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Download The PREDICTING OCCLUSAL FORCE AND AREA THROUGH A BIOMECHANICAL SIMULATION OF MASTICATION AND CONTROLLED STUDY By Heather Borgard B.Sc., Arizona State University, 2015 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF APPLIED SCIENCE in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Biomedical Engineering) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) March 2020 © Heather Borgard, 2020 The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, a thesis/dissertation entitled: Predicting occlusal force and area through a biomechanical simulation of mastication and controlled study submitted by Heather Borgard in partial fulfillment of the requirements for the degree of Master of Applied Science in Biomedical Engineering Examining Committee: Sid Fels Supervisor Antony Hodgson Supervisory Committee Member Eitan Prisman Supervisory Committee Member Additional Examiner ii Abstract Currently, most evaluations of patient outcome following mandibular reconstructive surgery are defined by a combination of qualitative analyses consisting of patient-reported functional ability and masticatory performance. Metrics such as occlusal pressure and jaw kinematics provide quantitative assessments of masticatory function, facilitating a more comprehensive evaluation of patient outcomes. This thesis proposes a novel virtual mastication framework for evaluating occlusal force and area based on metrics of masticatory force and kinematics taken in a clinical setting. Statistical shape modeling was used to develop a mandible atlas based on the morphological averages which contribute to both universal model creation and prediction of missing anatomy. The simulation was able to predict clinically verified maximum occlusal forces and contact areas based on data inputs of intraoral dentition scans and jaw constraints provided through a controlled study of healthy volunteers. In assembly with this framework, a validation study of an occlusal force and contact area measurement system (Dental Prescale II) was performed to gain principal masticatory function information with measured accuracy. This work serves as a foundation for implementing virtual tools within the maxillofacial reconstructive surgery clinical workflow. iii Lay Summary Standard follow-up for mandibular reconstructive surgery often lacks information regarding a quantitative evaluation of functional outcome, mainly due to the complexity of obtaining clinical measurements. This thesis explores the metrics of bite force and contact area in a biomechanical simulation based on a healthy population. The device used to collect this data was validated and found to be adequate for reliable measurements. The work presented in this thesis demonstrates the feasibility of creating these simulations for patient cases and examines how the process can fit into a typical clinical workflow for mandibular reconstructive surgery. iv Preface This thesis presented herein was approved by UBC Clinical Research Ethics Board, certificate numbers: H19-03452 and H17-02922. Most of the contributions described in Chapter 3 and Chapter 4.1 have been presented previously in [P3]. I was the primary author and main contributor to the overall design, planning, and testing of these methods described in [P3], under supervision of Dr. Sidney Fels. Amir Abdi gave data analysis support and editorial feedback to the paper. Some parts of Chapter 3 has been published in the paper [P4]. Amir Abdi was the primary author, and I provided some of the data analysis and assisted with writing and editing of the paper. The contributions described in Chapters 4 are not yet published [P1]. I am the primary author. Dr. Eitan Prisman provided the preoperative and postoperative Computed Tomography (CT) and patient data. Dr. Yasue Tanaka assisted with the validation study. Contributions in Chapter 2 and Chapter 4 have also been discussed in [P2] and [P5]. Xiaotian Wu was the primary author. I assisted with editing of the paper and registration methods. Journal Manuscripts [P1] Borgard, H., Tanaka, Y., Hattori, Y., Hannam, A., Prisman, E., Fels, S. Validation and Reliability of the GC Dental Prescale II in measuring occlusal force and contact area. (2020, expected). Journal of Dentistry v Peer-Reviewed Conference Papers [P2] Wu, X.C., Snchez, A., Kahng, P., Rees, C.A., Ponukumati, A.S., Eisen, E.A., Pastel, D.A., Borgard, H., Lloyd, J.E., Fels, S., Paydarfar, J.A., and Halter, R.J. (2019 in review). Estimating tongue deformation during laryngoscopy using hybrid FEM-multibody model and intraoperative tracking: a cadaver pilot study. Image- Guided Procedures, Robotic Interventions, and Modeling, part of SPIE Medical Imaging [P3] Borgard, H., Abdi, H. A., Prisman, E., Fels, S. Creation of Categorical Mandible Atlas to Benefit Non-Rigid Registration. (2019). CMBBE Proceedings. [P4] Abdi, A., Borgard, H., Abolmaesumi, P., Fels, S. (2019). AnatomyGen: Deep anatomy generation from dense representation with applications in mandible synthesis. Proceedings of Machine Learning Research. [P5] Wu, X.C., Sánchez, A., Kahng, P., Rees, C.A., Ponukumati, A.S., Eisen, E.A., Pastel, D.A., Borgard, H., Lloyd, J.E., Fels, S., Paydarfar, J.A., and Halter, R.J. (2019) Multi-modal Framework for Image-guided Trans-oral Surgery with Intraoperative Imaging and Deformation Modeling. Proceedings of IEEE Engineering in Medicine and Biology Society (EMBC). vi Table of Contents Abstract ................................................................................................................. iii Lay Summary ....................................................................................................... iv Preface .....................................................................................................................v Table of Contents ................................................................................................ vii List of Tables ..........................................................................................................x List of Figures ....................................................................................................... xi List of Abbreviations ........................................................................................ xvii Acknowledgements ............................................................................................ xix Chapter 1: Introduction ........................................................................................1 1.1 Motivation ............................................................................................... 2 1.2 Contributions........................................................................................... 8 1.3 Thesis Outline ....................................................................................... 10 Chapter 2: Background .......................................................................................12 2.1 Anatomy and Physiology of Mastication .............................................. 12 2.1.1 Skeletal System ................................................................................. 13 2.1.2 Muscular System ............................................................................... 20 2.1.3 Kinematics of Jaw Function.............................................................. 24 2.1.4 Neuromuscular Role in Mastication ................................................. 31 vii 2.2 Data Acquisition ................................................................................... 32 2.2.1 Magnetic Resonance Imaging ........................................................... 33 2.2.2 Computed Tomography .................................................................... 35 2.2.3 Additional Imaging ........................................................................... 36 2.2.4 Segmentation..................................................................................... 39 2.2.5 Electromyography ............................................................................. 41 2.3 Determination of Functional Metrics .................................................... 42 2.3.1 Qualitative Measurements ................................................................ 43 2.3.2 Product-Based Analysis .................................................................... 44 2.3.3 Kinematic and Maximal Range of Motion Measurements ............... 46 2.3.4 Force Measurements ......................................................................... 53 2.4 Modeling and Simulation of Mastication ............................................. 58 2.4.1 Subject-Specific Modeling................................................................ 59 2.4.2 Related Modelling Work................................................................... 64 2.4.3 ArtiSynth ........................................................................................... 65 2.4.4 Virtual Surgical Planning (VIPRE) .................................................. 68 2.5 Discussion ............................................................................................. 70 Chapter 3: Statistical Shape Modeling ..............................................................71 3.1 Geometric Morphometrics .................................................................... 71 3.1.1 Generalized Procrustes Analysis....................................................... 73 3.1.2 Principal Component Analysis
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