Objective To assess the influence of antioxidants (sodium ascorbate - SA, epigallocatechin-3-gallate (EGCG) from Camellia sinensis and punicalagin from Punica granatum) or lasers (Er:YAG and diode) on bleached dentin. Methods Four hundred and forty slabs of intracoronary dentin were prepared: 224 for bond strength (debonding test) (n = 14), 96 for chemical analysis (EDS) and morphology (SEM) (n = 6), 96 for interface analysis (n = 6) and 24 for atomic force microscopy (AFM). The slabs were distributed according to the post-treatment after bleaching (35% hydrogen peroxide): GI- no bleaching and no post-treatment, GII- only bleached, GIII- 10-days delay in restorative procedure, GIV- 10% SA (10 min), GV- 0.5% EGCG (10 min), GVI- 0.5% punicalagin (10 min), GVII- Er:YAG laser (0.80W, 20s) and GVIII- diode laser (1.5W, 20s). Restorative procedures were done. Half of the slabs were analyzed immediately and the others, after 12 months. Debonding and AFM data were analyzed by ANOVA and Tukey tests (α = 0.05). Results All the post-treatments, except for punicalagin, reestablished the immediate bond strength, similar to those restored after 10 days (p > 0.05). Following degradation, EGCG and punicalagin reestablished the bond strength (p < 0.05). Lasers were not effective in maintaining the bond strength after 12 months (p < 0.05). Higher O levels were found after bleaching but were reduced overtime. Ca and P remained stable. SEM and AFM showed residual granules of SA and irregular surface due to the laser action. After aging, tags and good interface were verified in GI, GIII, GV and GVI. Conclusion Sodium ascorbate, EGCG or lasers restored the immediate bond strength, but only the natural extracts were effective in the long-term durability of resin. Thus, EGCG at 0.5% for 10 min seems to be the best pre-restorative treatment for bleached substrate.

The objective of this study was to assess the influence of filling techniques on residual polymerization stresses in resin composite restorations of the tooth. Flat planes were ground in buccal enamel surfaces of extracted human premolars, followed by preparing Class II cavities. Indentation cracks were introduced in the planes and crack lengths were measured mesio-distally (x-direction) and cervico-incisally (y-direction). Cavities were filled with a resin composite and an adhesive using three methods; one with bulk filling and two with differing incremental filling techniques. The x- and y-tensile stresses were calculated from crack lengths measured repeatedly over 360 min after filling. Elastic modulus and polymerization shrinkage of the composite were also measured. Filling technique and time after fillings were statistically significant only for the y-stress. The incremental techniques generated smaller stresses than the bulk filling. The stresses developed for 60 min after filling, while the modulus and the shrinkage stopped developing within 10 min and 2 min after irradiation, respectively. The incremental technique, in which the proximal portion of the cavity was filled first, was effective in decreasing the residual tensile stress generated by the polymerization of resin composite.

Study design Cadaveric biomechanical with imaging analysis. Objective This study aims to compare the fixation failure between pedicel screws (PS) and cortical screws (CS), thus to investigate their failure mechanisms under vertical migration. Summary of background data Due to their minimal invasive nature, CS are gaining popularity. However, contradictions exist in the literature regarding whether CS may have superior fixation failure resistance compared to PS under vertical migration. Methods Human vertebral specimens were examined under Dual-energy X-ray. For each specimen, PS were inserted on the left and CS on the right with rods secured. Vertical force-displacement tests were applied to rods. MicroCT images were taken pre and post-MTS® for microstructural analysis. Results The average T-scores of the specimens were −4±0.25. Three phases of force-displacement behaviour featuring different PS and CS failure-resistance were discovered. For phase I, the force required to migrate PS tended to be slightly higher than CS. However, during phase II, a fixation instability occurred for PS and the CS fixation strength was superior. For phase III under large displacement, CS did not require increased force to displace, whereas PS re-stabilised and revealed improved displacement resistance. Both force analysis and microstructural analysis indicated that PS migrated along the direction of the vertical loading, whereas CS had a force component in the longitudinal axis of the screw. Conclusions Different failure mechanisms underlay PS and CS under large vertical displacement. PS fail with trabecular bone compaction possibly altering the initial material property surround the screw. CS fail with screw cut-out due to the force component along the screw axis.

Compromised osteoblast attachment on hydroxyapatite could be involved in the development of bone healing failure. We developed a bone-compatible scaffold that mimics bone structure with sub-micron hydroxyapatite (HA) surfaces, so that we could evaluate the effects of nitrogen-containing bisphosphonate (N-BP) on osteoblast behavior and bone healing. Human osteoblasts were seeded onto the bone-compatible scaffold with or without N-BP, and cell attachment and spreading behavior were evaluated 4 and 24 h after seeding. Then, mineralization was evaluated at 7 and 14 days. The osteoconductive activity of the scaffold was evaluated by implantation for 3 and 6 weeks into a rat cranial bone defect. The numbers of osteoblasts and their diameters were significantly less in N-BP-binding scaffolds than in untreated scaffolds at 4 and 24 h. Mineralization were also significantly less in the N-BP-binding scaffolds than in controls at 7 and 14 days. In vivo study revealed bone formation in N-BP-binding scaffolds was significantly less than in untreated scaffolds at 3 and 6 weeks. These results suggest that N-BP-binding to HA inhibited osteoblast attachment and spreading, thereby compromising bone healing process in the injured bone defect site.

Objectives To compare the effects of replacing reinforcing barium glass particles by DCPD (dicalcium phosphate dihydrate), as opposed to simply reducing glass filler content, on composite flexural properties and degree of conversion (DC). On a second set of experiments, composites with different “DCPD: glass” ratios were exposed to prolonged water immersion to verify if the presence of DCPD particles increased hydrolytic degradation. Methods: Two series of composites were prepared: 1) composites with total inorganic content of 50 vol% and “DCPD: glass” ratios ranging from zero (glass only) to 1.0 (DCPD only), in 0.25 increments, and 2) composites containing only silanized glass (from zero to 50 vol%). Disk-shaped specimens were fractured under biaxial flexural loading after 24 h in water. Another set of specimens of composites with different “DCPD: glass” ratios was stored in water for 24 h, 30, 60, 90 and 120 days and tested in flexure. DC was determined using FTIR spectroscopy. Data were analyzed using Kruskal-Wallis/Dunn test (flexural properties) or ANOVA/Tukey test (DC, alpha: 0.05). Results: For glass-only composites, reducing inorganic content caused a linear decrease in strength. The presence of DCPD did not affect composite strength up until a “DCPD: glass” ratio of 0.5. On the other hand, materials with 0.75 and 1.0 DCPD showed significantly lower strength than the glass-only composite with 12.5 vol% filler and the unfilled resin, respectively (p < 0.001). Except for the 0.25 DCPD composite, the presence of DCPD did not contribute to increase flexural modulus. After water storage, composites containing DCPD showed higher percent reductions in properties than the control, but only in a few cases the effect was statistically significant (strength: 0.5 DCPD, modulus: 0.25 and 1.0 DCPD). DC was only marginally affected by DCPD fraction. Significance: For composites with “DCPD: glass” of 0.25 and 0.5, reductions in strength were related to the lower glass content, and not due to the presence of DCPD. Flexural modulus was primarily defined by glass content. Overall, composites containing DCPD particles presented higher reductions in properties after water storage, but it remained within limits reported for commercial materials.

In order to produce anatomical models that feel realistic to the touch, artificial materials need to be found that mimic tactile properties of biological tissues. The aim of this study was to provide a guideline for identifying materials that feel similar to biological tissues, based on a quantifiable and reproducible measure. For this, a testing procedure was developed to identify mechanical properties that contribute to tactility. Bovine and porcine liver tissues were compared to different silicone elastomers and a soft 3D printed polymer. Macroindentation was chosen to simulate the palpation of material cubes with loading occurring during actual finger and material interaction. Elastic behaviour was considered by conducting quasistatic loading and unloading for extracting contact stiffness S and equivalent spring stiffness k. Viscoelasticity was quantified by means of force relaxation for calculating loss tangent tanδ based on a Prony series approach. Furthermore, Shore 00 hardness H was measured with a hand-held durometer. For assessing how well materials mimicked liver in terms of tactile properties, a mean error of all measured properties was introduced, referred to as tactile similarity error Q. The 3D printed polymer exhibited the highest error (Q=100−150%), while the material with the lowest error – thus representing liver best – was a super-soft silicone elastomer (nominal hardness of 30 Shore Units) with Q∼50%. In conclusion, a suitable material was found that best represented liver. However, the relatively high tactile similarity error, even for the best material tested, indicates that there is still room for improvement concerning material choice.

This study investigates the effect of tru-cut biopsy needle tip geometry on the needle deflection and tissue sampling length. Advances in medical imaging have allowed the identification of suspicious cancerous lesions which then require needle biopsy for tissue sampling and subsequent confirmatory pathological analysis. Precise needle insertion and adequate tissue sampling are essential for accurate cancer diagnosis and individualized treatment decisions. However, the single-bevel needles in current hand-held biopsy devices often deflect significantly during needle insertion, causing variance in the targeted and actual locations of the sampled tissue. This variance can lead to inaccurate sampling and false-negative results. There is also a limited understanding of factors affecting the tissue sampling length which is a critical component of accurate cancer diagnosis. This study compares the needle deflection and tissue sampling length between the existing single-bevel and exploratory multi-bevel needle tip geometries. A coupled Eulerian-Lagrangian finite element analysis was applied to understand the needle-tissue interaction during needle insertion. The needle deflection and tissue sampling length were experimentally studied using tissue-mimicking phantoms and ex-vivo tissue, respectively. This study reveals that the tissue separation location at the needle tip affects both needle deflection and tissue sampling length. By varying the tissue separation location and creating a multi-bevel needle tip geometry, the bending moments induced by the insertion forces can be altered to reduce the needle deflection. However, the tissue separation location also affects the tissue contact inside the needle groove, potentially reducing the tissue sampling length. A multi-bevel needle tip geometry with the tissue separation point below the needle groove face may reduce the needle deflection while maintaining a long tissue sampling length. Results from this study can guide needle tip design to enable the precise needle deployment and adequate tissue sampling for the needle biopsy procedures.

Purpose Analyze the biomechanical effect of postero-lateral instrumentation with and without posterior bone graft as well as effect of consolidation of the graft. Study objectives are (1) whether bone graft alone will provide enough additional strength to the weakened spine, (2) how the addition of posterior bone graft help in extending the life of the fusion construct, and (3) compare the effect of gradual consolidation of the bone-graft on the spine biomechanics. Methods A lumbar spine finite element model was used to analyze the effects of bone-graft alone and varying grades of bone-graft consolidation with postero-lateral instrumentation on spine biomechanics. The spine stiffness and stresses in the posterior rods and screws were determined for moments applied in the three physiological directions in addition to pre-load. Results Stiffness of a normal lumbar spine with a solid consolidated posterior bone graft was found to be 10 times that of an intact lumbar spine. Posterior instrumentation further increased the spine stiffness by 20 fold. A 50% solid consolidation of the graft reduced the screw-rod maximum von-Mises stress by 45% and a 65% reduction in screw-rod stress was calculated with completely fused graft. Conclusion A fused graft with posterior instrumentation provided a 200 fold increase in stiffness of an intact spine while producing stress shielding to the Ti rod-screw system. Considerable reduction of the maximum von-Mises stresses in the postero-lateral rod and screw fusion system (65%) will contribute to prevention of implant failure under repetitive loading highlighting the importance of consolidation of posterior bone-graft.

Introduction In complex clinical conditions when physiological bone regeneration is insufficient, there is a need to develop synthetic material-based scaffolds. The morphologic properties of porous scaffolds are of crucial importance. The dimensional accuracy of 3D printed scaffolds can be affected by a variety of factors. Materials and methods Three groups of 3D printed scaffolds were investigated: PLA1 (pure polylactic acid) printed with an FDM Ultimaker Original printer, PLA2 and composite PLA/hydroxyapatite (PLA/HAp) scaffolds printed with a Pharaoh XD 20. PLA/HAp filament was created with hot-melt extrusion (HME) equipment. The morphology of the prepared scaffolds was investigated with SEM, micro-CT and superimposition techniques, gravimetric and liquid displacement methods. Results Layer heights of PLA1 scaffolds varied the most. PLA1 scaffold volume statistically significantly differed from PLA2 (p < 0.001) and PLA/HAp (p < 0.01) groups. Filament composition had no effect on the volumes of the scaffolds printed with the Pharaoh XD 20 printer (p > 0.05). The total porosity of printed PLA/HAp scaffolds deviated the least from the original STL model. Conclusions This study showed that PLA/10% HAp filament fabricated with HME and printed with FFF 3D printer produced equal or even better accuracy of printed scaffolds than scaffolds printed with pure PLA filament. Further research is needed to analyze the effect of HAp on 3D scaffold morphology, accuracy, mechanical and biologic properties.

Stents have become the most successful device to treat advanced atherosclerotic lesions. However, one of the main issues with these interventions is the development of restenosis. The coating of stents with antiproliferative substances to reduce this effect is now standard, although such drugs can also delay re-endothelialization of the intima. The drug release strategy is therefore a key determinant of drug-eluting stent efficacy. Many mathematical models describing drug transport in arteries have developed and, usually separately, models describing the mechanics of arterial tissue have been devised. However, there the literature is lacking a comprehensive model that adequately takes into account both the mechanical deformation of the porous arterial wall and the resulting impact on drug transport properties. In this paper, we provide the most comprehensive study to date of the effect of stent mechanical expansion on the drug transport properties of a three-layer arterial wall. Our model incorporates the state-of-the art description of the mechanical properties of arterial tissue though an anisotropic, hyperelastic material model and includes a nonlinear saturable binding model to describe drug transport in the arterial wall. We establish relationships between mechanical force generated through device expansion and alteration in diffusion within the arterial wall and perform simulations to elucidate the impact of such alterations in spatio-temporal drug release and tissue uptake. Mechanical deformation of the arterial wall results in modified drug transport properties and tissue drug concentrations, highlighting the importance of coupling solid mechanics with drug transport.

Dental materials are known as efficient tools to revive the functionality and integrity of decayed/missing tooth structure. Being frequently subjected to different mixtures of tensile and shear loads accompanied by temperature changes and suffering from pre-existing voids and imperfect interfaces at the same time, dental restorations and prostheses are found to be susceptible to crack initiation and growth. In this paper, fracture properties of three dental biomaterials namely polymethylmethacrylate (PMMA), 75Sr and 75Sr10 undergoing mixed tensile-shear loads are investigated. The PMMA used in this study has application as a cold-cured acrylic resin for repairing dental prostheses, while 75Sr and 75Sr10 are dental restorative materials. Fracture growth angle and onset of crack propagation are evaluated experimentally using shortened semi-circular bend specimens made from PMMA. In addition, the generalized maximum tangential strain (GMTSN) criterion is applied to theoretically predict the fracture behavior of the tested PMMA, as well as two other dental bio-composites reported in the literature viz 75Sr and 75Sr10. Good agreement is met between theory and practice when comparing fracture curves extracted from the GMTSN criterion and the experimental data points. Further, it is found that conventional stress- and strain-based fracture models fail to provide suitable estimates of crack growth behavior.

Objectives Metal and Zirconia cantilever resin bonded fixed dental prosthesis (RBFDPs) are extensively used when missing anterior teeth. Lithium disilicate is not used a lot as it is not indicated by the manufacturers. The aim of this in vitro study was to investigate the fracture strength of lithium disilicate cantilever RBFDPs with different configurations and compare them to metal and zirconium RBFDPs. Methods Sound extracted human canines (N = 60) were divided into six groups, to be restored with a cantilever RBFDP. Specimen were randomly divided over 6 groups (n = 10): Full crown of lithium disilicate (FCL); Veneer wing of lithium disilicate (VL); Connector of lithium disilicate (CL); Palatal wing of lithium disilicate (PL); Palatal wing of zirconia (PZ) and Palatal wing of metal ceramic (PM). All bridges were bonded with an adhesive system. After thermalcyclic ageing (20 × 103x, 5–55 °C) all samples were loaded until fracture occurred. Failure types were classified and representative SEM done. Results The mean fracture strength results per group were: 588N (FCL) 588N (PM), 550N (CL), 534N (PL), 465N (VL), 38N (PZ). A significant (p = 0.001) difference was found between the groups, all groups had a higher fracture strength than the zirconia RBFDPs. Failure type analysis showed some trends among the groups. Irrepairable fractures of the root were only seen in samples restored with lithium disilicate. Metal and zirconia RBFDPs predominantly failed on the adhesive interface, where 60% of the zirconia samples had pretest debondings. Significance. No differences in fracture strength were found between cantilever RBFDPs made from metal or lithium disilicate. Metal (0% pre-test failures) and zirconium (60% pretest failures) RBFDPs failed predominantly on the adhesive interface whereas the lithium disilicate (0% pre-test failures) samples showed fractures in the contact area. The least invasive connector (CL) and Metal (PM) RBFDP obtained a high fracture strength and optimal fracture pattern.

Human dentine is a mineralised dental tissue that consists of dentinal tubules surrounded by two distinct dentinal phases: peritubular dentine (PTD) and intertubular dentine (ITD). Dental caries, which manifests itself as a consequence of demineralisation, is one of the most common chronic diseases that affect the function of human teeth. Due to the difference in the packing density of crystallites, PTD and ITD exhibit different reaction rates to acid dissolution. The present study evaluates how the effective Young's modulus degrades and how the effective stress redistributes in demineralised human dentine as a result of incremental acid dissolution process. An analytical two-layer composite model is proposed and used for the effective Young's modulus calculation. 3D numerical representative volume elements (RVEs) with different variations in PTD fraction and dentinal tubule density are established to evaluate effective stress redistribution and examine the critical factors that can affect the mechanical performance. The models are then applied on an actual dentine bulk sample. The results reveal how PTD serves as a protection to ITD thus highlight the important role that PTD plays for the structural integrity of dentine. The obtained insights are crucial for advancing the understanding of a variety of natural and therapeutic effects from the mechanical perspective, e.g. the mechanical performance assessment of human dentine subject to complex dynamic processes of de- and re-mineralisation that can occur in human dental caries and dental treatments. It will ultimately inspire the biomimetic design towards strengthening the dentine and dentine-like materials.

Two liquid monomers (CT-AL and CT-ACR) were synthesized from the acylation of tert-butyl catechol with different acid chlorides. The monomers were used to prepare photopolymerizable dental composite for completely replacing TEGDMA. Properties such as flexural strength, modulus of elasticity, degree of double bond conversion, polymerization shrinkage, as well as the polymerization stress were studied. Also, color alteration, translucency, and cytotoxicity were evaluated. The results show that the experimental materials formulated with CT-AL and CT-ACR have similar mechanical properties to a control material formulated with BisGMA/TEGDMA, similar polymerization shrinkage, and less polymerization stress. The composite formulated with the CT-AL monomer shows a similar degree of conversion (72%), while the composite formulated with the CT-ACR monomer has a degree of conversion lower (58%) than the control resin (71%). These results suggest that both monomers could have potential applications in the formulation of composites for dental restorations.

Additive manufacturing has significant advantages, in the biomedical field, allowing for customized medical products where complex architectures can be achieved directly. While additive manufacturing can be used to fabricate synthetic bone models, this approach is limited by the printing resolution, at the level of the trabecular bone architecture. Therefore, the aim of this study was to evaluate the possibilities of using Fused Deposition Modelling (FDM) to this end. To better mimic real bone, both in terms of mechanical properties and biodegradability, a composite of degradable polymer, poly(lactic acid) (PLA), and hydroxyapatite (HA) was used as the filament. Three PLA/HA composite formulations with 5-10-15 wt% HA were evaluated, and scaled up human trabecular bone models were printed using these materials. Morphometric and mechanical properties of the printed models were evaluated by micro-computed tomography, compression and screw pull out tests. It was shown that the trabecular architecture could be reproduced with FDM and PLA by applying a scaling factor of 2-4. The incorporation of HA particles reduced the printing accuracy, with respect to morphology, but showed potential for enhancement of the mechanical properties. The scaled-up models displayed comparable, or slightly enhanced, strength compared to the commonly used polymeric foam synthetic bone models (i.e. Sawbones). Reproducing the trabecular morphology by 3D printed PLA/HA composites appear to be a promising strategy for synthetic bone models, when high printed resolution can be achieved.

Purpose The study evaluated and compared the effect of pre-etching heat treatment and post-etching surface neutralization on the surface texture parameters and initial adhesion strength of orthodontic brackets bonded to lithium disilicate glass-ceramic using water-based and resin-based cement. Materials and methods A total of 120 samples were fabricated by duplicating the buccal surface of the maxillary premolar. The samples were randomly assigned to two groups: the cementing surface of group 1 samples was heat-treated, and that of group 2 samples was left untreated. The samples of each group were further divided into 4 subgroups (n = 15) according to the use of neutralization and the type of cement used for bonding. The surface texture parameters after etching were determined using a non-contact surface profilometer, and the bond strength was determined by a universal material tester. The results were analyzed by analysis of variance and the Scheffe post hoc test. Results The samples that were heat-treated showed statistically significant higher bond strength in all the subgroups, and the acid-neutralized samples showed higher bond strength using both types of cement; however, the increase was statistically significant only in resin-based cement-bonded samples. Resin-based cement-bonded samples showed higher bond strength than water-based cement-bonded samples. Conclusion Pre-etching heat treatment and post-etching acid neutralization of the cementing surface of lithium disilicate glass-ceramic significantly improve the surface texture and initial bond strength to orthodontic brackets.

The aim of this study was to evaluate the reliability of microshear (μSBS) and microtensile (μTBS) bond strength tests on composite repairs using universal adhesives with or without the application of additional silane. Cylindrical (μSBS) and block-shaped (μTBS) specimens were fabricated using nanofilled (F – Filtek One Bulk Fill) and a nanohybrid (T- Tetric EvoCeram Bulk Fill) bulk-fill composites. The specimens were aged by thermocycling (5,000 cycles, 5–55 °C), sandblasted, and then divided into three groups (n = 30) as follows: non-repaired cohesive (FC and TC), repaired with universal adhesives (FA, Scotchbond Universal; and TA, Adhese Universal), and with the application of additional silane (FS and TS). After 48 h, the specimens were repaired using the same composite. The μSBS and μTBS specimens exhibited bonded areas of 1 mm2 and were subjected to shear stress and tension until failure, at a crosshead speed of 0.5 mm/min in a universal testing machine. A Weibull analysis and Pearson correlation (α = 0.05) were applied to the data. At characteristic strength, FC, FA, and FS exhibited significantly higher μSBS when compared with TA and TS (p < 0.05), However when tested by μTBS at the same parameter, FA presented significantly lower bond strength when compared to FC, FS, and TA (p < 0.05). The correlation between Weibull modulus was strongly negative and not significant (p > 0.05). Both bond strength tests exhibited a material-dependent behavior. The microtensile bond strength test demonstrated more reliability than the microshear test for composite repair evaluation.

Characterization of material properties of human skin is required to develop a physics-based biomechanical model that can predict deformation of female breast after cosmetic and reconstructive surgery. In this paper, we have adopted an experimental approach to characterize the biaxial response of human skin using bulge tests. Skin specimens were harvested from breast and abdominal skin of female subjects who underwent mastectomy and/or reconstruction at The University of Texas MD Anderson Cancer Center and who provided informed consent. The specimens were tested within 2 h of harvest, and after freezing for different time periods but not exceeding 6 months. Our experimental results show that storage in a freezer at −20 °C for up to about 40 days does not lead to changes in the mechanical response of the skin beyond statistical variation. Moreover, displacement at the apex of the bulged specimen versus applied pressure varies significantly between different specimens from the same subject and from different subjects. The bulge test results were used in an inverse optimization procedure in order to calibrate two different constitutive material models – the angular integration model proposed by Lanir (1983) and the generalized structure tensor formulation of Gasser et al. (2006). The material parameters were estimated through a cost function that penalized deviations of the displacement and principal curvatures at the apex. Generally, acceptable fits were obtained with both models, although the angular integration model was able to fit the curvatures slightly better than the Gasser et al. model. The range of the model parameters has been extracted for use in physics-based biomechanical models of the breast.

The paper presents for the first time the material properties and energy absorption capacity of durian shells with an attempt to use as an alternative sustainable material and mimic their structural characteristics to design a bio-inspired structure for protective packaging applications. A series of quasi-static compression tests were carried out to determine Young's modulus and bioyield stress of the durian shells as well as their energy absorption capacity. The mesocarp layers and thorns are interesting parts for investigating their energy absorption characteristics because they play an important role in protecting the flesh of durians during their drop impact onto the ground. The mesocarp layers of the shell were subjected to axial and lateral compression while the thorn specimens were compressed under axial loading with an increasing number of thorns. The results showed that the densification strain, plateau stress and specific energy absorption of the mesocarp layer under lateral loading is higher than that under axial loading. Furthermore, the compression tests on the thorns demonstrated that an increase in the number of thorns helped to absorb more energy and the specific energy absorption of the thorns was nearly two times higher than that of the mesocarp layer under the axial loading. In addition, the cyclic loading of the thorns showed that the extent of reversibility of deformation in the thorns decreases from 32% at the first cycle to around 10% at the 9th-cycle. Finally, the microstructure of the thorn and mesocarp layer was investigated to explain the experimental observation. The results indicated that the spherical shape associated with the thorns and mesocarp materials displayed an excellent energy absorption efficiency that can be mimicked to design an effective bio-inspired absorber for packing applications.

Statement of problem The surface hardness and roughness of different glaze materials for denture base acrylic resins have not been well reported. Purpose The purpose of the study was to measure the surfaces hardness, elastic modulus and surface roughness of 5 different light-polymerized glaze materials for poly methyl methacrylate (PMMA) denture base materials. Material and methods A total of 210 PMMA resin specimens (10 × 5 × 2 mm) were prepared (30 per group); control group was untreated, group 1 was surface treated with conventional pumice and high shine paste; group 2 to 6 specimens were glaze coated with different commercially available denture glaze materials. 20 specimens out of 30 underwent thermocycling to simulate 6 months and 12 months in vivo. Nanoindentation was performed to measure the surface hardness and elastic modulus. Surface roughness was quantitatively analysed using surface metrology software and qualitatively analysed under scanning electron microscope (SEM). Collected data was statistically analysed using SPSS version 24. Results The mean surface hardness of tested specimens ranged from 0.33 ± 0.09 GPa to 0.68 ± 0.10 GPa. Specimens coated with Optiglaze produced statistically higher surface hardness compared to other groups (P < 0.01). Aging of 6 months and 12 months was found to have no statistical significance for all groups’ surface hardness values. For elastic modulus, specimens coated with Nanovarnish produced statistically higher values compared to other groups (P = 0.03). Thermocycling showed no influence on the elastic modulus of specimens. The mean surface roughness of all groups ranged from 0.16 ± 0.01 to 0.30 (±0.02) μm with no statistical significance between groups (P = 0.67). However, under SEM analysis, surfaces showed increased roughness over time. Conclusions Statistically significant differences in surface hardness and elastic modulus were found among the different types of surface coated denture acrylic resins. Silica-nanoparticle containing surface coatings produced the highest surface hardness and elastic modulus, however there was no statistical significance found in aging for 6 and 12 months. Contrary to expectations, the surface roughness did not have a significant increase in all groups over time, despite changes observed under SEM. Clinical implications This study will contribute to our understanding of surface glazed PMMA acrylic resin denture materials and how it improves the surface strength. This research can help dental clinicians and technicians select the most effective polishing and coating material for the dentures.

Current guidelines for abdominal aortic aneurysm (AAA) repair are primarily based on the maximum diameter. Since these methods lack robustness in decision making, new image-based methods for mechanical characterization have been proposed. Recently, time-resolved 3D ultrasound (4D US) in combination with finite element analysis was shown to provide additional risk estimators such as patient-specific peak wall stresses and wall stiffness in a non-invasive way. The aim of this study is to: 1) assess the reproducibility of this US-based stiffness measurement in vitro and in vivo, and 2) verify this 4D US stiffness using the gold standard: bi-axial tensile testing of the excised aortic tissue. For the in vitro study, 4D US data were acquired in an idealized inflation experiment using porcine aortas. The full aortic geometry was segmented and tracked over the cardiac cycle, and afterwards finite element analysis was performed by calibrating the finite element model to the measured US displacements to find the global aortic wall stiffness. For verification purposes, the porcine tissue was subjected to bi-axial tensile testing. Secondly, four AAA patients were included and 4D US data were acquired before open aortic surgery was performed. Similar to the experimental approach, the 4D US data were analyzed using the iterative finite element approach. During surgery, aortic tissue was harvested and the resulting tissue specimens were analyzed using bi-axial tensile testing. Finally, reproducibility was quantified for both methods. A high reproducibility was observed for the wall stiffness measurements using 4D US, i.e., an ICC of 0.91 (95% CI: 0.78–0.98) for the porcine aortas and an ICC of 0.98 (95% CI: 0.84–1.00) for the AAA samples. Verification with bi-axial tensile testing revealed a good agreement for the inflation experiment and a moderate agreement for the AAA patients, partially caused by the diseased state and inhomogeneities of the tissue. The performance of aortic stiffness characterization using 4D US revealed overall a high reproducibility and a moderate agreement with ex vivo mechanical testing. Future research should include more patient samples, to statistically assess the accuracy of the current in vivo method, which is not trivial due to the low number of open surgical interventions.

It has been shown that there exists significance dependence between hydration and biomechanical properties of hydrated tissues such as cornea. The primary purpose of this study was to determine hydration effects on mechanical properties of sclera. Sclera strips dissected from the posterior part of pig eyes along the superior-inferior direction were divided into four hydration groups by first drying them and then soaking them in PBS until their hydration reached to 75%, 100%, 150%, and 200%. The strips were subjected to ten consecutive cycles of loading and unloading up to 1 MPa. The response of samples at the tenth cycle was used to compute the tangent modulus, maximum strain, and hysteresis as a function of hydration. The experiments were done in oil in order to prevent hydration changes during the mechanical tests. The mechanical response of strips right after dissection, control group, was also measured. In general, significant softening of sclera strips was found with increasing hydration (p < 0.05). The stress-strain response of control group was between those of samples with hydration 150% and 200%. The experimental stress-strain data were successfully represented numerically with an exponential mathematical relation with R2 > 0.99. The present study showed that hydration would significantly alter the tensile response of sclera tissue. Thus, researchers interested in characterizing sclera biomechanical properties should control the hydration of specimens during the experimental measurements.

Stroke is a major cause of death worldwide. The rupture of atherosclerotic carotid plaques is the leading single cause of stroke. Currently there is no accepted clinical measure to quantitatively assess the risk of carotid plaque rupture. Structural analyses of vulnerable plaques, using finite element (FE) analysis, have retrospectively found that regions of high stress tend to be the site of plaque rupture. The current study proposes a new clinical measure, based on plaque geometry, to assess the risk of carotid plaque rupture. This measure, named the weighted curvature difference, is based on the curvature of both the lumen and intima-media boundary, and the local plaque thickness. A series of idealized and realistic, 2-D and 3-D geometries are used to systematically assess this novel geometrical metric. The areas predicted to be at high risk of rupture using this geometrical metric are compared with areas of high stress, obtained from both isotropic and anisotropic material models. These results are also compared with areas in diseased carotid arteries that are predicted to have high damage accumulation in collagen fibres using a continuum damage model. Results show the new geometrical metric consistently predicts the locations of high stress in all of the vessel geometries examined. The drawbacks of using lumen curvature only as a risk measure are highlighted; particularly in the case of outward remodelled vessels. Weighted curvature difference shows great potential to be used as a metric to efficiently distinguish the rupture prone areas in a diseased vessels in a way that is independent of material properties.

In recent years, mesh structures have attracted significant interest for structural and functional applications. However, the mechanical strength and energy absorption ability of uniform mesh structured materials degrade with density. To address this challenge, we propose the concept of functionally graded mesh structures. The objective of the proposed research is to fundamentally understand the compressive behavior of graded mesh structures. The compression-compression fatigue behavior of functionally graded Ti–6Al–4V mesh structure under identical bulk stress condition is studied here. During cyclic deformation, it was observed that the local stress distribution in the struts was not uniform because of inhomogeneous mechanical properties of the constituents. Fatigue cracks first initiated in the lowest strength constituent, and then propagated until structural failure occurred. However, no obvious damage was observed in other constituents during the entire process. In contrast with iso-strain state, the fatigue life of graded structure is mainly determined by the constituent with the lowest strength.

Bone is a natural composite and its cutting is a common procedure in orthopedic surgery. The processing damage, cutting force, and cutting heat strongly influence postoperative recovery. In this study, a orthogonal elliptical vibration-assisted (EVA) bone cutting system is developed based on semi-brittle behaviors of bone to experimentally investigate fracture, cutting force, roughness and temperature rise. To prevent large-scale fractures during bone cutting, an extended finite element method model incorporating detailed microstructure and material properties of bone is created to understand the crack-propagation mechanism. Both the simulation and the experiments demonstrate that the elliptical vibration could effectively control the direction of crack propagation. The experimental results also demonstrate that the cutting force and surface roughness decreases with an increase in the vibration frequency or amplitude, whereas temperature rise increases with the vibration frequency. These findings prove that the EVA could allow for low-trauma bone cutting in orthopedic surgery.

The lens capsule, a thin specialized basement membrane that encloses the crystalline lens, is essential for both the structural and biomechanical integrity of the lens. Knowing the mechanical properties of the lens capsule is important for understanding its physiological functioning, role in accommodation, age-related changes, and for providing a better treatment of a cataract. In this review, we have described the techniques used for the lens capsule biomechanical testing on the macro- and microscale and summarized the current knowledge about its mechanical properties.

Myocardial infarction (MI) is one of leading diseases to contribute to annual death rate of 5% in the world. In the past decades, significant work has been devoted to this subject. Biomechanics of infarcted left ventricle (LV) is associated with MI diagnosis, understanding of remodelling, MI micro-structure and biomechanical property characterizations as well as MI therapy design and optimization, but the subject has not been reviewed presently. In the article, biomechanics of infarcted LV was reviewed in terms of experiments achieved in the subject so far. The concerned content includes experimental remodelling, kinematics and kinetics of infarcted LVs. A few important issues were discussed and several essential topics that need to be investigated further were summarized. Microstructure of MI tissue should be observed even carefully and compared between different methods for producing MI scar in the same animal model, and eventually correlated to passive biomechanical property by establishing innovative constitutive laws. More uniaxial or biaxial tensile tests are desirable on MI, border and remote tissues, and viscoelastic property identification should be performed in various time scales. Active contraction experiments on LV wall with MI should be conducted to clarify impaired LV pumping function and supply necessary data to the function modelling. Pressure-volume curves of LV with MI during diastole and systole for the human are also desirable to propose and validate constitutive laws for LV walls with MI.

Prosthetic joint infection (PJI) is one of the most devastating failures in total joint replacement (TJR). Infections are becoming difficult to treat due to the emergence of multi-drug resistant bacteria. These bacteria produce biofilm on the implant surface, rendering many antibiotics ineffective by compromising drug diffusion and penetration into the infected area. With the introduction of new antibiotics there is a need to create benchmark data from the traditional antibiotic loaded bone cements. Vancomycin, one of the commonly used antibiotics, shows activity against Methicillin-resistant Staphylococcus aureus (MRSA) and S.epidermidis. In our study, vancomycin added to bone cement was evaluated for elution properties, antimicrobial properties, and mechanical properties of the bone cement. Vancomycin at five different loading masses (0.125, 0.25, 0.5, 1.0 and 2.0 g) was added to 40 g of Simplex™ P cement. Addition of vancomycin affected the mechanical properties and antimicrobial activity with significant differences from controls. Flexural and compression mechanical properties were compromised with added vancomycin. The flexural strength of samples with added vancomycin of 0.5 g and greater were not greater than ISO 5833 minimum requirements. 2.0 g of vancomycin added to bone cement was able to eliminate completely the four bacterial strains tested. 2.0 g of vancomycin also showed the highest mass elution from the cement over a 60-day period. Given the reduced flexural strength in samples with 0.5 g and greater of added vancomycin and the inability of vancomycin in amounts less than 2.0 g to eliminate bacteria, this study did not find an ideal amount of vancomycin added to Simplex™TM P that meets both strength and antibacterial requirements.

Sideways falls onto the hip are responsible for a great number of fractures in older adults. One of the possible ways to prevent these fractures is through early identification of people at great risk so that preventive measures can be properly implemented. Many numerical techniques that are designed to predict the femur fracture risk are validated through performing quasi-static (QS) mechanical tests on isolated cadaveric femurs, whereas the real hip fracture is a result of an impact (IM) incident. The goal of this study was to compare the fracture limits of the proximal femur under IM and QS conditions in the simulation of a sideways fall to identify any possible relationship between them. Eight pairs of fresh frozen cadaveric femurs were divided into two groups of QS and IM (left and right randomized). All femurs were scanned with a Hologic DXA scanner and then cut and potted in a cylindrical tube. To measure the stiffness in two conditions of the single-leg stance (SLS) and sideways fall (SWF), non-destructive tests at a QS displacement rate were performed on the two groups. For the destructive tests, the QS group was tested in SWF configuration with the rate of 0.017 mm/s using a material testing machine, and the IM group was tested in the same configuration inside a pneumatic IM device with the projectile target displacement rate of 3 m/s. One of the IM specimens was excluded due to the multiple strikes. The result of this study showed that there were no significant differences in the SLS and SWF stiffnesses between the two groups (P = 0.15 and P = 0.64, respectively). The destructive test results indicated that there was a significant difference in the fracture loads of the two groups (P < 0.00001) with the impact ones being higher; however, they were moderately correlated (R2 = 0.45). Also, the comparison of the fracture location showed a qualitatively good agreement between the two groups. Using the relationship developed herein, results from another study were extrapolated with errors of less than 12%, showing that meaningful predictions for the impact scenario can be made based on the quasi-static tests. The result of this study suggests that there is a potential to replace IM tests with QS displacement rate tests, and this will provide important information that can be used for future studies evaluating clinical factors related to fracture risk.

Niobium oxide coatings deposited on Ti6Al4V substrates by electron beam deposition and annealed in air at 600 °C and 800 °C were evaluated for their suitability towards dental, maxillofacial or orthopaedic implant applications. A detailed physico-chemical properties investigation was carried out in order to determine their elemental and phase composition, surface morphology and roughness, mechanical properties, wettability, and corrosion resistance in simulated body fluid solution (pH = 7.4) at room temperature. The biocompatibility of the bare Ti6Al4V substrate and coated surfaces was evaluated by testing the cellular adhesion and viability/proliferation of human osteosarcoma cells (MG-63) after 72 h of incubation. The coatings annealed at 800 °C exhibit more phase pure nanocrystalline Nb2O5 surfaces with enhanced wettability, reduced porosity and enhanced corrosion resistance properties making them good candidate for dental, maxillofacial or orthopaedic implant applications.

Osteoporosis (OP) is a widespread condition with commonly associated fracture sites at the hip, vertebra and wrist. This study examines the effects of age and osteoporosis on bone quality by comparing the efficacy of using parameters which indicate bone quality (both traditional clinical parameters such as bone mineral density (BMD), as well as apparent Young's modulus determined by finite element analysis, among others) to predict fracture. Non-fracture samples were collected from the femoral heads of 83 donors (44 males, 39 females), and fracture samples were obtained from the femoral heads of 17 donors (female). Microarchitectural parameters (Bone Volume/Total Volume [BV/TV], Bone Surface/Bone Volume [BS/BV], Tissue Mineral Density [TMD, etc.]) were measured from μCT of each sample as well as 2D and 3D fractal dimension (D2D and D3D respectively). A cube was cropped from μCT images and an isotropic hexahedral element was assigned to each voxel. Finite element analysis was used to calculate the Young's modulus for each sample. Overall, values for microarchitectural characteristics, fractal dimension measurements and Young's Modulus were consistent with values within literature. Significant correlations are observed between age and BV/TV for non-fracture males and females, as well as between age and volumetric BMD (vBMD) for the same groups. Significant differences are present between age-matched non-fracture and fracture females for BV/TV, BS/BV, vBMD, TMD, D2D, D3D, (p < 0.01 for all). Properties which are not age dependent are significantly different between age-matched non-fracture and fracture specimens, indicating OP is a disease, and not just an accelerated aging process.

Purpose To investigate the mechanical performance and fracture behavior of endocrown restorations prepared using different composite materials and following a direct technique. Methods: Sound molars were cut at 2 mm above the cementoenamel junction, endodontically treated, and allocated according to the type of restoration (n = 7): without post (endocrowns) or with post (post-retained restorations). Endocrowns were fabricated with conventional composite (Filtek Z350); bulk fill composite (Filtek Bulk Fill); conventional composite modeled using resin adhesives (SBMP: Scotchbond Multipurpose Adhesive; or SBU: Scotchbond Universal Adhesive); and lithium disilicate ceramic (E.max; Positive control). The post-retained restorations were fabricated with glass-fiber post combined with conventional or bulk fill composites. All restorations were bonded following an etch-and-rise adhesive approach or self-adhesive resin cement. The teeth were submitted to fatigue (Byocycle) and compression (EMIC DL500) testing at a crosshead speed of 1 mm/min. Data were analyzed with ANOVA and Tukey (p < 0.05) and Weibull analysis was carried out in order to evaluate the reliability of restorations. Results: The bulk-fill-based endocrown showed a stronger performance than the control. The presence of SBMP or the use of bulk-fill composite resulted in the occurrence of less aggressive fractures than the other restorative systems. Endocrowns bonded directly to the tooth seemed to produce similar fracture strength properties as compared to endocrowns bonded using self-adhesive resin cementation. The bulk-fill-based endocrown showed the greatest reliability of study. Conclusion: Resin-based restorative materials seem to be interesting alternative options to fabricate large dental restorations in lieu of the more traditionally used glass ceramics or root canal post systems.

Owing to the poor load-bearing ability and apparent cytotoxicity of polymeric and ceramic materials, magnesium-based materials can be an ideal substitute for bone repair applications. Magnesium is bioresorbable, unlike other metallic materials like titanium and stainless steel, has excellent biocompatibility, compressive strengths and elastic modulus similar to the natural bone, which circumvents the need for secondary surgery post-implantation in vivo. Against this background, in this study, magnesium-based nanocomposites were developed by using hydroxyapatite bioceramic as a nano reinforcement. Magnesium-based alloys were synthesized using selective alloying elements and hydroxyapatite incorporated nanocomposites were processed using the disintegrated melt deposition technique. The microstructure characterization revealed that the addition of hydroxyapatite resulted in superior grain refinement of the magnesium alloy matrix. The addition of hydroxyapatite improved the yield strength of the alloy matrix and displayed superior strength and ductility retention post corrosion for 21 days, under compression loading. The presence of hydroxyapatite improved the hydrophilicity of the alloy matrix thereby aiding the biocompatibility properties with improved corrosion resistance, level 0 cytotoxicity, and high cell attachment. Hence, the present study strongly suggests that magnesium alloy-based hydroxyapatite nanocomposites can be a suitable candidate for bone repair applications.

Owing to the unique non-self-similar hierarchical microstructure, enamel achieves the balance of high stiffness and toughness, and in turn provides important ideas for the bio-inspired materials design. In this study, a multiscale numerical study has been conducted to investigate whether the property of high stiffness and large energy dissipation could be duplicated in engineering materials through certain material design principles. Motivated by the structure of enamel, the bio-inspired materials consisting of hard and soft phases were considered, and the designing parameters including the cross-sectional shape, volume fraction, and inclination angle of the reinforcement, and other three parameters related to the waviness of the reinforcement were taken into account. It was found that by employing the non-self-similar hierarchical structure, the designed composites exhibited the balance between stiffness and toughness, which has not been achieved in many engineering materials yet. Furthermore, the influences of the aforementioned designing parameters on the mechanical performance of the composites have been elucidated. The findings of this study have provided a guideline for designing bio-inspired composites achieving the balance between stiffness and toughness.

Through biological evolution, bivalve mollusks developed shells to improve the utilization of metabolic energy and provide protection against external threats. In addition to the mechanical optimization of the microstructure, the design of the macroscopic shape of a bivalve shell naturally becomes a potential approach to achieving the aforementioned purposes. While the functions of some features of mollusk shells have been studied, the role of the suture-serrate margins, a common morphology of bivalve shell edges, in the global mechanical behaviors of bivalve shells requires further exploration. Here, we present how the serrate margins contribute to the global mechanical properties of bivalve shells. The results of the compression tests employed on a typical bivalve, M. mercenaria, showed that the complete bivalve shells with suture-serrate margins perform better in terms of strength and work to fracture than those without the margins under the same conditions (dry and wet). The primary failure types observed during compression reveal that the failure mechanisms of valve shells are dependent on the suture-serrate margin morphology and water content. Using numerical simulations, the mechanical functions of the suture-serrate margins were demonstrated. Specifically, serrate margins provide mutual resistance by “locking” complementary valves to redistribute and eliminate stress concentrations around pre-existing defects, thereby enhancing the mechanostability and strength of the entire structure.

Gastrointestinal (GI) diseases are often associated with hypertrophy of the layers of the GI wall, along with dilatation and a denervation of smooth muscle cells which alters the biomechanical properties of the tissue. ‘Balloon distension’ is a specialised experimental protocol performed on hollow organs to investigate their biomechanical properties. A balloon is inserted and pressurized during this procedure and the change in external diameter is monitored as a function of the applied pressure. A hyperelastic framework is often used in this context to evaluate the stresses in the wall after inflation. However, this only gives an idea about the final equilibrium state of the tissue, whereas the intermediate states of deformations are overlooked. GI soft tissues are viscoelastic, thus, the stress values during inflation are loading rate dependent and are higher than the equilibrium state values. Therefore, it is necessary to consider the time- and rate-dependent material properties during a balloon distension test. The aim of this work was to develop a viscoelastic framework for interpreting balloon distension experiments under finite deformation. To demonstrate the efficacy of the framework, it was used to recreate experimental results from intestinal and colonic tissue segments. In all cases, the simulation results were well matched (R2>0.9) with the experimental data.