title: Simulation of multi-stage nonlinear bone remodeling induced by fixed partial dentures of different configurations: a comparative clinical and numerical study.
abstract: This paper aimed to develop a clinically validated bone remodeling algorithm by integrating bone's dynamic properties in a multi-stage fashion based on a four-year clinical follow-up of implant treatment. The configurational effects of fixed partial dentures (FPDs) were explored using a multi-stage remodeling rule. Three-dimensional real-time occlusal loads during maximum voluntary clenching were measured with a piezoelectric force transducer and were incorporated into a computerized tomography-based finite element mandibular model. Virtual X-ray images were generated based on simulation and statistically correlated with clinical data using linear regressions. The strain energy density-driven remodeling parameters were regulated over the time frame considered. A linear single-stage bone remodeling algorithm, with a single set of constant remodeling parameters, was found to poorly fit with clinical data through linear regression (low [Formula: see text] and R), whereas a time-dependent multi-stage algorithm better simulated the remodeling process (high [Formula: see text] and R) against the clinical results. The three-implant-supported and distally cantilevered FPDs presented noticeable and continuous bone apposition, mainly adjacent to the cervical and apical regions. The bridged and mesially cantilevered FPDs showed bone resorption or no visible bone formation in some areas. Time-dependent variation of bone remodeling parameters is recommended to better correlate remodeling simulation with clinical follow-up. The position of FPD pontics plays a critical role in mechanobiological functionality and bone remodeling. Caution should be exercised when selecting the cantilever FPD due to the risk of overloading bone resorption.
authors.affiliation: School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Zhipeng
authors.initials: Z
authors.lastname: Liao
authors.affiliation: Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 9808575, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yoda
authors.affiliation: Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Am Mühlenberg 1, 14476, Potsdam, Germany.
authors.forename: Junning
authors.initials: J
authors.lastname: Chen
authors.affiliation: School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Keke
authors.initials: K
authors.lastname: Zheng
authors.affiliation: Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 9808575, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Swain
authors.affiliation: School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW, 2006, Australia. qing.li@sydney.edu.au.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
mesh_terms: D000465:Algorithms; D016723:Bone Remodeling; D003198:Computer Simulation; D003830:Denture, Partial, Fixed / Q000706:statistics & numerical data*; D006801:Humans; D008954:Models, Biological
keywords: Cantilever fixed partial denture; Multi-stage remodeling algorithm; Nonlinear bone remodeling; Occlusal loads; Overloading bone resorption