Biomechanical evaluation of a customized 3D‑printed polyetheretherketone condylar prosthesis

Guo,Fang; Huang,Shuo; Hu,Min; Yang,Chuncheng; Li,Dichen; Liu,Changkui

doi:10.3892/etm.2021.9779

Biomechanical evaluation of a customized 3D‑printed polyetheretherketone condylar prosthesis

Authors:
- Fang Guo
- Shuo Huang
- Min Hu
- Chuncheng Yang
- Dichen Li
- Changkui Liu
View Affiliations

Affiliations: Department of Oral and Maxillofacial Surgery, School of Stomatology, Xi'an Medical University, Xi'an, Shaanxi 710021, P.R. China, Department of Oral and Maxillofacial Surgery, General Hospital of PLA, Beijing 100853, P.R. China, State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, P.R. China
Published online on: February 11, 2021 https://doi.org/10.3892/etm.2021.9779
Article Number: 348
Copyright: © Guo et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The present study aimed to evaluate the biomechanical behavior of a custom 3D‑printed polyetheretherketone (PEEK) condylar prosthesis using finite element analysis and mechanical testing. The Mimics software was used to create a 3D model of the mandible, which was then imported into Geomagic Studio software to perform osteotomy of the lesion area. A customized PEEK condyle prosthesis was then designed and the finite element model of the PEEK condyle prosthesis, mandible and fixation screw was established. The maximum stress of the prosthesis and screws, as well as stress and strain of the cortical and cancellous bones in the intercuspal position, incisal clench, left unilateral molar clench and right unilateral molar clench was analyzed. The biomechanical properties of the prosthesis were studied using two models with different lesion ranges. To simulate the actual clinical situation, a special fixture was designed. The compression performance was tested at 1 mm/min for the condyle prosthesis, prepared by fused deposition modeling (FDM). The results of a finite element analysis suggested that the maximum stress of the condyle was 10.733 MPa and the maximum stress of the screw was 9.7075 MPa; both were far less than the yield strength of the material. The maximum force that the two designed prostheses were able to withstand was 3,814.7±442.6 N (Model A) and 4,245.7±348.3 N (Model B). Overall, the customized PEEK condyle prostheses prepared by FDM exhibited a uniform stress distribution and good mechanical properties, providing a theoretical basis for PEEK as a reconstruction material for repairing the temporomandibular joint.

View Figures

View References

1	Rodrigues YL, Mathew MT, Mercuri LG, da Silva JSP, Henriques B and Souza JCM: Biomechanical simulation of temporomandibular joint replacement (TMJR) devices: A scoping review of the finite element method. Int J Oral Maxillofac Surg. 47:1032–1042. 2018.PubMed/NCBI View Article : Google Scholar
2	Jones R: The use of virtual planning and navigation in the treatment of temporomandibular joint ankylosis. Aust Dent J. 58:358–367. 2013.PubMed/NCBI View Article : Google Scholar
3	Wolford LM, Dingwerth DJ, Talwar RM and Pitta MC: Comparison of 2 temporomandibular joint total joint prosthesis systems. J Oral Maxillofac Surg. 61:685–690; discussion 690. 2003.PubMed/NCBI View Article : Google Scholar
4	Zhao Y, Wong SM, Wong HM, Wu S, Hu T, Yeung KW and Chu PK: Effects of carbon and nitrogen plasma immersion ion implantation on in vitro and in vivo biocompatibility of titanium alloy. ACS Appl Mater Interfaces. 5:1510–1516. 2013.PubMed/NCBI View Article : Google Scholar
5	Niki Y, Matsumoto H, Otani T, Suda Y and Toyama Y: Metal ion concentrations in the joint fluid immediately after total knee arthroplasty. Mod Rheumatol. 11:192–196. 2001.PubMed/NCBI View Article : Google Scholar
6	Wang L, He S, Wu X, Liang S, Mu Z, Wei J, Deng F, Deng Y and Wei S: Polyetheretherketone/nano-fluorohydroxyapatite composite with antimicrobial activity and osseointegration properties. Biomaterials. 35:6758–6775. 2014.PubMed/NCBI View Article : Google Scholar
7	Sarot JR, Contar CM, Cruz AC and de Souza Magini R: Evaluation of the stress distribution in CFR-PEEK dental implants by the three-dimensional finite element method. J Mater Sci Mater Med. 21:2079–2085. 2010.PubMed/NCBI View Article : Google Scholar
8	Jonkergouw J, van de Vijfeijken SE, Nout E, Theys T, Van de Casteele E, Folkersma H, Depauw PR and Becking AG: Outcome in patient-specific PEEK cranioplasty: A two-center cohort study of 40 implants. J Craniomaxillofac Surg. 44:1266–1272. 2016.PubMed/NCBI View Article : Google Scholar
9	Lethaus B, Safi Y, ter Laak-Poort M, Kloss-Brandstätter A, Banki F, Robbenmenke C, Steinseifer U and Kessler P: Cranioplasty with customized titanium and PEEK implants in a mechanical stress model. J Neurotrauma. 29:1077–1083. 2012.PubMed/NCBI View Article : Google Scholar
10	Zegers T, Ter Laak-Poort M, Koper D, Lethaus B and Kessler P: The therapeutic effect of patient-specific implants in cranioplasty. J Craniomaxillofac Surg. 45:82–86. 2017.PubMed/NCBI View Article : Google Scholar
11	Hu B, Yang X, Hu Y, Lyu Q, Liu L, Zhu C, Zhou C and Song Y: The n-HA/PA66 cage versus the PEEK cage in anterior cervical fusion with single-level discectomy during 7 years of follow-up. World Neurosurg. 123:e678–e684. 2019.PubMed/NCBI View Article : Google Scholar
12	Zhang J, Pan A, Zhou L, Yu J and Zhang X: Comparison of unilateral pedicle screw fixation and interbody fusion with PEEK cage vs. standalone expandable fusion cage for the treatment of unilateral lumbar disc herniation. Arch Med Sci. 14:1432–1438. 2018.PubMed/NCBI View Article : Google Scholar
13	Kurtz SM and Devine JN: PEEK biomaterials in trauma, orthopedic, and spinal implants. Biomaterials. 28:4845–4869. 2007.PubMed/NCBI View Article : Google Scholar
14	Han ML, Li MH, Ji X, Han RY, Zhang N, Cui LH, Sun LF and Han CM: Establishment of TMJ defect models and evaluation on repair effect of CFR-PEEK material artificial joint in rabbits. J Jilin Univ Med Εd. 43:903–909. 2017.
15	Arabshahi Z, Kashani J, Rafiq M, Kadir A and Azari A: Influence of the TMJ implant geometry on stress distribution. Adv Mat Res. 488:991–995. 2012.
16	Hsu JT, Huang HL, Tu MG and Fuh LJ: Effect of bone quality on the artificial temporomandibular joint condylar prosthesis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 109:e1–e5. 2010.PubMed/NCBI View Article : Google Scholar
17	Huang HL, Su KC, Fuh LJ, Chen MY, Wu J, Tsai MT and Hsu JT: Biomechanical analysis of a temporomandibular joint condylar prosthesis during various clenching tasks. J Craniomaxillofac Surg. 43:1194–1201. 2015.PubMed/NCBI View Article : Google Scholar
18	Torstrick FB, Lin ASP, Potter D, Safranski DL, Sulchek TA, Gall K and Guldberg RE: Porous PEEK improves the bone-implant interface compared to plasma-sprayed titanium coating on PEEK. Biomaterials. 185:106–116. 2018.PubMed/NCBI View Article : Google Scholar
19	Kashi A, Chowdhury AR and Saha S: Finite element analysis of a TMJ implant. J Dent Res. 89:241–245. 2010.PubMed/NCBI View Article : Google Scholar
20	Chen X, Wang Y, Mao Y, Zhou Z, Zheng J, Zhen J, Qiu Y, Zhang S, Qin H and Yang C: Biomechanical evaluation of Chinese customized three-dimensionally printed total temporomandibular joint prostheses: A finite element analysis. J Craniomaxillofac Surg. 46:1561–1568. 2018.PubMed/NCBI View Article : Google Scholar
21	Rubin CT and Lanyon LE: Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int. 37:411–417. 1985.PubMed/NCBI View Article : Google Scholar
22	Jaworski ZF, Liskova-Kiar M and Uhthoff HK: Effect of long-term immobilisation on the pattern of bone loss in older dogs. J Bone Joint Surg Br. 62-B:104–110. 1980.PubMed/NCBI View Article : Google Scholar
23	Lovell NC: Structure function, and adaptation of compact bone. By R. Bruce Martin and David B. Burr. Am J Phys Anthropol. 82:116–117. 1990.
24	Mellal A, Wiskott HWA, Botsis J, Scherrer SS and Belser UC: Stimulating effect of implant loading on surrounding bone. Comparison of three numerical models and validation by in vivo data. Clin Oral Implants Res. 15:239–248. 2004.PubMed/NCBI View Article : Google Scholar
25	Sugiura T, Horiuchi K, Sugimura M and Tsutsumi S: Evaluation of threshold stress for bone resorption around screws based on in vivo strain measurement of miniplate. J Musculoskelet Neuronal Interact. 1:165–170. 2000.PubMed/NCBI