NiTi has been shown to be of great interest for bone implant applications. Introducing porosity to NiTi bone implants is an effective technique to tune their equivalent modulus of elasticity in order to acquire similar value to that of cortical bone. Moreover, such porous implants allow for better tissue ingrowth due to the interconnecting open pore structure. The effect of porosity percentage on the NiTi equivalent modulus of elasticity is well understood. However, the effect of porosity type on NiTi bone implant’s performance, in terms of the geometrical structure and other mechanical properties, has not yet been investigated. To this end, we simulated three porous structures made of shape memory Ti-rich Ni50.09Ti alloy. The effect of porosity type on the NiTi implant’s geometrical structure and mechanical properties was studied using numerical tests. The purpose is to compare three NiTi implants with different kinds of porosities, at a similar level of porosity (i.e., 69 %). The assigned porosity types in this study are Schwartz-type, Gyroid-type, and Diamond-type. Three triply periodic minimal surface (TPMS) models (9mm×9mm×9mm) with the assigned fixed level of porosity (69 %) were designed as CAD files using Solidworks. Each model was meshed, and the convergence study was conducted. The three models were then imported into a finite element package (ABAQUS). A UMAT code developed by IUT (Isfahan University of Technology) group was used to simulate the mechanical behavior of the shape memory NiTi alloy. All boundary conditions and loading conditions were applied to the models. Compressive mechanical tests were simulated in the finite element, and the resultant equivalent modulus of elasticity, elongations, stress, and strain was estimated. The results show anisotropic behavior within the three different porous structures. With the same level of porosity (i.e., 69 %), equivalent modulus of elasticity was observed to be 48.9, 34.8, and 30.2 GPa for Schwartz-type, Gyroid-type, and Diamond-type, respectively. Moreover, the Schwartz-type scaffold was seen to offer the highest stress at plateau start and the lowest residual strain after unloading, in comparison with the other two types of structure.

Additive manufacturing ( i.e. 3D printing) has only recently be shown as a well-established technology to create complex shapes and porous structures from different biocompatible metal powder such as titanium, nitinol, and stainless steel alloys. This allows for manufacturing bone fixation hardware with patient-specific geometry and properties (e.g. density and mechanical properties) directly from CAD files. Superelastic NiTi is one of the most biocompatible alloys with high shock absorption and biomimetic hysteresis behavior. More importantly, NiTi has the lowest stiffness (36–68 GPa) among all biocompatible alloys [1]. The stiffness of NiTi can further be reduced, to the level of the cortical bone (10–31.2 GPa), by introducing engineered porosity using additive manufacturing [2–4]. The low level of fixation stiffness allows for bone to receive a stress profile close to that of healthy bone during the healing period. This enhances the bone remodeling process (Wolf’s Law) which primarily driven by the pattern of stress. Also, this match in the stiffness of bone and fixation mitigates the problem of stress shielding and detrimental stress concentrations. Stress shielding is a known problem for the currently in-use Ti-6Al-4V fixation hardware. The high stiffness of Ti-6Al-4V (112 GPa) compared to bone results in the absence of mechanical loading on the adjacent bone that causes loss of bone mass and density and subsequently bone/implant failure. We have proposed additively manufactured porous NiTi fixation hardware with a patient-specific stiffness to be used for the mandibular reconstructive surgery (MRS). In MRS, the use of metallic fixation hardware and double barrel fibula graft is the standard methodology to restore the mandible functionality and aesthetic. A validated finite element model was developed from a dried cadaveric mandible using CT scan data. The model simulated a patient’s mandible after mandibular reconstructive surgery to compare the performance of the conventional Ti-6Al-4V fixation hardware with the proposed one (porous superelastic NiTi fixation plates). An optimized level of porosity was determined to match the NiTi equivalent stiffness to that of a resected bone, then it was imposed to the simulated fixation plates. Moreover, the material property of superelastic NiTi was simulated by using a validated customized code. The code was calibrated by using DSC analysis and mechanical tests on several prepared bulk samples of Ni-rich NiTi. The model was run under common activities such as chewing by considering different levels of the applied fastening torques on screws. The results show a higher level of stress distribution on mandible cortical bone in the case of using NiTi fixation plates. Based on wolf’s law it can lead to a lower level of stress shielding on the grafted bone and over time bone can remodel itself. Moreover, the results suggest an optimum fastening torque for fastening the screws for the superelastic fixations causes more normal distribution of stress on the bone similar to that for the healthy mandible. Finally, we successfully fabricated the stiffness-matched porous NiTi fixation plates using selective laser melting technique, and they were mounted on the dried cadaveric mandible used to create the finite element model.

Foot drop usually happens due to neurological and muscular diseases. It limits individuals’ abilities in ankle and toe represented in dorsiflexion during swing phase, and plantar flexion during heel strike. A non-surgical solution to such weakness is the use of ankle foot orthoses (AFOs) which can assist in such abnormal ambulation. The purpose of this work is to develop a new ankle foot orthosis that helps patients to have more normal ankle joint behavior. The proposed AFO device takes advantage of the superelastic behavior of Ni-rich NiTi alloys. In order to evaluate the performance of the Ni-rich NiTi hinged ankle foot orthoses, several motion analysis tests for a normal walking of a healthy subject were conducted. Also, a finite element model were developed to evaluate the performance of superelastic versus stainless steel springs. A Ni-rich NiTi wire was wrapped around a designed rod and the two heads were fixed to the rod (to get the shape of a spring). Then a heat treatment process was performed in a furnace to shape set the NiTi wires and to provide them with the needed superelastic behavior. The produced springs were connected to a designed hinged ankle foot orthoses. Motion analysis was performed on a healthy subject during normal walking in the case of using conventional stainless steel springs, and with using the produced NiTi springs. Joint kinematics and kinetics data of left lower limb (which was equipped with the AFO brace) were collected and calculated to compare normal walking patterns to the resultant walking patterns with the proposed ankle foot orthosis. The CAD file of the AFO, hinge structure and the springs were developed. Each component was meshed and the convergence study were conducted. A finite element model was developed after assembling and introducing all the interactions between parts in Abaqus. The boundary conditions were applied to the system in a way simulating normal walking conditions. Different material properties (stainless steel and superelastic NiTi) were assigned to the springs in the model to evaluate the performance of the system under the aforementioned loading scenario. The results of the motion analysis on a healthy subject during walking indicate that the use of the superelastic NiTi springs causes more normal walk compare to the use of the conventional stainless steel springs, especially during swing phase and heel strike. Moreover, the ankle has closer stiffness profile to the normal walking in the case of using NiTi springs. The results of the finite element analysis show that the super elastic behavior of NiTi results in more hinge rotation while the stress concentration developed on the springs is within the safe levels and cannot cause failure of the NiTi springs. Motion analysis and finite element models were conducted for the proposed hinged AFO and the results were compared with conventional AFO. By taking advantage of the super elastic characteristic of NiTi, more normal walking behavior was observed in the case of using the proposed AFO with Ni-rich NiTi springs.

NiTi alloys are interesting materials for biomedical implants since they offer unique characteristics such as superelastic behavior, low stiffness (I.e., modulus of elasticity) close to that of the cortical bone, and shock absorption. Thermal treatments are the most common and practical ways to improve the superelasticity of these alloys. In addition to the superelastic behavior of the metallic implants, it is important for the implants to have a stiffness similar to that of cortical bone in order to reduce the risk of failure caused by stress shielding. The cortical bone has a stiffness ranging from 12 to 31 GPa for different patients (e.g., sex, age, mechanical behavior of bone) and various bone locations (e.g., jaw implant, hip implant), while the untreated Ni-rich NiTi has the stiffness equal to 41.37 GPa. One recently used technique to lower the stiffness of NiTi implant is to introduce porosity into the implant. The major problem associated with the imposed porosity is stress concentration on the pore walls and the subsequent implant failure. In this work, the purpose is to tune the stiffness via changing the post-heat treatment conditions, i.e., aging time and aging temperature. In this study, several bulk specimens of Ni-rich NiTi (SLM Ni50.8Ti49.2) were additively manufactured using selective laser melting (SLM) technique. The samples were solution annealed (950 °C, 5.5 h) and subsequently water quenched to provide equilibrium state in the samples. Subsequently, different aging conditions (350 °C and 450 °C for 5 to 18 hours) were applied to the samples. Mechanical testing (compression) was conducted on the samples and the stiffness of each sample was defined to investigate the effect of aging on the stiffness. Our results indicate that the range of 29.9 to 43.7 GPa for stiffness can be achieved through the implant via different time period and temperatures for aging. The modulus of 43.7 GPa is attributed to 10 hours heat treatment under 450 °C and the modulus of 29.9 GPa is attributed to 18 hours heat treatment under 350 °C.

The most common method for mandibular reconstructive surgery is the use of a Ti-6Al-4V fixation device and a fibular double barrel graft. This highly stiff fixation hardware (E = 112 GPa) often shields the bone graft (E = 20 GPa) from carrying the load, which may result in bone resorption. Highly stiff Ti-6Al-4V fixation hardware is also likely to concentrate stress in the fixation plate or at screw threads, possibly leading to hardware cracking or screw pull-out. As a solution for that, we have proposed and studied the effect of using a low stiffness, porous NiTi fixation device [1–4]. Although the stress in the fixation device is increased, using such low stiffness fixation hardware, is preferable to have an even higher stress on the graft in order to minimize the risk of resorption or hardware failure. We assume that preloading screws allows them to better engage the fixation hardware with the plate and the surrounding bone and causes an increased von Mises stress. The fixation device can be patient-specific and additively manufactured, such that the shape would match the outer surface of the cortical bone. In this study, we modeled a healthy cadaver mandible via CT-derived 3D surface data. The mandible was virtually resected in the molar region (M 1−3 ). The model simulated the result of reconstructive surgery under the highest chewing loading regime (i.e., 526 N on first right molar tooth [5, 6]) where reconstruction was done with either Ti-6Al-4V fixation hardware or patient specific, stiffness-matched, porous NiTi fixation hardware. The calibration of the material properties for this simulation was done using experimentally obtained data (DSC and compression tests) of Ni-rich NiTi bulk samples. The analyzed term in the finite element analysis was stress distribution in the cortical and cancellous bone. Porous NiTi fixation devices were also produced using Selective Laser Melting (SLM) using the geometry of the aforementioned cadaver mandible. In this paper we have studied the effect of additional torque or preload on the performance of the fixation plates. The finite element analysis demonstrated that applying a preload to the screws increased the stress on the bone. Under similar levels of applied preload, the porous NiTi fixation device showed an increased level of von Mises stress in the bone, particularly in the graft. Additionally, the analysis indicated the higher level of stress on the bone surrounding the screws for the case of using NiTi, which could contribute to increasing screw stability. The fabricated patient-specific fixation hardware not only matched the shape of cortical bone but also contained the level of porosity that defines the appropriate modulus of elasticity.

Selective laser melting (SLM) is an additive manufacturing technique in which complex parts can be fabricated directly by melting layers of powder from a CAD model. SLM has a wide range of application in biomedicine and other engineering areas and it has a series of advantages over traditional processing techniques. A large number of variables including laser power, scanning speed, scanning line spacing, layer thickness, material based input parameters, etc. have a considerable effect on SLM process materials. The interaction between these parameters is not completely studied. Limited studies on balling effect in SLM, densifications under different processing conditions, and laser re-melting, have been conducted that involved microstructural investigation. Grain boundaries are amongst the most important microstructural properties in polycrystalline materials with a significant effect on the fracture and plastic deformation. In SLM samples, in addition to the grain boundaries, the microstructure has another set of connecting surfaces between the melt pools. In this study, a computational framework is developed to model the mechanical response of SLM processed materials by considering both the grain boundaries and melt pool boundaries in the material. To this end, a 3D finite element model is developed to investigate the effect of various microstructural properties including the grains size, melt pools size, and pool connectivity on the macroscopic mechanical response of the SLM manufactured materials. A conventional microstructural model for studying polycrystalline materials is modified to incorporate the effect of connecting melt pools beside the grain boundaries. In this model, individual melt pools are approximated as overlapped cylinders each containing several grains and grain boundaries, which are modeled to be attached together by the cohesive zone method. This method has been used in modeling adhesives, bonded interfaces, gaskets, and rock fracture. A traction-separation description of the interface is used as the constitutive response of this model. Anisotropic elasticity and crystal plasticity are used as constitutive laws for the material inside the grains. For the experimental verification, stainless steel 316L flat dog bone samples are fabricated by SLM and tested in tension. During fabrication, the power of laser is constant, and the scan speed is changed to study the effect of fabrication parameters on the mechanical properties of the parts and to compare the result with the finite element model.

The aim of this article is to investigate the effect of two different fixation hardware materials on bone remodeling after a mandibular reconstruction surgery and to restore the mandible’s function, healthy appearance, mastication, swallowing, breathing, and speech. The hypothesis is that using fixation hardware with stiffness close to that of the surrounding bone will result in a more successful healing process in the mandible bone. The finite element model includes the material properties and forces of the cancellous bone, cortical bone, ligaments, muscles, and teeth. The reconstruction surgery is modeled by including the fixation hardware and the grafted bone. In the sectioned mandible, to best mimic the geometry of the mandible, two single barrel grafts are placed at the top of each other to form a double barrel graft set. Two different materials were used as the mandibular fixation parts, stiff Ti-6Al-4V, and porous superelastic Nickel-Titanium (NiTi) alloys. A comparison of these two alloys demonstrates that using porous NiTi alloy as the fixation part results in a faster healing pace. Furthermore, the density distribution in the mandibular bone after the healing process is more similar to the normal mandible density distribution. The simulations results indicate that the porous superelastic NiTi fixation hardware transfers and distributes the existing forces on the mandible bone more favorably. The probability of stress shielding and/or stress concentration decrease. This type of fixation hardware, therefore, is more appropriate for mandible bone reconstruction surgery.

Mandibular segmental defect reconstruction is most often necessitated by tumor resection, trauma, infection, or osteoradionecrosis. The standard of care treatment for mandibular segmental defect repair involves using metallic plates to immobilize fibula grafts, which replace the resected portion of mandible. Surgical grade 5 titanium (Ti-6Al-4V) is commonly used to fabricate the fixture plate due to its low density, high strength, and high biocompatibility. One of the potential problems with mandibular reconstruction is stress shielding caused by a stiffness mismatch between the Titanium fixation plate and the remaining mandible bone and the bone grafts. A highly stiff fixture carries a large portion of the load (e.g., muscle loading and bite force), therefore the surrounding mandible would undergo reduced stress. As a result the area receiving less strain would remodel and may undergo significant resorption. This process may continue until the implant fails. To avoid stress shielding it is ideal to use fixtures with stiffness similar to that of the surrounding bone. Although Ti-6Al-4V has a lower stiffness (110 GPa) than other common materials (e.g., stainless steel, tantalum), it is still much stiffer than the cancellous (1.5–4.5 GPa) and cortical portions of the mandible (17.6–31.2 GPa). As a solution, we offer a nitinol in order to reduce stiffness of the fixation hardware to the level of mandible. To this end, we performed a finite element analysis to look at strain distribution in a human mandible in three different cases: I) healthy mandible, II) resected mandible treated with a Ti-6Al-4V bone plate, III) resected mandible treated with a nitinol bone plate. In order to predict the implant’s success, it is useful to simulate the stress-strain trajectories through the treated mandible. This work covers a modeling approach to confirm superiority of nitinol for mandibular reconstruction. Our results show that the stress-strain trajectories of the mandibular reconstruction using nitinol fixation is closer to normal than if grade 5 surgical titanium fixation is used.