A stent is a device designed to restore flow through constricted arteries. These tubular scaffold devices are delivered to the afflicted region and deployed using minimally invasive techniques. Stents must have sufficient radial strength to prop the diseased artery open. The presence of a stent can subject the artery to abnormally high stresses that can trigger adverse biologic responses culminating in restenosis. The primary aim of this investigation was to investigate the effects of varying stent “design parameters” on the stress field induced in the normal artery wall and the radial displacement achieved by the stent. The generic stent models were designed to represent a sample of the attributes incorporated in present commercially available stents. Each stent was deployed in a homogeneous, nonlinear hyperelastic artery model and evaluated using commercially available finite element analysis software. Of the designs investigated herein, those employing large axial strut spacing, blunted corners, and higher amplitudes in the ring segments induced high circumferential stresses over smaller areas of the artery’s inner surface than all other configurations. Axial strut spacing was the dominant parameter in this study, i.e., all designs employing a small stent strut spacing induced higher stresses over larger areas than designs employing the large strut spacing. Increasing either radius of curvature or strut amplitude generally resulted in smaller areas exposed to high stresses. At larger strut spacing, sensitivity to radius of curvature was increased in comparison to the small strut spacing. With the larger strut spacing designs, the effects of varying amplitude could be offset by varying the radius of curvature and vice versa. The range of minimum radial displacements from the unstented diastolic radius observed among all designs was less than $90μm$. Evidence presented herein suggests that stent designs incorporating large axial strut spacing, blunted corners at bends, and higher amplitudes exposed smaller regions of the artery to high stresses, while maintaining a radial displacement that should be sufficient to restore adequate flow.

Purpose: To examine the solid mechanical effects of varying stent design and atherosclerotic plaque stiffness on the biomechanical environment induced in a diseased artery wall model. Methods: Computational modeling techniques were employed to investigate the final radius of the lumen and artery wall stresses after stent implantation. Two stent designs were studied (one stiff and one less stiff). The stenotic artery was modeled as an axisymmetrical diseased vessel with a 20% stenosis by diameter. The material properties of the diseased tissue in the artery models varied. Atherosclerotic plaques half as stiff (0.5×), of equal stiffness (1.0×), or twice as stiff (2.0×) as the artery wall were investigated. Results: Final lumen radius was dependent on stent design, and the stiffer stent deformed the artery to an approximately 10% greater radius than the more compliant design. Alternatively, circumferential stress levels were dependent on both stent design and plaque material properties. Overall, the stiffer stent subjected the artery wall to much higher stress values than the more compliant design, with differences in peak values of 0.50, 0.31, and 0.09 MPa for the 2.0×, 1.0×, and 0.5× stiff plaques, respectively. Conclusion: Evidence suggests that a judicious choice of stent design can minimize stress while maintaining a patent lumen in stenotic arteries. If confronted with a rigid, calcified plaque, stent design is more important, as design differences can impose dramatically different stress fields, while still providing arterial patency. Alternatively, stent design is not as much of an issue when treating a soft, lipid-laden plaque, as stress fields do not vary significantly among stent designs.

Background: Sculpted physical models and castings of the anatomy of cleft lip and palate are used for parent, patient, and trainee education of cleft lip and palate conditions. In this study, we designed a suite of digital 3-dimensional (3D) models of cleft lip and palate anatomy with additive manufacturing techniques for patient education. Methods: CT scans of subjects with isolated cleft palate, unilateral and bilateral cleft lip and palate, and a control were obtained. Soft tissue and bony structures were segmented and reconstructed into digital 3D models. The oral soft tissues overlying the cleft palate were manually molded with silicone putty and scanned using CT to create digital 3D models. These were then combined with the original model to integrate with segmentable soft tissues. Bone and soft tissues were 3D printed in different materials to mimic the rigidity/softness of the relevant anatomy. These models were presented to the parents/patients at our craniofacial clinic. Visual analog scale (VAS) surveys were obtained pertaining to the particular use of the models, to ascertain their value in parental education. Results: A total of 30 parents of children with cleft conditions completed VAS evaluations. The models provided the parents with a better understanding of their child’s condition with an overall evaluation score of 9.35 ± 0.5. Conclusions: We introduce a suite of 3D-printed models of cleft conditions that has a useful role in patient, parental, and allied health education with highly positive feedback.

Introduction: The purpose of this study was to compare the stress distributions in the teeth treated through minimally invasive access (MIA) designs to those of the teeth treated through traditional straight-line access and their relationship to the final restoration using three-dimensional finite element analysis (FEA). Materials and Methods: Four FEA models of an extracted mandibular first molar were constructed. An intact model served as the control, whereas the other three were prepared with either an MIA or traditional straight-line access. Simulated composite access fillings with or without a simulated gold crown were applied to the models, followed by application of an occlusal load of 100 N. Von Mises stresses in the teeth were then calculated and analyzed. Results: Stress values within the dentin for baseline, MIA with composite filling, MIA with composite filling and crown, and traditional access with composite filling and crown were 10.14 MPa, 6.98 MPa, 11.79 MPa, and 16.81 MPa, respectively. Higher stress values indicate that the tooth is more prone to fracture. Conclusions: A traditional endodontic access cavity may render a tooth more susceptible to fracture compared with an MIA design.