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A comparative study on complete and implant retained denture treatments: a biomechanics perspective

Chen J, Ahmad R, Suenaga H, Li W, Swain M, Li Q

J Biomech, 2015 Feb 5;48(3):512-9.
PMID: 25560272 DOI: 10.1016/j.jbiomech.2014.11.043

Although implant-retained overdenture allows edentulous patients to take higher occlusal forces than the conventional complete dentures, the biomechanical influences have not been explored yet. Clinically, there is limited knowledge and means for predicting localized bone remodelling after denture treatment with and without implant support. By using finite element (FE) analysis, this article provides an in-silico approach to exploring the treatment effects on the oral mucosa and potential resorption of residual ridge under three different denture configurations in a patient-specific manner. Based on cone beam computerized tomography (CBCT) scans, a 3D heterogeneous FE model was created; and the supportive tissue, mucosa, was characterized as a hyperelastic material. A measured occlusal load (63N) was applied onto three virtual models, namely complete denture, two and four implant-retained overdentures. Clinically, the bone resorption was measured after one year in the two implant-retained overdenture treatment. Despite the improved stability and enhanced masticatory function, the implant-retained overdentures demonstrated higher hydrostatic stress in mucosa (43.6kPa and 39.9kPa for two and four implants) at the posterior ends of the mandible due to the cantilever effect, than the complete denture (33.4kPa). Hydrostatic pressure in the mucosa signifies a critical indicator and can be correlated with clinically measured bone resorption, pointing to severer mandibular ridge resorption posteriorly with implant-retained overdentures. This study provides a biomechanical basis for denture treatment planning to improve long-term outcomes with minimal residual ridge resorption.
Extracellular matrix integrity affects the mechanical behaviour of in-situ chondrocytes under compression

Moo EK, Han SK, Federico S, Sibole SC, Jinha A, Abu Osman NA, et al.

J Biomech, 2014 Mar 21;47(5):1004-13.
PMID: 24480705 DOI: 10.1016/j.jbiomech.2014.01.003

Cartilage lesions change the microenvironment of cells and may accelerate cartilage degradation through catabolic responses from chondrocytes. In this study, we investigated the effects of structural integrity of the extracellular matrix (ECM) on chondrocytes by comparing the mechanics of cells surrounded by an intact ECM with cells close to a cartilage lesion using experimental and numerical methods. Experimentally, 15% nominal compression was applied to bovine cartilage tissues using a light-transmissible compression system. Target cells in the intact ECM and near lesions were imaged by dual-photon microscopy. Changes in cell morphology (N(cell)=32 for both ECM conditions) were quantified. A two-scale (tissue level and cell level) Finite Element (FE) model was also developed. A 15% nominal compression was applied to a non-linear, biphasic tissue model with the corresponding cell level models studied at different radial locations from the centre of the sample in the transient phase and at steady state. We studied the Green-Lagrange strains in the tissue and cells. Experimental and theoretical results indicated that cells near lesions deform less axially than chondrocytes in the intact ECM at steady state. However, cells near lesions experienced large tensile strains in the principal height direction, which are likely associated with non-uniform tissue radial bulging. Previous experiments showed that tensile strains of high magnitude cause an up-regulation of digestive enzyme gene expressions. Therefore, we propose that cartilage degradation near tissue lesions may be due to the large tensile strains in the principal height direction applied to cells, thus leading to an up-regulation of catabolic factors.
Dual photon excitation microscopy and image threshold segmentation in live cell imaging during compression testing

Moo EK, Abusara Z, Abu Osman NA, Pingguan-Murphy B, Herzog W

J Biomech, 2013 Aug 9;46(12):2024-31.
PMID: 23849134 DOI: 10.1016/j.jbiomech.2013.06.007

Morphological studies of live connective tissue cells are imperative to helping understand cellular responses to mechanical stimuli. However, photobleaching is a constant problem to accurate and reliable live cell fluorescent imaging, and various image thresholding methods have been adopted to account for photobleaching effects. Previous studies showed that dual photon excitation (DPE) techniques are superior over conventional one photon excitation (OPE) confocal techniques in minimizing photobleaching. In this study, we investigated the effects of photobleaching resulting from OPE and DPE on morphology of in situ articular cartilage chondrocytes across repeat laser exposures. Additionally, we compared the effectiveness of three commonly-used image thresholding methods in accounting for photobleaching effects, with and without tissue loading through compression. In general, photobleaching leads to an apparent volume reduction for subsequent image scans. Performing seven consecutive scans of chondrocytes in unloaded cartilage, we found that the apparent cell volume loss caused by DPE microscopy is much smaller than that observed using OPE microscopy. Applying scan-specific image thresholds did not prevent the photobleaching-induced volume loss, and volume reductions were non-uniform over the seven repeat scans. During cartilage loading through compression, cell fluorescence increased and, depending on the thresholding method used, led to different volume changes. Therefore, different conclusions on cell volume changes may be drawn during tissue compression, depending on the image thresholding methods used. In conclusion, our findings confirm that photobleaching directly affects cell morphology measurements, and that DPE causes less photobleaching artifacts than OPE for uncompressed cells. When cells are compressed during tissue loading, a complicated interplay between photobleaching effects and compression-induced fluorescence increase may lead to interpretations in cell responses to mechanical stimuli that depend on the microscopic approach and the thresholding methods used and may result in contradictory interpretations.
Biomechanical evaluation of the relationship between postural control and body mass index

Ku PX, Abu Osman NA, Yusof A, Wan Abas WA

J Biomech, 2012 Jun 1;45(9):1638-42.
PMID: 22507349 DOI: 10.1016/j.jbiomech.2012.03.029

Postural stability is crucial in maintaining body balance during quiet standing, locomotion, and any activities that require a high degree of balance performance, such as participating in sports and dancing. Research has shown that there is a relationship between stability and body mass. The aims of this study were to examine the impact that two variables had on static postural control: body mass index (BMI) and gender. Eighty healthy young adults (age=21.7±1.8 yr; height=1.65±0.09 m; mass=67.5±19.0 kg) participated in the study and the static postural control was assessed using the Biodex Balance System, with a 20 Hz sampling rate in the bipedic stance (BLS) and unipedic stance (ULS) for 30s. Five test evaluations were performed for each balance test. Postural control was found to be negatively correlated with increased adiposity, as the obese BMI group performed significantly poorer than the underweight, normal weight and overweight groups during BLS and ULS tests. The underweight, normal weight and overweight groups exhibited greater anterior-posterior stability in postural control during quiet stance. In addition, female displayed a trend of having a greater postural sway than male young adults, although it was evidenced in only some BMI groups. This study revealed that BMI do have an impact on postural control during both BLS and ULS. As such, BMI and gender-specific effects should be taken into consideration when selecting individuals for different types of sporting activities, especially those that require quiet standing.
Biomechanical characterisation of ovine spinal facet joint cartilage

Abd Latif MJ, Jin Z, Wilcox RK

J Biomech, 2012 May 11;45(8):1346-52.
PMID: 22483055 DOI: 10.1016/j.jbiomech.2012.03.015

The spinal facet joints are known to be an important component in the kinematics and the load transmission of the spine. The articular cartilage in the facet joint is prone to degenerative changes which lead to back pain and treatments for the condition have had limited long term success. There is currently a lack of information on the basic biomechanical properties of the facet joint cartilage which is needed to develop tissue substitution or regenerative interventions. In the present study, the thickness and biphasic properties of ovine facet cartilage were determined using a combination of indentation tests and computational modelling. The equilibrium biphasic Young's modulus and permeability were derived to be 0.76±0.35 MPa and 1.61±1.10×10⁻¹⁵ m⁴/(Ns) respectively, which were within the range of cartilage properties characterised from the human synovial joints. The average thickness of the ovine facet cartilage was 0.52±0.10 mm, which was measured using a needle indentation test. These properties could potentially be used for the development of substitution or tissue engineering interventions and for computational modelling of the facet joint. Furthermore, the developed method to characterise the facet cartilage could be used for other animals or human donors.
Identifying gait asymmetry using gyroscopes--a cross-correlation and Normalized Symmetry Index approach

Gouwanda D, Senanayake SM

J Biomech, 2011 Mar 15;44(5):972-8.
PMID: 21306714 DOI: 10.1016/j.jbiomech.2010.12.013

Injury to a lower limb may disrupt natural walking and cause asymmetrical gait, therefore assessing the gait asymmetry has become one of the important procedures in gait analysis. This paper proposes the use of wireless gyroscopes as a new instrument to determine gait asymmetry. It also introduces two novel approaches: normalized cross-correlations (Cc(norm)) and Normalized Symmetry Index (SI(norm)). Cc(norm) evaluates the waveform patterns generated by the lower limb in each gait cycle. SI(norm) provides indications on the timing and magnitude of the bilateral differences between the limbs while addressing the drawbacks of the conventional methods. One-way ANOVA test reveals that Cc(norm) can be considered as single value indicator that determines the gait asymmetry (p<0.01). The experiment results showed that SI(norm) in asymmetrical gait were different from normal gait. SI(norm) in asymmetrical gait were found to be approximately 20% greater than SI(norm) in normal gait during pre-swing and initial swing.
A comparison of two global positioning system devices for team-sport running protocols

Willmott AGB, James CA, Bliss A, Leftwich RA, Maxwell NS

J Biomech, 2019 01 23;83:324-328.
PMID: 30563764 DOI: 10.1016/j.jbiomech.2018.11.044

The comparability and reliability of global positioning system (GPS) devices during running protocols associated with team-sports was investigated. Fourteen moderately-trained males completed 690 m of straight-line movements, a 570 m change of direction (COD) course and a 642.5 m team-sport simulated circuit (TSSC); on two occasions. Participants wore a FieldWiz GPS device and a Catapult MinimaxX S4 10-Hz GPS device. Typical error of measurement (TE) and coefficient of variation (CV%) were calculated between GPS devices, for the variables of total distance and peak speed. Reliability comparisons were made within FieldWiz GPS devices, between sessions. Small TE were observed between FieldWiz and Catapult GPS devices for total distance and peak speed during straight-line (16.9 m [2%], 1.2 km·h-1 [4%]), COD (31.8 m [6%], 0.4 km·h-1 [2%]) and TSSC protocols (12.9 m [2%], 0.5 km·h-1 [2%]), respectively, with no significant mean bias (p > 0.05). Small TE were also observed for the FieldWiz GPS device between sessions (p > 0.05) for straight-line (9.6 m [1%], 0.2 km·h-1 [1%]), COD (12.8 m [2%], 0.2 km·h-1 [1%]) and TSSC protocols (6.9 m [1%], 0.6 km·h-1 [2%]), respectively. Data from the FieldWiz GPS device appears comparable to established devices and reliable across a range of movement patterns associated with team-sports.
In search of sports biomechanics' holy grail: Can athlete-specific optimum sports techniques be identified?

Glazier PS, Mehdizadeh S

J Biomech, 2019 Sep 20;94:1-4.
PMID: 31427095 DOI: 10.1016/j.jbiomech.2019.07.044

The development of methods that can identify athlete-specific optimum sports techniques-arguably the holy grail of sports biomechanics-is one of the greatest challenges for researchers in the field. This 'perspectives article' critically examines, from a dynamical systems theoretical standpoint, the claim that athlete-specific optimum sports techniques can be identified through biomechanical optimisation modelling. To identify athlete-specific optimum sports techniques, dynamical systems theory suggests that a representative set of organismic constraints, along with their non-linear characteristics, needs to be identified and incorporated into the mathematical model of the athlete. However, whether the athlete will be able to adopt, and reliably reproduce, his/her predicted optimum technique will largely be dependent on his/her intrinsic dynamics. If the attractor valley corresponding to the existing technique is deep, or if the attractor valleys corresponding to the existing technique and the predicted optimum technique are in different topographical regions of the dynamic landscape, technical modifications may be challenging or impossible to reliably implement even after extended practice. The attractor layout defining the intrinsic dynamics of the athlete, therefore, needs to be determined to establish the likelihood of the predicted optimum technique being reliably attainable by the athlete. Given the limited set of organismic constraints typically used in mathematical models of athletes, combined with the methodological challenges associated with mapping the attractor layout of an athlete, it seems unlikely that athlete-specific optimum sports techniques will be identifiable through biomechanical optimisation modelling for the majority of sports skills in the near future.
Iliotibial band tension affects patellofemoral and tibiofemoral kinematics

Merican AM, Amis AA

J Biomech, 2009 Jul 22;42(10):1539-1546.
PMID: 19481211 DOI: 10.1016/j.jbiomech.2009.03.041

The iliotibial band (ITB) has an important role in knee mechanics and tightness can cause patellofemoral maltracking. This study investigated the effects of increasing ITB tension on knee kinematics. Nine fresh-frozen cadaveric knees had the components of the quadriceps loaded with 175 N. A Polaris optical tracking system was used to acquire joint kinematics during extension from 100 degrees to 0 degrees flexion. This was repeated after the following ITB loads: 30, 60 and 90 N. There was no change with 30 N load for patellar translation. On average, at 60 and 90 N, the patella translated laterally by 0.8 and 1.4mm in the mid flexion range compared to the ITB unloaded condition. The patella became more laterally tilted with increasing ITB loads by 0.7 degrees, 1.2 degrees and 1.5 degrees for 30, 60 and 90 N, respectively. There were comparable increases in patellar lateral rotation (distal patella moves laterally) towards the end of the flexion cycle. Increased external rotation of the tibia occurred from early flexion onwards and was maximal between 60 degrees and 75 degrees flexion. The increase was 5.2 degrees, 9.5 degrees and 13 degrees in this range for 30, 60 and 90 N, respectively. Increased tibial abduction with ITB loads was not observed. The combination of increased patellar lateral translation and tilt suggests increased lateral cartilage pressure. Additionally, the increased tibial external rotation would increase the Q angle. The clinical consequences and their relationship to lateral retinacular releases may be examined, now that the effects of a tight ITB are known.
Order error in the calculation of continuous relative phase

Mehdizadeh S, Glazier PS

J Biomech, 2018 05 17;73:243-248.
PMID: 29628131 DOI: 10.1016/j.jbiomech.2018.03.032

The aims of this study were to demonstrate "order error" in the calculation of continuous relative phase (CRP) and to suggest two alternative methods-(i) constructing phase-plane portraits by plotting position over velocity; and (ii), the Hilbert transform-to rectify it. Order error is the change of CRP order between two degrees of freedom (e.g., body segments) when using the conventional method of constructing phase-plane portraits (i.e., velocity over position). Both sinusoidal and non-sinusoidal simulated signals as well as signals from human movement kinematics were used to investigate order error and the performance of the two alternative methods. Both methods have been shown to lead to correct results for simulated sinusoidal and non-sinusoidal signals. For human movement data, however, the Hilbert transform is superior for calculating CRP.
Patellar tendon in vivo regional strain with varying knee angle

Pearson SJ, Mohammed ASA, Hussain SR

J Biomech, 2017 08 16;61:45-50.
PMID: 28736078 DOI: 10.1016/j.jbiomech.2017.06.038

PURPOSE: Descriptive data on the aspects of site specific in vivo tendon strain with varying knee joint angle are non-existent. The present study determines and compares surface and deep layer strain of the patellar tendon during isometric contractions across a range of knee joint angles.
METHODS: Male participants (age 22.0±3.4) performed ramped isometric knee extensions at knee joint angles of 90°, 70°, 50° and 30° of flexion. Strain patterns of the anterior and posterior regions of the patellar tendon were determined using real-time B-mode ultrasonography at each knee joint angle. Regional strain measures were compared using an automated pixel tracking method.
RESULTS: Strain was seen to be greatest for both the anterior and posterior regions with the knee at 90° (7.76±0.89% and 5.06±0.76%). Anterior strain was seen to be significantly greater (p<0.05) than posterior strain for all knee angles apart from 30°, 90°=(7.76vs. 5.06%), 70°=(4.77vs. 3.75%), and 50°=(3.74vs. 2.90%). The relative strain (ratio of anterior to posterior), was greatest with the knee joint angle at 90°, and decreased as the knee joint angle reduced.
CONCLUSIONS: The results from this study indicate that not only are there greater absolute tendon strains with the knee in greater flexion, but that the knee joint angle affects the regional strain differentially, resulting in greater shear between the tendon layers with force application when the knee is in greater degrees of flexion. These results have important implications for rehabilitation and training.
Estimation of vertical ground reaction force during running using neural network model and uniaxial accelerometer

Ngoh KJ, Gouwanda D, Gopalai AA, Chong YZ

J Biomech, 2018 07 25;76:269-273.
PMID: 29945786 DOI: 10.1016/j.jbiomech.2018.06.006

Wearable technology has been viewed as one of the plausible alternatives to capture human motion in an unconstrained environment, especially during running. However, existing methods require kinematic and kinetic measurements of human body segments and can be complicated. This paper investigates the use of neural network model (NN) and accelerometer to estimate vertical ground reaction force (VGRF). An experimental study was conducted to collect sufficient samples for training, validation and testing. The estimated results were compared with VGRF measured using an instrumented treadmill. The estimates yielded an average root mean square error of less than 0.017 of the body weight (BW) and a cross-correlation coefficient greater than 0.99. The results also demonstrated that NN could estimate impact force and active force with average errors ranging between 0.10 and 0.18 of BW at different running speeds. Using NN and uniaxial accelerometer can (1) simplify the estimation of VGRF, (2) reduce the computational requirement and (3) reduce the necessity of multiple wearable sensors to obtain relevant parameters.
Effect of noise and filtering on largest Lyapunov exponent of time series associated with human walking

Mehdizadeh S, Sanjari MA

J Biomech, 2017 11 07;64:236-239.
PMID: 28958634 DOI: 10.1016/j.jbiomech.2017.09.009

This study aimed to determine the effect of added noise, filtering and time series length on the largest Lyapunov exponent (LyE) value calculated for time series obtained from a passive dynamic walker. The simplest passive dynamic walker model comprising of two massless legs connected by a frictionless hinge joint at the hip was adopted to generate walking time series. The generated time series was used to construct a state space with the embedding dimension of 3 and time delay of 100 samples. The LyE was calculated as the exponential rate of divergence of neighboring trajectories of the state space using Rosenstein's algorithm. To determine the effect of noise on LyE values, seven levels of Gaussian white noise (SNR=55-25dB with 5dB steps) were added to the time series. In addition, the filtering was performed using a range of cutoff frequencies from 3Hz to 19Hz with 2Hz steps. The LyE was calculated for both noise-free and noisy time series with different lengths of 6, 50, 100 and 150 strides. Results demonstrated a high percent error in the presence of noise for LyE. Therefore, these observations suggest that Rosenstein's algorithm might not perform well in the presence of added experimental noise. Furthermore, findings indicated that at least 50 walking strides are required to calculate LyE to account for the effect of noise. Finally, observations support that a conservative filtering of the time series with a high cutoff frequency might be more appropriate prior to calculating LyE.
The limits of stability and muscle activity in middle-aged adults during static and dynamic stance

Ku PX, Abu Osman NA, Wan Abas WAB

J Biomech, 2016 Dec 08;49(16):3943-3948.
PMID: 27865478 DOI: 10.1016/j.jbiomech.2016.11.006

Balance control plays an important role in maintaining daily activity. However, studies on postural control among middle-aged adults are scarce. This study aims (i) to examine directional control (DCL) and electromyography activity (EMG) for different stability levels, and (ii) to determine left-right asymmetry for DCL and muscle activity among sedentary middle-aged adults. Twenty healthy, middle-aged adults (10 males, 10 females; age=50.0±7.5yrs; body height: 1.61±0.10m; body mass: 70.0±14.5kg) participated in the study. EMG for left and right side of rectus femoris (RF), biceps femoris (BF), and medial gastrocnemius (MG) were recorded. Two-way repeated measures analysis of variance was used to assess the effect of dynamic level on DCL and EMG, whereas independent sample t-test was conducted to analyse the asymmetries of DCL and EMG for the left and right leg. When the dynamic tilt surface increased, DCL scores significantly decreased (except forward, forward-rightward, and backward-leftward direction) and only RF muscle indicated significant differences. Left-right asymmetry was found in BF and MG muscles. No significant gender difference was observed in DCL and EMG. These data demonstrated that increased dynamic tilt surface may increase the displacement of center of pressure of certain directions, and stimulate RF activity in dynamic stance among sedentary middle-aged adults. Further studies should be conducted to examine the dynamic stance and muscle activity of the lower limb in age-matched patient groups with balance abnormalities.

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