AccScience Publishing / IJB / Volume 10 / Issue 6 / DOI: 10.36922/ijb.3943
RESEARCH ARTICLE

Biomechanical analysis of partial mandibular implants with various lattice designs of different material properties: In vitro study and finite element analysis

Hao Zhang1 Lih Jyh Fuh1,2 Jui Ting Hsu3 Zhe Min Lim1 Heng Li Huang1,4*
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1 School of Dentistry, China Medical University, Taichung, Taiwan
2 Department of Dentistry, China Medical University Hospital, Taichung, Taiwan
3 Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
4 Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
IJB 2024, 10(6), 3943 https://doi.org/10.36922/ijb.3943
Submitted: 14 June 2024 | Accepted: 2 September 2024 | Published: 2 September 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

For patients with mandibular bone defects, although reconstruction plates can be used for repair, achieving both occlusal function and facial aesthetics is challenging. In the present study, in vitro experiments and finite element analysis (FEA) were conducted to determine the biomechanical characteristics of multiple porous lattice structures of varying shapes and diameters that were used for mandibular implants. Additionally, an abutment designed to carry occlusal forces was added to the top of the implants. The stress distribution of four lattice designs (tetrahedron, quad-diametral-cross, hex-star, and hex-vase) of three sizes (2.5, 3.0, and 3.5 mm) in cubic porous models were analyzed by FEA. Subsequently, two optimal designs for 3D-printed titanium alloy were selected. These designs, featuring different lattice diameters (0.5, 0.7, and 0.9 mm), were tested to determine their elastic modulus, which was used in another FEA of a mandibular implant designed for a patient with a malignant tumor in the right mandible. This model, which included an abutment design, was subjected to a vertical force of 100 N and muscle forces generated by biting. This analysis was conducted to determine the elastic modulus of the implant and the values of stress and strain on the implant and surrounding bone. The lattice designs of quad-diametral-cross and hex-vase exhibited smaller high-stress regions than those of tetrahedron and hex-star. In vitro tests revealed that the elastic modulus of the lattices increased with the rod diameter. When these values were applied to mandibular implants, Young’s modulus decreased, which in turn increased the frictional stress observed at the interface between the abutment and the implant. However, the implant’s maximum stress remained below its yield strength (910 MPa), and the strain on the surrounding bone varied between 1500 and 3000 μstrain. As indicated by Frost’s theory, these implants are unlikely to damage the surrounding bone tissue and are likely to support bone growth.  

Graphical abstract
Keywords
Mandibular segmental resection
Porous lattice design
Lattice size
Rod diameter
Mandibular implant
Abutment
In vitro experiment
Finite element analysis
Funding
This study was supported by the Ministry of Science and Technology, Taiwan (Project No. MOST 111-2221-E-039-008-MY2).
Conflict of interest
All authors declare that they have no conflict of interest.
References
  1. Seikaly H, Chau J, Li F, et al. Bone that best matches the properties of the mandible. J Otolaryngol. 2003;32(4):262-265. doi: 10.2310/7070.2003.41646
  2. Bak M, Jacobson AS, Buchbinder D, Urken ML. Contemporary reconstruction of the mandible. Oral Oncol. 2010;46(2):71-76. doi: 10.1016/j.oraloncology.2009.11.006
  3. Schlueter B, Kim KB, Oliver D, Sortiropoulos G. Cone beam computed tomography 3D reconstruction of the mandibular condyle. Angle Orthod. 2008;78(5):880-888. doi: 10.2319/072007-339.1
  4. van Baar GJC, Forouzanfar T, Liberton NPTJ, Winters HAH, Leusink FKJ. Accuracy of computer-assisted surgery in mandibular reconstruction: a systematic review. Oral Oncol. 2018;84:52-60. doi: 10.1016/j.oraloncology.2018.07.004
  5. Baltatu MS, Tugui CA, Perju MC, et al. Biocompatible titanium alloys used in medical applications. Rev Chim. 2019;70(4):1302-1306. doi: 10.37358/RC.19.4.7114
  6. Ran Q, Yang W, Hu Y, et al. Osteogenesis of 3D printed porous Ti6Al4V implants with different pore sizes. J Mech Behav Biomed Mater. 2018;84:1-11. doi: 10.1016/j.jmbbm.2018.04.010
  7. Taniguchi N, Fujibayashi S, Takemoto M, et al. Effect of pore size on bone ingrowth into porous titanium implants fabricated by additive manufacturing: An in vivo experiment. Mater Sci Eng C Mater Biol Appl. 2016;59:690-701. doi: 10.1016/j.msec.2015.10.069
  8. Eshkalak SK, Ghomi ER, Dai Y, Choudhury D, Ramakrishna S. The role of three-dimensional printing in healthcare and medicine. Mater Des. 2020;194:108940. doi: 10.1016/j.matdes.2020.108940
  9. Gao H, Li X, Wang C, Ji P, Wang C. Mechanobiologically optimization of a 3D titanium-mesh implant for mandibular large defect: a simulated study. Mater Sci Eng C Mater Biol Appl. 2019;104:109934. doi: 10.1016/j.msec.2019.109934
  10. Hosseini S, Hudak R, Penhaker M, Majernik J. Fatigue of Ti- 6Al-4V. In: Biomedical Engineering-Technical Applications in Medicine. London, UK: IntechOpen; 2012:75-92. doi: 10.5772/45753
  11. Davoodi E, Montazerian H, Esmaeilizadeh R, et al. Additively manufactured gradient porous Ti-6Al-4V hip replacement implants embedded with cell-laden gelatin methacryloyl hydrogels. ACS Appl Mater Interfaces. 2021;13(19):22110-22123. doi: 10.1021/acsami.0c20751
  12. Farajpour H, Bastami F, Bohlouli M, Khojasteh A. Reconstruction of bilateral ramus-condyle unit defect using custom titanium prosthesis with preservation of both condyles. J Mech Behav Biomed Mater. 2021;124:104765. doi: 10.1016/j.jmbbm.2021.104765
  13. Luo D, Rong Q, Chen Q. Finite-element design and optimization of a three-dimensional tetrahedral porous titanium scaffold for the reconstruction of mandibular defects. Med Eng Phys. 2017;47:176-183. doi: 10.1016/j.medengphy.2017.06.015
  14. Liu R, Su Y, Yang W, et al. Novel design and optimization of porous titanium structure for mandibular reconstruction. Appl Bionics Biomech. 2022;2022:8686670. doi: 10.1155/2022/8686670
  15. Touré G, Gouet E. Use of a 3-dimensional custom-made porous titanium prosthesis for mandibular body reconstruction with prosthetic dental rehabilitation and lipofilling. J Oral Maxillofac Surg. 2019;77(6):1305-1313. doi: 10.1016/j.joms.2018.12.026
  16. Cheng KJ, Liu YF, Wang R, et al. Topological optimization of 3D printed bone analog with PEKK for surgical mandibular reconstruction. J Mech Behav Biomed Mater. 2020;107:103758. doi: 10.1016/j.jmbbm.2020.103758
  17. Qassemyar Q, Assouly N, Temam S, Kolb F. Use of a three-dimensional custom-made porous titanium prosthesis for mandibular body reconstruction. Int J Oral Maxillofac Surg. 2017;46(10):1248-1251. doi: 10.1016/j.ijom.2017.06.001
  18. Ardila CM, Hernández-Arenas Y, Álvarez-Martínez E. Mandibular body reconstruction utilizing a three-dimensional custom-made porous titanium plate: a four-year follow-up clinical report. Case Rep Dent. 2022; 2022:5702066. doi: 10.1155/2022/5702066
  19. Park JH, Odkhuu M, Cho S, Li J, Park BY, Kim JW. 3D-printed titanium implant with pre-mounted dental implants for mandible reconstruction: a case report. Maxillofac Plast Reconstr Surg. 2020;42(1):28. doi: 10.1186/s40902-020-00272-5
  20. Raz K, Chval Z, Sedlacek F. Compressive strength prediction of quad-diametral lattice structures. Key Eng Mater. 2020;847:69-74. doi: 10.4028/www.scientific.net/KEM.847.69
  21. Kim JW, Oh CW, Kim BS, Jeong SL, Jung GH, Lee DH. Structure-mechanical analysis of various fixation constructs for basicervical fractures of the proximal femur and clinical implications; finite element analysis. Injury. 2023;54(2):370-378. doi: 10.1016/j.injury.2022.12.004
  22. Huang HL, Lin TW, Tsai HL, Wu YL, Wu AYJ. Biomechanical effects of bone atrophy, implant design, and vertical or tilted of posterior implant on all-on-four concept implantation: finite element analysis. J Med Biol Eng. 2022;42(4):488-497. doi: 10.1007/s40846-022-00725-4
  23. Grant JA, Bishop NE, Götzen N, Sprecher C, Honl M, Morlock MM. Artificial composite bone as a model of human trabecular bone: the implant-bone interface. J Biomech. 2007;40(5):1158-1164. doi: 10.1016/j.jbiomech.2006.04.007
  24. Bozkaya D, Müftü S. Mechanics of the taper integrated screwed-in (TIS) abutments used in dental implants. J Biomech. 2005;38(1):87-97. doi: 10.1016/j.jbiomech.2004.03.006
  25. Huang HL, Su KC, Fuh LJ, et al. Biomechanical analysis of a temporomandibular joint condylar prosthesis during various clenching tasks. J Craniomaxillofac Surg. 2015;43(7):1194-1201. doi: 10.1016/j.jcms.2015.04.016
  26. Korioth TW, Hannam AG. Mandibular forces during simulated tooth clenching. J Orofac Pain. 1994;8(2):178-189.
  27. Moiduddin K, Anwar S, Ahmed N, Ashfaq M, Al-Ahmari A. Computer assisted design and analysis of customized porous plate for mandibular reconstruction. Irbm. 2017;38(2):78-89. doi: 10.1016/j.irbm.2017.01.003
  28. Peng WM, Cheng KJ, Liu YF, et al. Biomechanical and mechanostat analysis of a titanium layered porous implant for mandibular reconstruction: the effect of the topology optimization design. Mater Sci Eng C Mater Biol Appl. 2021;124:112056. doi: 10.1016/j.msec.2021.112056
  29. Liu Y, Wang H, Li S, et al. Compressive and fatigue behavior of beta-type titanium porous structures fabricated by electron beam melting. Acta Mater. 2017;126:58-66. doi: 10.1016/j.actamat.2016.12.052
  30. Torres-Sanchez C, Al Mushref FRA, Norrito M, Yendall K, Liu Y, Conway PP. The effect of pore size and porosity on mechanical properties and biological response of porous titanium scaffolds. Mater Sci Eng C Mater Biol Appl. 2017;77:219-228. doi: 10.1016/j.msec.2017.03.249
  31. Arabnejad S, Johnston B, Tanzer M, Pasini D. Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty. J Orthop Res. 2017;35(8):1774-1783. doi: 10.1002/jor.23445
  32. Knoll WD, Gaida A, Maurer P. Analysis of mechanical stress in reconstruction plates for bridging mandibular angle defects. J Craniomaxillofac Surg. 2006;34(4):201-209. doi: 10.1016/j.jcms.2006.01.004
  33. Afazov S, Denmark WA, Toralles BL, Holloway A, Yaghi A. Distortion prediction and compensation in selective laser melting. Addit Manuf. 2017;17:15-22. doi: 10.1016/j.addma.2017.07.005
  34. Frost HM. A 2003 update of bone physiology and Wolff ’s Law for clinicians. Angle Orthod. 2004;74(1):3-15. doi: 10.1043/0003-3219(2004)074<0003:AUOBPA>2.0.CO;2
  35. Biewener AA. Safety factors in bone strength. Calcif Tissue Int. 1993;53(Suppl 1):S68-S74. doi: 10.1007/BF01673406

 

 

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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing