A study of the temporomandibular joint during bruxism

A finite element model of the temporomandibular joint (TMJ) and the human mandible was fabricated to study the effect of abnormal loading, such as awake and asleep bruxism, on the articular disc. A quasilinear viscoelastic model was used to simulate the behaviour of the disc. The viscoelastic nature of this tissue is shown to be an important factor when sustained (awake bruxism) or cyclic loading (sleep bruxism) is simulated. From the comparison of the two types of bruxism, it was seen that sustained clenching is the most detrimental activity for the TMJ disc, producing an overload that could lead to severe damage of this tissue

On the Use of Bone Remodelling Models to Estimate the Density Distribution of Bones. Uniqueness of the Solution

Bone remodelling models are widely used in a phenomenological manner to estimate numerically the distribution of apparent density in bones from the loads they are daily subjected to. These simulations start from an arbitrary initial distribution, usually homogeneous, and the density changes locally until a bone remodelling equilibrium is achieved. The bone response to mechanical stimulus is traditionally formulated with a mathematical relation that considers the existence of a range of stimulus, called dead or lazy zone, for which no net bone mass change occurs. Implementing a relation like that leads to different solutions depending on the starting density. The non-uniqueness of the solution has been shown in this paper using two different bone remodelling models: one isotropic and another anisotropic. It has also been shown that the problem of non-uniqueness is only mitigated by removing the dead zone, but it is not completely solved unless the bone formation and bone resorption rates are limited to certain maximum values.Ministerio de Economía y Competitividad DPI2013-44371-PMinisterio de Economía y Competitividad DPI2014-58233-

About kinematic consistency in the inverse dynamics problem in biomechanics

No se encuentra entidad editora.The inverse dynamic analysis is used in the study of the human gait to evaluate the reaction forces transmitted between anatomical segments and to calculate the net joint moments resulting from the muscle activity in each joint. There are two approaches well defined. In the clinical field reconstruction techniques are often applied. The errors caused, mainly, by the relative movement of the skin over the bones make that the joint centres localized in two adjacent segments do not place the same position in the space. Velocities and accelerations are obtained through numerical derivation of the position. Finally, joint moment are calculated to balance the equilibrium equations. On the other hand, the engineers employ multibody models. They apply techniques to reduce the measurement errors and to obtain kinematically consistent data up to the acceleration level and calculate reaction and driving actions by means of the Lagrange multipliers. There is no agreement about which approach provides better results. The first procedure presents errors due to the skin motion which are avoid in the second method introducing errors inherent to the model. In this work, the two approaches were compared. Dynamic residuals defined to balance the Newton's equations were used as a measure of the model goodness. A discussion about the effect of the kinematically inconsistent data on the second approach was carried out. Results highlighted that the addition to the recorded motion of kinematic constrains according to a multibody model could lead to worse results in the inverse dynamic problem

Influence of the Temporomandibular Joint in the Estimation of Bone Density in the Mandible through a Bone Remodelling Model

Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedThe temporomandibular joint (TMJ) plays a key role in the distribution of stresses in the mandible during mastication and consequently in the distribution of bone density, due to the interconnection between both variables through bone remodelling. Two finite element models of the mandible were compared to study the influence of the redistribution of stresses produced by the joint: (1) a model without TMJ, but with simplified boundary conditions to replace the joint, as done in previous models; (2) a more realistic model including the articular disc and some ligaments present in the TMJ. The stresses and strains in both models were compared through the strain energy density, used in many bone remodelling models as a measure of the mechanical stimulus. An anisotropic bone remodelling model was used to simulate the behaviour of mandible bone and to estimate its density distribution. The results showed that the TMJ strongly affects the stress distribution, the mechanical stimulus, and eventually the bone density, and not only locally in the condyle, but also in the whole mandible. It is concluded that it is utterly important to include a detailed model of the TMJ to estimate more correctly the stresses in the mandible during mastication and, from them, the bone density and anisotropy distribution

Influence of musculotendon geometry variability in muscle forces and hip bone-on-bone forces during walking

Inverse dynamics problems are usually solved in the analysis of human gait to obtain reaction forces and moments at the joints. However, these actions are not the actual forces and moments supported by the joint structure, because they do not consider the forces of the muscles acting across the joint. Therefore, to analyse bone-on bone forces it is necessary to estimate those muscle forces. Usually, this problem is addressed by means of optimization algorithms. One of the parameters required to solve this problem is the musculotendon geometry. These data are usually taken from cadavers or MRI data from several subjects, different from the analysed subject. Then, the model is scaled to the subject morphology. This procedure constitutes a source of error. The goals of this work were two. First, to perform a sensitivity analysis of the influence of muscle insertion locations on the muscle forces acting on the hip joint and on the hip joint bone-on-bone forces. Second, to compare the hip joint bone-on-bone forces during gait cycle obtained through muscle insertion locations taken from a musculoskeletal model template and a scaling procedure to those obtained from a subject-specific model using an MRI of the subject. The problem was solved using OpenSim. Results showed that anatomical variability should be analysed from two perspectives. One the one hand, throughout the gait cycle, in a global way. On the other hand, at a characteristic instant of the gait cycle. Variations of ±1 cm in the position of the attachment points of certain muscles caused variations of up to 14.21% in averaged deviation of the muscle forces and 58.96% in the peak force in the modified muscle and variations up to 57.23% in the averaged deviation of the muscle force and up to 117.23% in the peak force in the rest of muscles. Then, the influence of that variability on muscle activity patterns and hip bone-on-bone forces could be described more precisely. A biomechanical analysis of a subject-specific musculoskeletal model was carried out. Using MRI data, variations up to 5 cm in the location of the insertion points were introduced. These modifications showed significant differences between the baseline model and the customized model: within the range [-12%, 10%] for muscle forces and around 35% of body weight for hip bone-on-bone forces.Ministerio de Economía, Industria y Competitividad DPI2016-80796-P

Quasi-Linear Viscoelastic Model of the Articular Disc of the Temporomandibular Joint

A precise characterization of the articular disc of the temporomandibular joint (TMJ) is essential to study the masticatory biomechanics. The disc is responsible for the load distribution over the articular surface and for absorbing impacts during mastication. The main objective of this work is to characterize the mechanical behaviour of the articular disc under compression, the usual stress state during mastication. A quasi-linear viscoelastic (QLV) model, with a hyperelastic response for the elastic function, is proposed to describe the mechanical behaviour of the articular disc. The validity of that simplified model relies on the independence of their constants with the strain level and strain rate. The independence of the strain level was proved in a previous work. In this paper, different loading rates were tested to fully confirm the validity of the model in the physiological range of loads. Moreover, the strong non-linearity of the stress-strain relation made the exponential strain energy function the most suitable of the different models tried to represent the elastic response of the QLV model

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Análisis geométricamente no lineal en dinámica de mecanismos flexibles

El comportamiento dinámico de los mecanismos flexibles es difícil de modelar, debido a la existencia de rotaciones finitas aparecen términos geométricamente no lineales, además de estar acoplados tanto movimiento de sólido rígido con el debido a las deformaciones elásticas como el desplazamiento longitudinal y transversal elásticos a través de la rotación de sólido rígido. A todos estos efectos se suma, en determinadas aplicaciones, la aparición de grandes desplazamientos elásticos o fuerzas axiales altas, que introducen nuevo término geométricamente no lineales en las ecuaciones del movimiento. En esta tesis se han desarrollado dos nuevas formulaciones, con un mayor grado de aproximación que la existentes en la literatura dependiendo del sistema de coordenadas elegido, las no linealidades geométricas parecen en los términos de rigidez o en los de variando sustancialmente la eficacia computacional y estacionalidad del método

Dinámica de mecanismos sensibles: no-linealidades geométricas

En Dinámica de mecanismos flexibles las vibraciones longitudinales y transversales están acopladas aún cuando se utiliza una teoría elástica lineal