CT-based Finite Element Models Research Articles

The effects of material and structural properties of the periodontal ligament in mechanical function of tooth-PDL-bone complex in dental trauma: A sensitivity study using finiteelement analysis

Periodontal ligament (PDL) plays a crucial role in transferring load from tooth to its adjacent bone, and its role is more pronounced in case of trauma, due to its shock-absorbing character, which has not been fully understood yet. Different constitutive models have correlated mechanical function of PDL with its anisotropic, inhomogeneous, non-linear elastic nature, and it was variably modeled using Finite Element (FE) simulations of dental trauma. Furthermore, since capturing accurate dimension of PDL is difficult, various thicknesses were considered for PDL in FE reconstruction process. In this study, the sensitivity of FE analyses to variation in mechanical properties, including a large range of elastic properties for a linear elastic model, also a hyper-elastic material model, and various thicknesses of PDL was investigated by developing a CT-based FE model of tooth-PDL-bone complex. Results of this study highlighted the crucial role of PDL in absorption and dissipation of energy, as well as in stress distribution within alveolar bone during dental trauma. It was observed that as Young's modulus of PDL decreases and its thickness increases, its shock-absorbing capacity would be escalated. Moreover, it was found that inclusion of PDL reduces the maximum von Mises stress exerted on the alveolar bone by about 60% in some areas, compared to the case in which the PDL is absent. Results of this work underscore the need of presenting comprehensive constitutive models to describe mechanical behavior of PDL, with the goal of understanding the behavior of a tooth-PDL-bone complex in pathological conditions, such as trauma.

Denosumab treatment is associated with decreased cortical porosity and increased bone density and strength at the proximal humerus of ovariectomized cynomolgus monkeys.

Upper extremity fractures, including those at the humerus, are common among women with postmenopausal osteoporosis. Denosumab was shown to reduce humeral fractures in this population; however, no clinical or preclinical studies have quantified the effects of denosumab on humerus bone mineral density or bone microarchitecture changes. This study used micro-computed tomography (μCT) and computed tomography (CT), alongside image-based finite element (FE) models derived from both modalities, to quantify the effects of denosomab (DMAb) and alendronate (ALN) on humeral bone from acutely ovariectomized (OVX) cynomolgus monkeys. Animals were treated with 12 monthly injections of s.c. vehicle (VEH; n=10), s.c. denosumab (DMAb; 25mg/kg, n=9), or i.v. alendronate (ALN; 50μg/kg, n=10). Two more groups received 6months of VEH followed by 6months of DMAb (VEH-DMAb; n=7) or 6months of ALN followed by 6months of DMAb (ALN-DMAb; n=9). After treatment, humeri were harvested and μCT was used to quantify tissue mineral density, trabecular morphology, and cortical porosity at the humeral head. Clinical CT imaging was also used to quantify trabecular and cortical bone mineral density (BMD) at the ultra-proximal, proximal, 1/5 proximal and midshaft of the bone. Finally, μCT-based FE models in compression, and CT-based FE models in compression, torsion, and bending, were developed to estimate differences in strength. Compared to VEH, groups that received DMAb at any time demonstrated lower cortical porosity and/or higher tissue mineral density via μCT; no effects on trabecular morphology were observed. FE estimated strength based on μCT was higher after 12-months DMAb (p=0.020) and ALN-DMAb (p=0.024) vs. VEH; respectively, FE predicted mean (SD) strength was 4649.88 (710.58) N, and 4621.10 (1050.16) N vs. 3309.4 (876.09) N. All antiresorptive treatments were associated with higher cortical BMD via CT at the 1/5 proximal and midshaft of the humerus; however, no differences in CT-based FE predicted strength were observed. Overall, these results help to explain the observed reductions in humeral fracture rate following DMAb treatment in women with postmenopausal osteoporosis.

Predicting rupture locations of ascending aortic aneurysms using CT-based finite element models

Accurate rupture risk assessment of ascending aortic aneurysms is important for reducing aneurysm-related mortality. More recently, computational models have been shown to better predict rupture risk than diameter-based measurements. However, it remains unclear whether finite element (FE) models of the ascending aorta can predict rupture location, and over what timeframe those predictions are reliable. The aim of this study was to evaluate FE models of the ascending aorta generated from computed tomography (CT) scans in predicting rupture location. Pre- and post-rupture CT scans were obtained of 12 patients who underwent emergency surgical repair for ascending aorta rupture with varying time intervals between scans (20 days – 6 years). A rigid iterative closest point (ICP) registration was used to overlay post-rupture aortic geometries with pre-rupture FE models and directly compare predicted regions of high equivalent strain with actual rupture. The FE model predicted the rupture location in the 5 patients with the shortest time intervals between the pre- and post-rupture scans (20 days – 2 years, 3 months). However, rupture location was not predicted in the 4/5 patients with greater than 3 years between scans. Achieving a physiological equivalent strain distribution in the FE model was highly dependent on the resolution of the pre-rupture scan and whether contrast agent was present. The results suggest there may be a time interval beyond which FE predictions of rupture location may not be reliable. The results in this study may help clinical validation of FE models of ascending aortic aneurysms predicting rupture risk.

Finite element analysis potentially identifies nonessential prophylactic stabilization in femurs with metastatic disease.

Metastatic bone disease (MBD) is often managed by non-specialized orthopedic surgeons who rely on Mirels' criteria to predict pathologic fracture risk. However, low specificity of Mirels' criteria implies many lesions are scored at high fracture risk when the actual mechanical fracture risk is minimal. Our goal was to retrospectively compare mechanical fracture risk in MBD patients to Mirels' score and clinical treatment received. Using a CT-based finite element (FE) model of the proximal femur affected by MBD, femur strength and load-to-strength ratio (LSR) were determined for 52 femurs from 48 patients. Associations of femur strength with pain and Mirels' scores (Pearson r/Spearman ρ correlations), and the decision to operate (percentile analysis), and associations of LSR with pain and Mirels' scores (Spearman correlations) were determined. Nineteen of 52 femurs (37%) had a very low computed mechanical fracture risk (LSR < 0.4); 5 of those 19 underwent prophylactic stabilization, suggesting that clinical decision-making in MBD is substantially influenced by non-mechanical factors that likely overestimate pathologic fracture risk. Of the 30 femurs managed non-operatively, 24 had a low computed mechanical fracture risk (LSR ≤ 0.5), none of which (0%) experienced a fracture within 9 months. Patient-reported pain did not correlate with femur strength (r = -0.05, p = 0.748) nor with LSR (ρ = 0.07, p = 0.632). Mirels' score correlated weakly with femur strength (ρ = -0.32, p = 0.019) and with LSR (ρ = 0.29, p = 0.034). Computational mechanical tools like this FE model could be used as a clinical decision aid when considering non-surgical management in appropriate patients, potentially alleviating nonessential surgical treatment in some patients with femur MBD.

Experimental and numerical investigation on fatigue damage in micro-lattice materials by Digital Volume Correlation and [formula omitted]CT-based finite element models

This work addresses the fatigue behaviour of two strut-based topologies of micro-lattice materials, focusing in particular on the damage evolution throughout the fatigue life. An experimental campaign is performed on micro-lattice specimens tested in fatigue with different stress ratio (R = 0, R = −1 and R = 10). A methodological approach for metal foams is adopted to analyse the experimental tests and to characterize the fatigue damage evolution. To validate this approach the Digital Volume Correlation technique is applied on two in-situ experimental fatigue tests conducted inside a Micro-Computed Tomography scanner. An analysis based on a finite element model of the as-manufactured geometry and the application of a suitable multi-axial fatigue criterion to evaluate the local stress field shows good results in predicting the fatigue failure location.

Optimal placement of fixation system for scaffold-based mandibular reconstruction

A current challenge in bone tissue engineering is to create favourable biomechanical conditions conducive to tissue regeneration for a scaffold implanted in a segmental defect. This is particularly the case immediately following surgical implantation when a firm mechanical union between the scaffold and host bone is yet to be established via osseointegration. For mandibular reconstruction of a large segmental defect, the position of the fixation system is shown here to have a profound effect on the mechanical stimulus (for tissue regeneration within the scaffold), structural strength, and structural stiffness of the tissue scaffold-host bone construct under physiological load. This research combines computer tomography (CT)-based finite element (FE) modelling with multiobjective optimisation to determine the optimal height and angle to place a titanium fixation plate on a reconstructed mandible so as to enhance tissue ingrowth, structural strength and structural stiffness of the scaffold-host bone construct. To this end, the respective design criteria for fixation plate placement are to: (i) maximise the volume of the tissue scaffold experiencing levels of mechanical stimulus sufficient to initiate bone apposition, (ii) minimise peak stress in the scaffold so that it remains intact with a diminished risk of failure and, (iii) minimise scaffold ridge displacement so that the reconstructed jawbone resists deformation under physiological load. First, a CT-based FE model of a reconstructed human mandible implanted with a bioceramic tissue scaffold is developed to visualise and quantify changes in the biomechanical responses as the fixation plate's height and/or angle are varied. The volume of the scaffold experiencing appositional mechanical stimulus is observed to increase with the height of the fixation plate. Also, as the principal load-transfer mechanism to the scaffold is via the fixation system, there is a significant ingress of appositional stimulus from the buccal side towards the centre of the scaffold, notably in the region bounded by the screws. Next, surrogate modelling is implemented to generate bivariate cubic polynomial functions of the three biomechanical responses with respect to the two design variables (height and angle). Finally, as the three design objectives are found to be competing, bi- and tri-objective particle swarm optimisation algorithms are invoked to determine the most optimal Pareto solution, which represents the best possible trade-off between the competing design objectives. It is recommended that consideration be given to placing the fixation system along the upper boundary of the mandible with a small clockwise rotation about its posterior end. The methodology developed here forms a useful decision aid for optimal surgical planning.

Stiffness and Strength Predictions From Finite Element Models of the Knee are Associated with Lower-Limb Fractures After Spinal Cord Injury.

Spinal cord injury (SCI) is associated with bone fragility and fractures around the knee. The purpose of this investigation was to validate a computed tomography (CT) based finite element (FE) model of the proximal tibia and distal femur under biaxial loading, and to retrospectively quantify the relationship between model predictions and fracture incidence. Twenty-six cadaveric tibiae and femora (n = 13 each) were loaded to 300N of compression, then internally rotated until failure. FE predictions of torsional stiffness (K) and strength (Tult) explained 74% (n = 26) and 93% (n = 7) of the variation in experimental measurements, respectively. Univariate analysis and logistic regression were subsequently used to determine if FE predictions and radiographic measurements from CT and dual energy X-ray absorptiometry (DXA) were associated with prevalent lower-limb fracture in 50 individuals with SCI (n = 14 fractures). FE and CT measures, but not DXA, were lower in individuals with fracture. FE predictions of Tult at the tibia demonstrated the highest odds ratio (4.98; p = 0.006) and receiver operating characteristic (0.84; p = 0.008) but did not significantly outperform other metrics. In conclusion, CT-based FE model predictions were associated with prevalent fracture risk after SCI; this technique could be a powerful tool in future clinical research.

The Role of Footwear in the Pathogenesis of Hallux Valgus: A Proof-of-Concept Finite Element Analysis in Recent Humans and Homo naledi.

Hallux valgus (HV), the bunion of the first metatarsophalangeal joint (MTPJ), bothers many adults. No consensus has been reached about the causes of HV, be it a hereditary, or acquired, or multifactorial disease. Nor has agreement been reached using MTPJ angle to assess HV based on X-ray because in most cases the assessment of MTPJ is not reliable as it depends on the posture during scanning. In this study, we assume that HV is predominately acquired and that shoe wearing per se is an important player in HV pathogenesis. To verify our hypothesis, a CT-based finite element (FE) model of the first MTPJ of fossil remains of bear-footed Homo naledi was created and compared to that of five contemporary shoe-wearing wrestlers (10 models from two scans at an interval of about 18 months) because Homo naledi's first MTPJ is an ideal model for non-shoe wearing with parallel sesamoid grooves. We developed the first MTPJ structure transformation method and created MTPJ joint capsule model for both Homo naledi and wrestlers. Constraint on the medial side of the first MTPJ capsule was set to simulate shoe-wearing conditions compared to the lack of medial constraint for barefooted conditions. Analysis of eight FE models of different angles for the first MTPJ of Homo naledi was performed by the first MTPJ transformation method and results showed that stress concentrated on the medial capsule of the first MTPJ in simulated shoe-wearing conditions, even at MTPJ angle of 0°. Increase in the first MTPJ angle further increased stress concentration on the medial side, and stress-growth relationship might reveal the causes of HV. We further developed a method to position the first MTPJ in wrestlers and created CT-based models at two time points. It was evident that the first MTPJ angle increased in all but one athlete, with a maximal increase of 4.03 degrees. This verifies our hypothesis that HV might be developed by wearing shoes. Further longitudinal studies with larger sample sizes are needed to additionally validate our results and determine the magnitude of the effects of shoe wearing on development and progression of HV.

Strain shielding for cemented hip implants

BackgroundLong-term survival of hip implants is of increasing relevance due to the rising life expectancy. The biomechanical effect of strain shielding as a result of implant insertion may lead to bone resorption, thus increasing risk for implant loosening and periprosthetic fractures. Patient-specific quantification of strain shielding could assist orthopedic surgeons in choosing the biomechanically most appropriate prosthesis. MethodsValidated quantitative CT-based finite element models of five femurs in intact and implanted states were considered to propose a systematic algorithm for strain shielding quantification. Three different strain measures were investigated and the most appropriate measure for strain shielding quantification is recommended. It is used to demonstrate a practical femur-specific implant selection among three common designs. FindingsStrain shielding measures demonstrated similar trends in all Gruen zones except zone 1, where the volumetric strain measure differed from von-Mises and maximum principal strains. The volumetric strain measure is in better agreement with clinical bone resorption records. It is also consistent with the biological mechanism of bone remodeling so it is recommended for strain shielding quantification. Applying the strain shielding algorithm on three different implants for a specific femur suggests that the collared design is preferable. Such quantitative biomechanical input is valuable for practical patient specific implant selection. InterpretationVolumetric strain should be considered for strain shielding examination. The presented methodology may potentially enable patient-specific pre-operative strain shielding evaluation so to minimize strain shielding. It should be further used in a longitudinal study so to correlate between strain shielding predictions and clinical bone resorption.

Calibration with or without phantom for fracture risk prediction in cancer patients with femoral bone metastases using CT-based finite element models.

The objective of this study was to develop a new calibration method that enables calibration of Hounsfield units (HU) to bone mineral densities (BMD) without the use of a calibration phantom for fracture risk prediction of femurs with metastases using CT-based finite element (FE) models. Fifty-seven advanced cancer patients (67 femurs with bone metastases) were CT scanned atop a separate calibration phantom using a standardized protocol. Non-linear isotropic FE models were constructed based on the phantom calibration and on two phantomless calibration methods: the “air-fat-muscle” and “non-patient-specific” calibration. For air-fat-muscle calibration, peaks for air, fat and muscle tissue were extracted from a histogram of the HU in a standardized region of interest including the patient’s right leg and surrounding air. These CT peaks were linearly fitted to reference “BMD” values of the corresponding tissues to obtain a calibration function. For non-patient-specific calibration, an average phantom calibration function was used for all patients. FE failure loads were compared between phantom and phantomless calibrations. There were no differences in failure loads between phantom and air-fat-muscle calibration (p = 0.8), whereas there was a significant difference between phantom and non-patient-specific calibration (p<0.001). Although this study was not designed to investigate this, in four patients who were scanned using an aberrant reconstruction kernel, the effect of the different kernel seemed to be smaller for the air-fat-muscle calibration compared to the non-patient-specific calibration. With the air-fat-muscle calibration, clinical implementation of the FE model as tool for fracture risk assessment will be easier from a practical and financial viewpoint, since FE models can be made using everyday clinical CT scans without the need of concurrent scanning of calibration phantoms.

Prediction of lumbar vertebral body compressive strength of overweight and obese older adults using morphed subject-specific finite-element models to evaluate the effects of weight loss.

Diet and exercise can promote weight loss in older adults; however, there is potential to increase fracture risk due to loss of bone mineral density (BMD) known to accompany weight loss. Weight loss effects on measures of bone quality and strength are currently unknown. The purpose of this study is to develop subject-specific finite-element (FE) models of the lumbar spine and study the effect of intentional weight loss on bone strength in a pilot data set. Computed tomography (CT) scans of the lumbar spine of 30 overweight and obese (mean BMI = 29.7 ± 3.9kg/m2), older adults (mean age = 65.9 ± 4.6years) undergoing an 18-month intentional weight loss intervention were obtained at baseline and post-intervention. Measures of volumetric BMD (vBMD) and variable cortical thickness were derived from each subject CT scan. Development of the subject-specific FE models of the lumbar spine involved model morphing techniques to accelerate the development of the models. vBMD-derived material properties and cortical thickness measures were directly mapped to baseline and post-intervention models. Bone strength was estimated through simulation of a quasi-static uniaxial compression test. From baseline to 18-month post-weight loss intervention, there were statistically significant decreases in estimated bone strength (6.5% decrease; p < 0.05). Adjusting for baseline bone measures and gender revealed no statistically significant correlations between weight change and change in vBMD, cortical thickness, or bone strength. Integration of CT-based measures and FE models with conventional areal BMD can improve the understanding of the effects of intentional weight loss on bone health.

Can patient-specific finite element models better predict fractures in metastatic bone disease than experienced clinicians?: Towards computational modelling in daily clinical practice.

ObjectivesIn this prospective cohort study, we investigated whether patient-specific finite element (FE) models can identify patients at risk of a pathological femoral fracture resulting from metastatic bone disease, and compared these FE predictions with clinical assessments by experienced clinicians.MethodsA total of 39 patients with non-fractured femoral metastatic lesions who were irradiated for pain were included from three radiotherapy institutes. During follow-up, nine pathological fractures occurred in seven patients. Quantitative CT-based FE models were generated for all patients. Femoral failure load was calculated and compared between the fractured and non-fractured femurs. Due to inter-scanner differences, patients were analyzed separately for the three institutes. In addition, the FE-based predictions were compared with fracture risk assessments by experienced clinicians.ResultsIn institute 1, median failure load was significantly lower for patients who sustained a fracture than for patients with no fractures. In institutes 2 and 3, the number of patients with a fracture was too low to make a clear distinction. Fracture locations were well predicted by the FE model when compared with post-fracture radiographs. The FE model was more accurate in identifying patients with a high fracture risk compared with experienced clinicians, with a sensitivity of 89% versus 0% to 33% for clinical assessments. Specificity was 79% for the FE models versus 84% to 95% for clinical assessments.ConclusionFE models can be a valuable tool to improve clinical fracture risk predictions in metastatic bone disease. Future work in a larger patient population should confirm the higher predictive power of FE models compared with current clinical guidelines.Cite this article: F. Eggermont, L. C. Derikx, N. Verdonschot, I. C. M. van der Geest, M. A. A. de Jong, A. Snyers, Y. M. van der Linden, E. Tanck. Can patient-specific finite element models better predict fractures in metastatic bone disease than experienced clinicians? Towards computational modelling in daily clinical practice. Bone Joint Res 2018;7:430–439. DOI: 10.1302/2046-3758.76.BJR-2017-0325.R2.

Effect of different CT scanners and settings on femoral failure loads calculated by finite element models.

ABSTRACTIn a multi‐center patient study, using different CT scanners, CT‐based finite element (FE) models are utilized to calculate failure loads of femora with metastases. Previous studies showed that using different CT scanners can result in different outcomes. This study aims to quantify the effects of (i) different CT scanners; (ii) different CT protocols with variations in slice thickness, field of view (FOV), and reconstruction kernel; and (iii) air between calibration phantom and patient, on Hounsfield Units (HU), bone mineral density (BMD), and FE failure load. Six cadaveric femora were scanned on four CT scanners. Scans were made with multiple CT protocols and with or without an air gap between the body model and calibration phantom. HU and calibrated BMD were determined in cortical and trabecular regions of interest. Non‐linear isotropic FE models were constructed to calculate failure load. Mean differences between CT scanners varied up to 7% in cortical HU, 6% in trabecular HU, 6% in cortical BMD, 12% in trabecular BMD, and 17% in failure load. Changes in slice thickness and FOV had little effect (≤4%), while reconstruction kernels had a larger effect on HU (16%), BMD (17%), and failure load (9%). Air between the body model and calibration phantom slightly decreased the HU, BMD, and failure loads (≤8%). In conclusion, this study showed that quantitative analysis of CT images acquired with different CT scanners, and particularly reconstruction kernels, can induce relatively large differences in HU, BMD, and failure loads. Additionally, if possible, air artifacts should be avoided. © 2018 Orthopaedic Research Society. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 36:2288–2295, 2018.

Establishment and Validation of a Computed Tomography–Based Finite Element Model of Lumbar3-5 Vertebrae

Objective: To describe a rapid method for establishing a finite element model of the lumbar vertebrae by using computed tomography (CT) images Methods: CT images of the L3-L5 vertebrae of a 75-year-old man were acquired and used to establish a finite element model using the Minics 10.01 and Hypermesh 11.0 softwares. Soft tissues, such as the intervertebral discs and ligaments, were manually meshed. The model thus generated was subjected to a vertical force of 400 N and a torsion force of 10 N·m to simulate the conditions of the human spine in the standing position. Results: The CT-based finite element model of the lumbar vertebrae was successfully established, accurately reflecting the anatomy of both vertebrae and attached soft tissues. The biomechanical response of the model to the external testing forces was within the accepted normal ranges. Conclusion: We constructed a feasible and accurate CT-based finite element model of the lumbar vertebrae with manually meshing of the soft tissue data. This model showed good consistency with in vitro experimental data. Thus, our method appeared to be useful in the construction of a finite element model of the spine.

Femoral fracture type can be predicted from femoral structure: A finite element study validated by digital volume correlation experiments.

Proximal femoral fractures can be categorized into two main types: Neck and intertrochanteric fractures accounting for 53% and 43% of all proximal femoral fractures, respectively. The possibility to predict the type of fracture a specific patient is predisposed to would allow drug and exercise therapies, hip protector design, and prophylactic surgery to be better targeted for this patient rendering fracture preventing strategies more effective. This study hypothesized that the type of fracture is closely related to the patient-specific femoral structure and predictable by finite element (FE) methods. Fourteen femora were DXA scanned, CT scanned, and mechanically tested to fracture. FE-predicted fracture patterns were compared to experimentally observed fracture patterns. Measurements of strain patterns to explain neck and intertrochanteric fracture patterns were performed using a digital volume correlation (DVC) technique and compared to FE-predicted strains and experimentally observed fracture patterns. Although loaded identically, the femora exhibited different fracture types (six neck and eight intertrochanteric fractures). CT-based FE models matched the experimental observations well (86%) demonstrating that the fracture type can be predicted. DVC-measured and FE-predicted strains showed obvious consistency. Neither DXA-based BMD nor any morphologic characteristics such as neck diameter, femoral neck length, or neck shaft angle were associated with fracture type. In conclusion, patient-specific femoral structure correlates with fracture type and FE analyses were able to predict these fracture types. Also, the demonstration of FE and DVC as metrics of the strains in bones may be of substantial clinical value, informing treatment strategies and device selection and design. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:993-1001, 2018.

The use of subject-specific Finite Element analysis of L1-L4 vertebra to screening osteoporosis in postmenopausal women.

The aim of this work is to study Computed Tomography (CT)-based Finite Element (FE) modelling of lumbar vertebra to classify osteoporotic patients using dual-energy x-ray absorptiometry (DXA) as reference. Cohort comprised 15 postmenopausal female patients with CT-DXA pairs. Sixty subject-specific CT-based FE models were constructed of L1 to L4 vertebrae. Load-displacement in each node of the models was analyzed. Mean kurtosis values of displacement distributions between osteoporosis and healthy groups at L1 level showed a statistically significant difference (p<;0.005). The CT-based FE model of L1 vertebra with patient specific material properties can be used to identify osteoporosis patients.

Automatic CT-based finite element model generation for temperature-based death time estimation: feasibility study and sensitivity analysis.

Temperature-based death time estimation is based either on simple phenomenological models of corpse cooling or on detailed physical heat transfer models. The latter are much more complex but allow a higher accuracy of death time estimation, as in principle, all relevant cooling mechanisms can be taken into account.Here, a complete workflow for finite element-based cooling simulation is presented. The following steps are demonstrated on a CT phantom: Computer tomography (CT) scan Segmentation of the CT images for thermodynamically relevant features of individual geometries and compilation in a geometric computer-aided design (CAD) model Conversion of the segmentation result into a finite element (FE) simulation model Computation of the model cooling curve(MOD) Calculation of the cooling time(CTE) For the first time in FE-based cooling time estimation, the steps from the CT image over segmentation to FE model generation are performed semi-automatically. The cooling time calculation results are compared to cooling measurements performed on the phantoms under controlled conditions. In this context, the method is validated using a CT phantom. Some of the phantoms' thermodynamic material parameters had to be determined via independent experiments.Moreover, the impact of geometry and material parameter uncertainties on the estimated cooling time is investigated by a sensitivity analysis.

Prediction of femoral strength using 3D finite element models reconstructed from DXA images: validation against experiments

Computed tomography (CT)-based finite element (FE) models may improve the current osteoporosis diagnostics and prediction of fracture risk by providing an estimate for femoral strength. However, the need for a CT scan, as opposed to the conventional use of dual-energy X-ray absorptiometry (DXA) for osteoporosis diagnostics, is considered a major obstacle. The 3D shape and bone mineral density (BMD) distribution of a femur can be reconstructed using a statistical shape and appearance model (SSAM) and the DXA image of the femur. Then, the reconstructed shape and BMD could be used to build FE models to predict bone strength. Since high accuracy is needed in all steps of the analysis, this study aimed at evaluating the ability of a 3D FE model built from one 2D DXA image to predict the strains and fracture load of human femora. Three cadaver femora were retrieved, for which experimental measurements from ex vivo mechanical tests were available. FE models were built using the SSAM-based reconstructions: using only the SSAM-reconstructed shape, only the SSAM-reconstructed BMD distribution, and the full SSAM-based reconstruction (including both shape and BMD distribution). When compared with experimental data, the SSAM-based models predicted accurately principal strains (coefficient of determination >0.83, normalized root-mean-square error <16%) and femoral strength (standard error of the estimate 1215 N). These results were only slightly inferior to those obtained with CT-based FE models, but with the considerable advantage of the models being built from DXA images. In summary, the results support the feasibility of SSAM-based models as a practical tool to introduce FE-based bone strength estimation in the current fracture risk diagnostics.

Simplified versus geometrically accurate models of forefoot anatomy to predict plantar pressures: A finite element study

Integration of patient-specific biomechanical measurements into the design of therapeutic footwear has been shown to improve clinical outcomes in patients with diabetic foot disease. The addition of numerical simulations intended to optimise intervention design may help to build on these advances, however at present the time and labour required to generate and run personalised models of foot anatomy restrict their routine clinical utility. In this study we developed second-generation personalised simple finite element (FE) models of the forefoot with varying geometric fidelities. Plantar pressure predictions from barefoot, shod, and shod with insole simulations using simplified models were compared to those obtained from CT-based FE models incorporating more detailed representations of bone and tissue geometry. A simplified model including representations of metatarsals based on simple geometric shapes, embedded within a contoured soft tissue block with outer geometry acquired from a 3D surface scan was found to provide pressure predictions closest to the more complex model, with mean differences of 13.3kPa (SD 13.4), 12.52kPa (SD 11.9) and 9.6kPa (SD 9.3) for barefoot, shod, and insole conditions respectively. The simplified model design could be produced in <1h compared to >3h in the case of the more detailed model, and solved on average 24% faster. FE models of the forefoot based on simplified geometric representations of the metatarsal bones and soft tissue surface geometry from 3D surface scans may potentially provide a simulation approach with improved clinical utility, however further validity testing around a range of therapeutic footwear types is required.

Simulated bone remodeling around tilted dental implants in the anterior maxilla.

Dental implants have to be placed with the long axis in different angulations due to the change in bone morphology. The objective of this study was to investigate the different bone remodeling response induced by the tilted dental implants and to assess whether it could lead to bone loss and implant failure. In this study, bone remodeling due to palato-labially inclined dental implants placed in the anterior maxillary incisor region was simulated. CT-based finite element models of a maxillary bone with dental implants were created herein. Five dental implants were placed at [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text], respectively. The remodeling progression was recorded and compared. Model [Formula: see text] (palatal side) shows the highest bone density values, but the inclined implant at [Formula: see text] (labial side) leads to significant bone loss. From a biomechanical perspective, it is speculated that a palatally inclined implant is more likely to enhance the bone density in the maxillary anterior region, but labial inclination of implant could jeopardize its stability.