Application of the Finite Element Method in Implant Dentistry
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However, indirect validation may be unavoidable in FEA because no concrete biological outcome can be directly attributed to most FEA studies of force distribution; thus, it is difficult to generate outcome data for comparison with experimental data. Therefore, FEA studies should include a validation method to prove the close similarity of the results to the actual clinical situation. The purpose of this literature review of FEA studies was to examine their model validation process and establish the criteria for evaluating validation methods with respect to their similarity to biological behavior.
All studies included in this review eligibility criteria were FEA studies of the stress distribution of dental implants and surrounding bone using any type of validation method, and all were published in English. The selected articles were then read and summarized, and the validation techniques used in each article were assessed and categorized in a hierarchy Fig.
Flowchart of literature review. These articles were all FEA studies published from to Hierarchy of validations based on their similarity to real biomechanical behaviors. Proportion of dental implant FEA articles with a validation. Left Among totally FEA articles of dental implants which we were able to access English full text up to January , there are only 47 articles with a validation. Based on the validation methods described in the articles, the top portion of the validation hierarchy comprised studies that used a customized clinical method in a human for validation [ 10 ].
The next level of the hierarchy comprised studies that used models for validation, including animal models [ 11 , 12 , 13 ] and mechanical experiments. Mechanical experiments were divided according to the material used for bone models and the techniques used for testing those models. The materials were divided into homogenous bone, heterogeneous bone, and artificial materials such as acrylic, polyurethane, plastic bone material, and others.
Various validation methods were used in studies that employed mechanical testing of bone models using these specific artificial materials, such as digital image correction [ 11 ], photo-elastic stress analysis [ 15 ], and use of a strain gauge test attached to a model this was the most commonly used method, described in 15 of 48 articles. These techniques also involved measurement of the implant displacement and fatigue testing of an implant body.
The next level of the hierarchy comprised studies that used literature or clinical data from other articles to compare with results of FEA. The final level comprised studies that used other computer software for support but did not perform an actual experiment. We classified all validation processes based on their similarity to real biomechanical behaviors into the following hierarchy levels A to G Fig.
The top level of the hierarchy, level A, includes in vivo methods of FEA validation conducted in humans. In , Heckmann et al. They used a computer-aided design CAD model of an implant embedded in a bone block for FEA, and strain gauge experiments were performed under the same loading conditions with the use of a resin bone model and a human being for validation.
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Three studies conducted animal experiments for FEA validation. In , Hou et al. In , Natali et al. Similarly, in , Cha et al.
finite element analysis of dental implant
The next two levels in the hierarchy comprised in vivo model experiments on a section of a cadaver level C and the bone of heterogeneous animals level D. Most of these studies involved mechanical testing, such as recording strain by a strain gauge attached to a dry skull or a section of bovine, porcine, or sheep bone.
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Bardyn et al. Olsen et al. Additionally, in , Huang et al. The resonance frequency was compared between the two techniques, but in this case, FEA seemed more likely to serve as a validation technique to support the results of the model experiment.
Finite Elements Method in Implant Prosthetics
Level E includes the use of special materials and specific methods to measure the force distribution and photoelastic resin as well as a technique called digital image correlation described by Tiossi et al. Comparisons of these artificial materials is difficult because it is challenging to determine how much more accurate one technique is over another technique. Even after subcategorizing the techniques from E1 to E5, we found that no one technique was superior to any other.
The last level, level G, includes validation performed by another type of computer software such as two-dimensional FEA, i. The use of FEA for dental implants and surrounding bone has increased during the past few decades.
However, FEA studies of implants using validation experiments are comparatively rare. While prior studies had effectively outlined the importance of validation in biomechanical FEA, no reviews of studies that applied validation to computational biomechanics of dental implants have been performed.
According to these studies, we established a hierarchy based on the evidence level of the validations A to G, i. Many recent papers [ 10 , 11 , 12 , 14 , 15 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 35 , 36 , 39 , 41 , 42 , 43 , 44 , 45 , 47 , 48 , 50 , 51 , 52 , 54 , 55 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ] have described the use of FEA to evaluate the stress distribution of implant fixtures and surrounding bone, with a particular focus on different fixture lengths, shapes, connection designs, and prostheses.
The following questions are worthy of consideration by oral scientists and clinicians: Can a finite element model really create a virtual condition simulating the biomechanical behavior of the craniomandibular system? To what extent can we predict biological activities with finite element models [ 9 ]? The complexity of living organisms and internal biological phenomena is impossible to fully and precisely duplicate with individual-level specificity using a computer. However, we can evaluate the limitations of current technology and build a model with the highest level of evidence possible.
Because of the limitations of computer technology, most FEA models [ 75 , 76 , 77 , 78 , 79 ] simplify the skeletal muscle architecture in terms of a uniform fiber length, pennation angle, and line of action and represent the architecture using a Hill-based muscle model. However, how well the modeling of skeletal muscles as one-dimensional strings represents the behavior of the full three-dimensional muscles remains unknown. Reducing the complexity of the muscles to strings entirely neglects the variations in muscle density deformation and structure during the complex movement of real muscle specimens, which is difficult to acquire.
This review focused on validation of FEA and established a hierarchy of validation techniques from high to low as a reference for further FEA studies. However, due to the limitations of this study, the boundary conditions and finite element method FEM settings were not considered. For example, some research may have involved high-level validation performed in vivo, but the original FEM model was built by CAD using only a simple flat two-layer bone and without any model verification.
Some other studies used a simulated bone computed tomography data from homogeneous, heterogeneous, or artificial materials as an FEM geometry reference and performed the validation on that material only, without seeking to perform validation using a more realistic material.
Both the use of a detailed, accurate model that closely resembles the real condition and the performance of validation to prove its accuracy are important.
As computer technology has progressed, model verification has become more sophisticated and complicated; however, validation still should not be ignored. While conducting this review, we also considered future efforts. There are two types of FEA studies: time-dependent studies, which have a validity period within which the process must take place, and time-independent studies, which have no validity period but only analyze the stress distribution at a single point in time.
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Maeda and Wood [ 80 ] simulated a bone-dependent bone resorption process using an FEM model and shape-optimization algorithm. To explain or analyze the mechanical properties involved in biological phenomena such as motor tasks mastication, walking, or heart contraction , a time-dependent finite element model may provide a more realistic view. However, if time-dependent performance criteria are considered the most common is to clarify the influence of musculoskeletal structure on function or the performance of a motor task , dynamic optimization and boundary conditions are required.
This means that a much more complex model including many parameters and properties must be built, despite some of these real-world physiological data being unknown. This difficulty may explain why time-dependent models of mastication for FEA are rare. High-level validation of FEA using in vivo experiments is still rare in the dental implant field.
Application of finite element analysis in implant dentistry: a review of the literature.
It is necessary to clearly indicate the validation process of the model when a study using FEA is presented. The hierarchy proposed in this study based on the evidence level of the validations can be applied to evaluate the clinical significance of studies using FEA. Application of the finite element method in dental implant research.
Comput Methods Biomech Biomed Engin. The prosthetic influence and biomechanics on peri-implant strain: a systematic literature review of finite element studies. J Oral Maxillofac Res. Gass SI. Decision-adding models: validation, assessment and related issues for policy analysis. Oper Res. Requirements for comparing the performance of finite element models of biological structures.
J Theor Biol. Hannam AG. FEA analysis to be run on a relatively normal Von Mises stress. The von Mises criterion is reduces degrees of freedom from infinite to computer, but it also sometimes tends to a formula for calculating whether the stress finite with the help of discretization i. For two- combination at a given point will cause meshing nodes and elements as shown in dimensional analysis, the element shapes failure.
Figure 3 . Three- equivalent stress, which is then compared to dimensional meshing dimensional modeling produces more the yield stress of the material Figure 7. A considerable factor of ignorance can remain as to whether the structure will be adequate for all design loads. Significant changes in designs involve risk. Designs will require prototypes to be built and field tested. The field tests may involve expensive strain gauging to evaluate strength and deformation. With FEA, the weight of a design can be minimized, and there can be a reduction in the number of prototypes built.
Field testing will be used to establish loading on structures, which can be used to do future design improvements via FEA . Applications of finite element analysis in dentistry? FEA has been applied for the description of form changes in biological structures Fig 5: 2-D FEA Effect of tensile load around implant morphometrics , especially in the area of growth and development [16,17]. The knowledge of physiological values of alveolar stresses is important for the understanding of stress related bone remodeling and also provides a guideline reference for the design of dental implants .
FEA is also useful for designing and studying structures with inherent material homogeneity and potentially complicated shapes such as dental implants .