises stress and maximum principle stress as well as principle strain distribution were unevenly distributed between the hemi-maxillae.

Stress analysis of unilateral cleft palate using a three dimensional finite element model of pediatric subject -specific maxilla

This paper presents our experience in using FE modeling of clinically relevant cases specifically in mandibular surgery. A semi-automatic procedure integrated with a group of Virtual Basic-based codes has been developed to clean the geometric models. Consequently, the time required for generate the tetrahedral volumetric mesh of mandible from patient-specific CT data has been reduced to less than 40 hours. Pre- and post-operation FE meshes are shown to be consistent and can be used for further modeling and analysis.

Finite element (FE) modeling of the mandible: from geometric model to tetrahedral volumetric mesh.

Three-Dimensional Finite Element Analysis of the Fifth Metatarsal Jones Fracture

A finite element (FE) model of pediatric patient-specific mandible is presented as a component of craniofacial surgery planning to predict more precisely the complex biomechanical reactions under mechanical loading. Such model needs to be validated prior to application. The FE model validation, however, is a challenge since invasive tests and measurements on a pediatric patient are prohibited. This study developed a procedure to partially validate a FE model of a pediatric patient-specific mandible. An experimental study was carried out under various loading conditions using an acrylic model of the mandible and skull. The model was created using a rapid prototyping technique based on clinically available patient-specific CT data. A comparison between experimental and numerical data was performed to evaluate the validity of the FE model. The measured strains were in good agreement with the computed strains; the correlation coefficient between measured and computed strain values was 0.9968.

Validation of a finite element model of pediatric patient-specific mandible

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