Torres-San-Miguel et al 2017a - Revision history

Rimni at 14:26, 6 July 2021

2021-07-06T14:26:15Z

Show changes

Rimni: /* 2. Background, methods and materials */

2021-07-06T13:53:36Z

‎2. Background, methods and materials

Rimni: /* 2. Background, methods and materials */

2021-07-06T13:52:28Z

‎2. Background, methods and materials

Rimni at 13:43, 6 July 2021

2021-07-06T13:43:54Z

Move page script: Move page script moved page Review Torres-San-Miguel et al 2017a to Torres-San-Miguel et al 2017a

2019-02-28T11:06:44Z

Move page script moved page Review Torres-San-Miguel et al 2017a to Torres-San-Miguel et al 2017a

Rimni at 09:51, 27 February 2019

2019-02-27T09:51:06Z

Rimni at 09:49, 27 February 2019

2019-02-27T09:49:59Z

Rimni at 09:49, 27 February 2019

2019-02-27T09:49:25Z

Rimni at 09:48, 27 February 2019

2019-02-27T09:48:30Z

Rimni at 09:47, 27 February 2019

2019-02-27T09:47:46Z

@@ Line 67: / Line 67: @@
 | (b) 3D model reconstruction.
 |- style="text-align: center; font-size: 75%;"
-| colspan="2" style="padding:10px;"| '''Figure 1'''. X-Ray tomography process.
+| colspan="2" style="padding:10px;"| '''Figure 1'''. X-Ray tomography process
 |}
@@ Line 106: / Line 106: @@
 | (c) Inferior view of the mandibular bone alignment.
 |- style="text-align: center; font-size: 75%;"
-| colspan="3" style="padding:10px;"| '''Figure 2:''' Face-jaw model reconstruction.
+| colspan="3" style="padding:10px;"| '''Figure 2'''. Face-jaw model reconstruction
 |}
@@ Line 123: / Line 123: @@
 | (c) Final assembly of the implant.
 |- style="text-align: center; font-size: 75%;"
-| colspan="3" style="padding:10px;"| '''Figure 3''': A general view of the main model for the patient face deficiencies without the chin.
+| colspan="3" style="padding:10px;"| '''Figure 3'''. A general view of the main model for the patient face deficiencies without the chin
 |}
@@ Line 255: / Line 255: @@
 |style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F6.png|360px|Loading and boundary conditions at the jaw prosthesis.]]
 |- style="text-align: center; font-size: 75%;"
-| colspan="1" | '''Figure 5'''. Loading and boundary conditions at the jaw prosthesis.
+| colspan="1" | '''Figure 5'''. Loading and boundary conditions at the jaw prosthesis
 |}

@@ Line 52: / Line 52: @@
 ==2. Background, methods and materials==
-''As background, a male person around 40 years old came to an ordinary dentist appointment suffering from an apparent uncontrollable molar pain. The dentist treated the pain and took an X-Ray tomographic slice, where a bone tumour was found.'' The present research started with the X-Ray tomography study and the biopsy analysis. After an extensive evaluation, a bone cancer tumour was determined to be the cause of pain. The bone tumour had a cystic aspect, osteolytic, multi-ocular, with well-defined and clear edges, of approximately 6 cm long and 3 cm height and located at the left lower jaw size. The tumour was extracted surgically, by a mandibulectomy or jaw resection. It was necessary to place a Titanium chin support in order to avoid a collapse in the muscles and face tissue.
+''As background, a male person around 40 years old came to an ordinary dentist appointment suffering from an apparent uncontrollable molar pain. The dentist treated the pain and took an X-Ray tomographic slice, where a bone tumour was found.'' The present research started with the X-Ray tomography study and the biopsy analysis ([[#img-1|Figure 1]]). After an extensive evaluation, a bone cancer tumour was determined to be the cause of pain. The bone tumour had a cystic aspect, osteolytic, multi-ocular, with well-defined and clear edges, of approximately 6 cm long and 3 cm height and located at the left lower jaw size. The tumour was extracted surgically, by a mandibulectomy or jaw resection. It was necessary to place a Titanium chin support in order to avoid a collapse in the muscles and face tissue.
 Thus, an implant that could avoid deformation of the mandibular tissue and dropping of the face muscles, was required. It was necessary to prevent an misalignment of teeth so as to facilitate the daily activities (speech in a normal way, chewing, feeding, swallowing). This is a regular situation when facing a partial lost of the mandible bone due to the extraction of a cancer tumour.
@@ Line 67: / Line 67: @@
 | (b) 3D model reconstruction.
 |- style="text-align: center; font-size: 75%;"
-| colspan="2" style="padding:10px;"| '''Figure 1:''' X-Ray tomography process.
+| colspan="2" style="padding:10px;"| '''Figure 1'''. X-Ray tomography process.
 |}
-X-Ray tomography data allowed damage evaluation from surgical procedure, and determined the volumetric space vacancy at the lower jaw (see Figure F2a). On the other hand, ScanIp® software was used to process 400 slices, so to develop patient's head. Figure F2b shows jaw resection and a simple chin that maintains the aesthetics and functionality of the remaining third branch of the jaw.
+X-Ray tomography data allowed damage evaluation from surgical procedure, and determined the volumetric space vacancy at the lower jaw ([[#img-2|Figure 2a]]). On the other hand, ScanIp® software was used to process 400 slices, so to develop patient's head. ([[#img-2|Figure 2b]]) shows jaw resection and a simple chin that maintains the aesthetics and functionality of the remaining third branch of the jaw.
 Clinical studies of the patient were used to generate a personalised implant proposal. A review of jaw prosthesis available in the domestic and international markets allowed to establish some important parameters to be considered for the customised design of the jaw endo-prosthesis. The most important ones are:
@@ Line 90: / Line 90: @@
-It should be pointed out that jaw prosthesis service life is directly related to displacement, micro-movements and implant rotation. Thus, prostheses ought to have smooth surfaces and avoid sharp edges, in order to eliminate stress concentration into the implant and in the elements that should be used to fix the jaw prosthesis at the mandibular joint. Jaw prosthesis must be wider in the lateral direction, far away from the average mid-line face; it should not be very rigid, have enough stability to control vibrations and should anticipate particle migration from the articulate surface towards the zygomatic area. Thus, this work allows the establishment of a criterion for the development of a personalised jaw prosthesis geometry. The initial geometry for the design of the implant is taken from X-Ray tomography data, to generate the working planes necessary for each mandibular bone area, as it is shown in Figure F2a. An exterior silhouette of the main mandibular geometry was developed, from  which it was possible to obtain the bold dimensions of the implant, the main angles of the jaw and the internal relations of the condylar alignment. In the same way, a line is drawn that crosses through the centre of all the circumferences that wrap the jaw healthy body, so as to obtain the average curvature line and establish the maximum and minimum values for the teeth pieces alignment.
+It should be pointed out that jaw prosthesis service life is directly related to displacement, micro-movements and implant rotation. Thus, prostheses ought to have smooth surfaces and avoid sharp edges, in order to eliminate stress concentration into the implant and in the elements that should be used to fix the jaw prosthesis at the mandibular joint. Jaw prosthesis must be wider in the lateral direction, far away from the average mid-line face; it should not be very rigid, have enough stability to control vibrations and should anticipate particle migration from the articulate surface towards the zygomatic area. Thus, this work allows the establishment of a criterion for the development of a personalised jaw prosthesis geometry. The initial geometry for the design of the implant is taken from X-Ray tomography data, to generate the working planes necessary for each mandibular bone area, as it is shown in [[#img-2|Figure 2a]]. An exterior silhouette of the main mandibular geometry was developed, from  which it was possible to obtain the bold dimensions of the implant, the main angles of the jaw and the internal relations of the condylar alignment. In the same way, a line is drawn that crosses through the centre of all the circumferences that wrap the jaw healthy body, so as to obtain the average curvature line and establish the maximum and minimum values for the teeth pieces alignment.
 <div id='img-2a'></div>
@@ Line 127: / Line 127: @@
-In Figure 3a, a general view of the main model for the patient face deficiencies without the chin, is shown. This model is extremely important because the accuracy is a variable that delimits the success of the patient's aesthetic. As mentioned by <span id='citeF-21'></span>[[#cite-21|[21]]], the manufacture by means of stereolithography shows some significant differences, but these are clinically irrelevant; for this reason, fused deposition modelling technique was used to evaluate the behaviour and assembly of mandibular endo-prosthesis (also see Figure [[#img-3|3]]). Figure F3b shows a sagittal view, where the simulation of the implant that will be placed at the mandibular joint is featured. In Figure F3c, an inferior view of the half jaw replacement can be appreciated, which also presents a better perspective of the new jaw prosthesis. This constitutes the model that will be used for FEM analyses. The model of the implant was built up with Powersheape®software, which allowed the development of a half mirror model of the missing jaw. It also allowed the construction of anchored zones for customised implant and the alignment of posts for the placement of teeth.
+In [[#img-3|Figure 3]], a general view of the main model for the patient face deficiencies without the chin, is shown. This model is extremely important because the accuracy is a variable that delimits the success of the patient's aesthetic. As mentioned by <span id='citeF-21'></span>[[#cite-21|[21]]], the manufacture by means of stereolithography shows some significant differences, but these are clinically irrelevant; for this reason, fused deposition modelling technique was used to evaluate the behaviour and assembly of mandibular endo-prosthesis (also see [[#img-3|Figure 3]]). [[#img-3|Figure 3b]] shows a sagittal view, where the simulation of the implant that will be placed at the mandibular joint is featured. In [[#img-3|Figure 3c]], an inferior view of the half jaw replacement can be appreciated, which also presents a better perspective of the new jaw prosthesis. This constitutes the model that will be used for FEM analyses. The model of the implant was built up with Powersheape®software, which allowed the development of a half mirror model of the missing jaw. It also allowed the construction of anchored zones for customised implant and the alignment of posts for the placement of teeth.
 The jaw prosthesis was modelled with an ABS polymer before the reconstruction surgical procedure, in order to check the elements assembling. This polymer model allowed the simulation of one of the three-dimensional available designs of the jaw prosthesis. The 3D face bone model allowed the simulation of the face of the patient, so to identify areas that surgeon should cut off as well as space voids that should be filled up, thus, determining the best way to insert prosthesis. Additionally, useful information from the equipment to be used in the surgical procedure, consisting in data of the contact that should be generated to improve the union between the implant against the joint bone, were considered. In this way, it is possible to diagnose a treatment plan. This can only be possible by obtaining the anatomical model of the damaged area with X-Ray tomographic shots.
-It is important to mention, that for every clinical case, it is possible to design and develop a partial or complete prosthesis with this methodology. The later depends on patient, his pathology, patient's age and the medical surgeon indications in order to establish the best technology for the substitution of the bone structure that has been damaged. Nonetheless this advantages, our proposal results in a handcrafted procedure. Figure [[#img-3|3]] shows the use of fused deposition modelling technique to a 3D model.
+It is important to mention, that for every clinical case, it is possible to design and develop a partial or complete prosthesis with this methodology. The later depends on patient, his pathology, patient's age and the medical surgeon indications in order to establish the best technology for the substitution of the bone structure that has been damaged. Nonetheless this advantages, our proposal results in a handcrafted procedure.  [[#img-3|Figure 3]] shows the use of fused deposition modelling technique to a 3D model.
 <div id='img-4a'></div>
@@ Line 147: / Line 147: @@
 |}
-The new lower jaw implant shows a prosthesis device that should allow the patient to maintain his teeth, bite, eat, swallow, as well as a correct alignment. Figure [[#img-4|4]] shows jaw prosthesis. This device was generated from computer X-Ray tomography taken from the patient, which helped to determine specific and personal data, so to generate the optimised solution for the person. The principal advantage is the obtainment of customised prosthesis that considers the patient's morphological geometry, as well as a specific suitable fixation between condyles and chin.
+The new lower jaw implant shows a prosthesis device that should allow the patient to maintain his teeth, bite, eat, swallow, as well as a correct alignment.  [[#img-4|Figure 4]] shows jaw prosthesis. This device was generated from computer X-Ray tomography taken from the patient, which helped to determine specific and personal data, so to generate the optimised solution for the person. The principal advantage is the obtainment of customised prosthesis that considers the patient's morphological geometry, as well as a specific suitable fixation between condyles and chin.
 ===2.1 Numerical analysis===
@@ Line 176: / Line 176: @@
 |}
-where <math display="inline">K</math> refers to a physiologic constant, <math display="inline">X_{Mi}</math> refers to the muscle cross section, and <math display="inline">(EMG)_{Mi}</math> refers to the activity. The <math display="inline">K</math> value is considered as 40 N/cm<math display="inline">^2</math> <span id='citeF-23'></span>[[#cite-23|[23]]], independently of the age, sex and muscle of the person. There are studies where cross section of the muscle has been measured <span id='citeF-23'></span>[[#cite-23|[23]]]. Table [[#table-1|1]] shows average obtained values.
+where <math display="inline">K</math> refers to a physiologic constant, <math display="inline">X_{Mi}</math> refers to the muscle cross section, and <math display="inline">(EMG)_{Mi}</math> refers to the activity. The <math display="inline">K</math> value is considered as 40 N/cm<math display="inline">^2</math> <span id='citeF-23'></span>[[#cite-23|[23]]], independently of the age, sex and muscle of the person. There are studies where cross section of the muscle has been measured <span id='citeF-23'></span>[[#cite-23|[23]]].  [[#table-1|Table 1]] shows average obtained values.
 {|  class="floating_tableSCP wikitable" style="text-align: right; margin: 1em auto;min-width:50%;font-size:85%;"
 |-
 | style="text-align: left;" |          '''Muscular group'''
@@ Line 247: / Line 248: @@
 |}
-The total average chewing load for all muscles is 911.6 N. The maximum anatomical chewing load corresponds to the maximum contractile power of the muscles when they open the jaw. The chewing load is calculated based on the relation between the load developed by a skeletal muscle and the muscular cross unit area. In <span id='citeF-27'></span>[[#cite-27|[27]]], authors reported that chewing load is between 210 to 400 kg (2060.1 to 3924 N). The numerical analysis presented in this work considered diverse parameters such as average maximum loads (i.e. that the load is uniformly distributed along the chewing line) and applied elastic, isotropic and homogeneous conditions. The numerical simulation was performed in a 3D model, with high order elements with 20 nodes. Figure [[#img-5|5]] shows applied boundary conditions at the edges of jaw implant, as well as the exerted loads. The used mechanical properties are those for Titanium (ELI) Grade 5 alloy alpha beta with 6% Al and 4% V, Young’s modulus 200 GPa, Poisson relation of 0.28 and a yield strength of 900 MPa <span id='citeF-28'></span>[[#cite-28|[28]]].
+The total average chewing load for all muscles is 911.6 N. The maximum anatomical chewing load corresponds to the maximum contractile power of the muscles when they open the jaw. The chewing load is calculated based on the relation between the load developed by a skeletal muscle and the muscular cross unit area. In <span id='citeF-27'></span>[[#cite-27|[27]]], authors reported that chewing load is between 210 to 400 kg (2060.1 to 3924 N). The numerical analysis presented in this work considered diverse parameters such as average maximum loads (i.e. that the load is uniformly distributed along the chewing line) and applied elastic, isotropic and homogeneous conditions. The numerical simulation was performed in a 3D model, with high order elements with 20 nodes.  [[#img-5|Figure 5]] shows applied boundary conditions at the edges of jaw implant, as well as the exerted loads. The used mechanical properties are those for Titanium (ELI) Grade 5 alloy alpha beta with 6% Al and 4% V, Young’s modulus 200 GPa, Poisson relation of 0.28 and a yield strength of 900 MPa <span id='citeF-28'></span>[[#cite-28|[28]]].
 <div id='img-5'></div>
@@ Line 254: / Line 255: @@
 |style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F6.png|360px|Loading and boundary conditions at the jaw prosthesis.]]
 |- style="text-align: center; font-size: 75%;"
-| colspan="1" | '''Figure 5:''' Loading and boundary conditions at the jaw prosthesis.
+| colspan="1" | '''Figure 5'''. Loading and boundary conditions at the jaw prosthesis.
 |}

@@ Line 30: / Line 30: @@
 |}
 -->
 ==Abstract==

@@ Line 270: / Line 270: @@
 {| class="floating_imageSCP" style="text-align: center; border: 1px solid #BBB; margin: 1em auto; width: 80%;max-width: 80%;"
 |-
-|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F7a.png|186px|Total displacement.]]
+|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F7a.png|286px|Total displacement.]]
-|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F7b.png|186px|von Misses stress.]]
+|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F7b.png|286px|von Misses stress.]]
-|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F7c.png|186px|Strain.]]
+|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F7c.png|286px|Strain.]]
 |- style="text-align: center; font-size: 75%;"
 | (a) Total displacement.

@@ Line 302: / Line 302: @@
 <div id='img-8b'></div>
 <div id='img-8'></div>
-{| class="floating_imageSCP" style="text-align: center; border: 1px solid #BBB; margin: 1em auto; width: 100%;max-width: 100%;"
+{| class="floating_imageSCP" style="text-align: center; border: 1px solid #BBB; margin: 1em auto; width: 70%;max-width: 70%;"
 |-
-|[[Image:review_Torres-San-Miguel_et_al_2017a-F9a.png|192px|Frontal plane.]]
+|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F9a.png|192px|Frontal plane.]]
-|[[Image:review_Torres-San-Miguel_et_al_2017a-F9b.png|186px|Cross plane.]]
+|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F9b.png|186px|Cross plane.]]
 |- style="text-align: center; font-size: 75%;"
 | (a) Frontal plane.
 | (b) Cross plane.
 |- style="text-align: center; font-size: 75%;"
-| colspan="2" | '''Figure 8:''' Jaw surgery.
+| colspan="2" style="padding:10px;"| '''Figure 8:''' Jaw surgery.
 |}

← Older revision	Revision as of 11:06, 28 February 2019
(No difference)

@@ Line 268: / Line 268: @@
 <div id='img-6c'></div>
 <div id='img-6'></div>
-{| class="floating_imageSCP" style="text-align: center; border: 1px solid #BBB; margin: 1em auto; width: 100%;max-width: 100%;"
+{| class="floating_imageSCP" style="text-align: center; border: 1px solid #BBB; margin: 1em auto; width: 80%;max-width: 80%;"
 |-
-|[[Image:review_Torres-San-Miguel_et_al_2017a-F7a.png|186px|Total displacement.]]
+|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F7a.png|186px|Total displacement.]]
-|[[Image:review_Torres-San-Miguel_et_al_2017a-F7b.png|186px|von Misses stress.]]
+|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F7b.png|186px|von Misses stress.]]
-|[[Image:review_Torres-San-Miguel_et_al_2017a-F7c.png|186px|Strain.]]
+|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F7c.png|186px|Strain.]]
 |- style="text-align: center; font-size: 75%;"
 | (a) Total displacement.
@@ Line 278: / Line 278: @@
 | (c) Strain.
 |- style="text-align: center; font-size: 75%;"
-| colspan="3" | '''Figure 6:''' Maximum loading FEM results.
+| colspan="3" style="padding:10px;"| '''Figure 6:''' Maximum loading FEM results.
 |}
@@ Line 284: / Line 284: @@
 <div id='img-7'></div>
-{| class="floating_imageSCP" style="text-align: center; border: 1px solid #BBB; margin: 1em auto; width: 100%;max-width: 100%;"
+{| class="floating_imageSCP" style="text-align: center; border: 1px solid #BBB; margin: 1em auto; width: 60%;max-width: 60%;"
 |-
-|[[Image:review_Torres-San-Miguel_et_al_2017a-F8.png|270px|New half lower jaw prosthesis attache into the model.]]
+|style="padding:10px;"|[[Image:review_Torres-San-Miguel_et_al_2017a-F8.png|270px|New half lower jaw prosthesis attache into the model.]]
 |- style="text-align: center; font-size: 75%;"
-| colspan="1" | '''Figure 7:''' New half lower jaw prosthesis attache into the model.
+| colspan="1" style="padding-bottom:10px;"| '''Figure 7:''' New half lower jaw prosthesis attache into the model.
 |}

@@ Line 181: / Line 181: @@
 {|  class="floating_tableSCP wikitable" style="text-align: right; margin: 1em auto;min-width:50%;font-size:85%;"
-|+ style="font-size: 75%;" |<span id='table-1'></span>Table 1: Average values of chewing muscles <span id='citeF-23'></span>[[#cite-23|[23]]].
+|+ <span id='table-1'></span>Table 1: Average values of chewing muscles <span id='citeF-23'></span>[[#cite-23|[23]]].
 |-
 | style="text-align: left;" |          '''Muscular group'''