Jesus Alejandro Serrato-Pedrosa

Background/Objectives: Residual enamel fracture is a frequent complication of extensively prepared teeth. This finite element analysis (FEA) characterized stresses in enamel, dentin and restoration of a mandibular first molar restored with a ceromer onlay under vertical and oblique loading, and their sensitivity to boundary conditions and restoration stiffness. Methods: A single-geometry model from cone-beam computed tomography used linear elastic, isotropic materials and bonded interfaces. A static 698 N load was applied axially and at 30° with the root fixed 2 mm below the cervical limit of enamel. Mesh, support position, an elastic periodontal ligament (PDL) support and restoration modulus were varied. Maximum principal stress (σ1) was reported as peak, 99th percentile and proportion of nodes above published strengths. Results: Peak enamel σ1 was 51.0 MPa (vertical) and 167.6 MPa (oblique); 1.6% and 7.6% of enamel nodes reached 11.5 MPa, the lowest reported tensile strength. Peaks lay at the restoration margin and cervical edge, growing with mesh refinement. An elastic PDL support raised the enamel 99th percentile by 7% to 15%; restoration modulus changed it by +11% to −15%. Conclusions: Tensile concentrations are localized, increase with load obliquity and depend on the support conditions analyzed. Validation is required.

Computational biomechanics has grown substantially alongside imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI), which together enable high-fidelity biomodels of both hard and soft tissues. Most such biomodels, however, are represented as continuous homogeneous solids, limiting their capacity to reproduce the internal architecture of living tissues. Micro-finite element (μFE) analysis has addressed this limitation for bone at sub-millimetric scales using micro-CT data, but its adoption remains constrained by scanner availability, computational cost, and workflow complexity. This work proposes a methodological framework, termed intrabiofidelity, as a taxonomic descriptor complementary to biofidelity that characterizes the degree to which a biomodel reproduces the internal morphology and morphometry of a tissue. A reproducible pipeline based on ScanIP^® segmentation of MRI-derived DICOM data, SolidWorks^® solidification, and ANSYS^® Workbench finite element analysis is presented, through which a macro-scale trabecular representation is extracted from the distal femoral cancellous bone and integrated into a knee biomodel. Two numerical analyses were performed under an equivalent bipodal-standing load with orthotropic material properties for cortical and trabecular bone: one with external biofidelity only (Case 1), and one incorporating macro-scale intrabiofidelity in the trabecular bone (Case 2). The introduction of intrabiofidelity produced a substantial redistribution of peak von Mises stress between compartments. Trabecular peak stress increased from 2.66 to 12.10 MPa (a 4.5-fold elevation), while cortical peak stress decreased from 56.25 to 45.97 MPa (an 18.3% reduction), whereas the volume-averaged stress remained essentially unchanged in both tissues, indicating that intrabiofidelity primarily affects local concentrations rather than the bulk stress state. Principal stress data further revealed that the trabecular region transitions from a low-stress, predominantly compressive state in Case 1 to one in which substantial local tensile and compressive concentrations of comparable magnitude coexist in Case 2. The proposed methodology provides an accessible workflow for macro-scale integration of internal bone architecture using routinely available MRI data and commercial FEA software, and introduces intrabiofidelity as a terminological complement useful for teaching and for systematically documenting the fidelity of computational biomodels.

Introduction: Scientific understanding of dental implant success has evolved significantly. Nowadays, it is well established that the long-term stability of an implant relies on osseointegration, a complex biological process directed by molecular and genetic signals at the bone-implant interface. This systematic review research synthesizes the recent scientific literature to identify specific genes and expression patterns that can indicate implant outcomes. Hence, the systematic review examines key signaling pathways, the influence of implant surface characteristics on cellular responses, and the potential for patient-specific therapeutic strategies. Methods: For this synthesis, relevant studies published between January 2020 and May 2025 were identified using the MEDLINE (via PubMed), Scopus and Web of Science databases, along the PRISMA methodology was employed. Furthermore, a quantitative meta-analysis was performed on a subset of homogenous in vitro studies. Results: The collected evidence reveals a distinct molecular signature for successful integration, initiated by the increased expression of primary bone-regulating genes, such as RUNX2 and followed by the production of essential bone matrix proteins. In contrast, implant failure and peri-implantitis show a consistent association with a malfunctioning inflammatory response. This state is marked by elevated concentrations of inflammatory messengers ( IL-1β , IL-6 , and TNF-α ) and an imbalanced RANKL/OPG ratio that favors bone resorption. Crucially, the implant surface is not a passive component in this process, its micro and nanoscale features are shown to actively guide these genetic pathways and shape the resulting cellular behavior. The findings revealed that modified implant surfaces significantly upregulate the expression of the key osteogenic transcription factor RUNX2 (Standardized Mean Difference: 2.58; 95% CI: 1.21 to 3.95; p < 0.001). Discussion: The central conclusion is that specific, measurable gene expression patterns show promise as potential indicators of the biological processes governing dental implant outcomes. The emerging paradigm of implantogenomics aims to enable clinicians to perform personalized risk assessments and utilize advanced implant technologies to design individual, unique biological profile therapies and strategies, thereby optimizing the potential for long-term clinical success.

The widely available options of different manufacturers in dental implant systems have complicated the selection criteria process for periodontists, necessitating careful consideration of various factors when selecting suitable solutions for individual patient needs. Optimal implant selection requires careful consideration of the patient-specific factors, implant design, and surgical technique. Understanding the biomechanical behavior of implant–tissue interactions is crucial for achieving successful and long-lasting implant therapy. To adequately address this issue and improve the rigorous selection criteria from a biomechanically numerical approach, this research aims to analyze the stress distribution fields, strain patterns, and load transfer displacements within the implant system and the implant–biological interface (gingival and bony tissues) of titanium three-piece to two–one-piece ceramic implant systems. Thus, three different commercially available dental implants designed to be placed in the jaw molar region were considered for evaluation through the finite element method under both oblique and occlusal loading conditions. The results have exhibited an increasing trend to highlight the outstanding behavior of two-piece ceramic implants to dissipate the stress distribution better (6 and 2 times lower than the three- and one-piece systems under occlusal loads and almost 5 and 1.3 times more efficient for oblique loading, respectively), minimize peak stress values (below 100 MPa), and reduce strain peak patterns compared with the other two evaluated designs. On the other hand, the effects generated in biological tissues are strongly associated with implant geometry features. This biomechanical approach could provide a promising strategy for predicting micro-strains and micromotion in implant system pieces and geometries. Hence, these findings contribute to a deeper understanding of the biomechanics spectrum in the behavior of dental implant systems and emphasize the importance of carefully selecting appropriate material systems for accurate patient-specific biomechanical performance.

The study of the phenomena occurring in the plantar region is remarkably intriguing, especially when performing a normal gait cycle where the foot is under loading conditions. The effects presented in the foot while walking provide relevant indicators regarding clinical means for enhancing regular performance or rehabilitation therapies. Nevertheless, more than traditional methods are needed to biomechanically evaluate foot structural conditions, leading to an incomplete database for determining the patient’s needs so that advanced methodologies provide detailed medical assessment. Therefore, it is necessary to employ technological engineering tools to optimize biomechanical plantar pressure evaluations to reach suitable personalized treatments. This research initially evaluated numerically the pressure points in the foot sole region in each one of the five stance phases in a normal gait cycle. Medical imaging techniques were utilized to construct an anatomically accurate biomodel of the soft tissues of the right foot. The Finite Element Method was employed to predict peak plantar pressure in barefoot conditions for all stance phases; results from this case study presented a close alignment with gait experimental testing implemented to analyze the feasibility and validation of all mechanical considerations for the numerical analyses. Hence, having a solid foundation in the biomechanical behavior from the first case study close estimates, a 3D-printable patient-specific insole was designed and numerically analyzed to observe the mechanical response in the plantar critical zones utilizing a personalized orthotic device. Results from the second case study notably demonstrated a crucial decrement in excessive pressure values. Employing morphological customization orthopedics modeling combined with 3D-printable materials is revolutionizing assistive device design and fabrication techniques. The fundamental contribution of this research relies on deepening the knowledge of foot biomechanics from an interdisciplinary approach by numerically analyzing pressure distribution in critical regions for all five stances phases; thus, based on the methods employed, the results obtained contribute to the advances of patient-specific foot orthopedics.

Plantar pressure distribution is a thoroughly recognized parameter for evaluating foot structure and biomechanical behavior, as it is utilized to determine musculoskeletal conditions and diagnose foot abnormalities. Experimental testing is currently being utilized to investigate static foot conditions using invasive and noninvasive techniques. These methods are usually expensive and laborious, and they lack valuable data since they only evaluate compressive forces, missing the complex stress combinations the foot undergoes while standing. The present investigation applied medical and engineering methods to predict pressure points in a healthy foot soft tissue during normal standing conditions. Thus, a well-defined three-dimensional foot biomodel was constructed to be numerically analyzed through medical imaging. Two study cases were developed through a structural finite element analysis. The first study was developed to evaluate barefoot behavior deformation and stresses occurring in the plantar region. The results from this analysis were validated through baropodometric testing. Subsequently, a customized 3D model total-contact foot orthosis was designed to redistribute peak pressures appropriately, relieving the plantar region from excessive stress. The results in the first study case successfully demonstrated the prediction of the foot sole regions more prone to suffer a pressure concentration since the values are in good agreement with experimental testing. Employing a customized insole proved to be highly advantageous in fulfilling its primary function, reducing peak pressure points substantially. The main aim of this paper was to provide more precise insights into the biomechanical behavior of foot pressure points through engineering methods oriented towards innovative assessment for absolute customization for orthotic devices.