Comparison of different orthodontic devices for mandibular symphyseal distraction osteogenesis: A finite element study

Boccaccio, Antonio; Lamberti, Luciano; Pappalettere, Carmine; Cozzani, Mauro

doi:10.1016/j.ajodo.2006.09.066

Cited by 32 publications

(21 citation statements)

References 16 publications

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“…A number of studies have used the finite element (FE) method to investigate the mechanics of mandibular distraction osteogenesis [5,7,8,11,32]. Loboa et al [35] used a FE approach to study tissue differentiation at different stages of mandibular distraction osteogenesis in a rat model.…”

Section: Introductionmentioning

confidence: 99%

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

Boccaccio

Prendergast

Pappalettere

et al. 2007

Med Biol Eng Comput

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Mandibular symphyseal distraction osteogenesis is a common clinical procedure to modify the geometrical shape of the mandible for correcting problems of dental overcrowding and arch shrinkage. In spite of consolidated clinical use, questions remain concerning the optimal latency period and the influence of mastication loading on osteogenesis within the callus prior to the first distraction of the mandible. This work utilized a mechano-regulation model to assess bone regeneration within the callus of an osteotomized mandible. A 3D model of the mandible was reconstructed from CT scan data and meshed using poroelastic finite elements. The stimulus regulating tissue differentiation within the callus was hypothesized to be a function of the strain and fluid flow computed by the finite element model. This model was then used to analyse tissue differentiation during a fifteen day latency period, defined as the time between the day of the osteotomy and the day when the first distraction is given to the device. The following predictions are made: (i) the mastication forces generated during the latency period support osteogenesis in certain regions of the callus, and that during the latency period the percentage of progenitor cells differentiating into osteoblasts increases; (ii) reducing the mastication load by 70% during the latency period increases the number of progenitor cells differentiating into osteoblasts; (iii) the stiffness of new tissue increases at a slower rate on the side of bone callus next to the occlusion of the mandibular ramus which could cause asymmetries in the bone tissue formation with respect to the middle sagittal plane. Although the model predicts that the mastication loading generates such asymmetries, their effects on the spatial distribution of callus mechanical properties are insignificant for typical latency periods used clinically. It is also predicted that a latency period of longer than a week will increase the risk of premature bone union across the callus.

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Section: Introductionmentioning

confidence: 99%

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

Boccaccio

Prendergast

Pappalettere

et al. 2007

Med Biol Eng Comput

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“…They concluded that higher rates of expansion reduce the stress in the mandible and allow better control of the displacement field induced on the mandibular arch. The same authors 6 have also investigated how the displacement and stress field induced by the device in the mandible changes when full mastication loads are applied. An average change of 7% in the displacement field was predicted, with a maximum Von Mises stress of about 30 MPa in regions close to the point where the device is attached to the mandible.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Expansion Rates on Mandibular Distraction Osteogenesis: A Computational Analysis

Boccaccio

Pappalettere²,

Kelly

2007

Ann Biomed Eng

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“…Because they are designed and attached differently, the distractors apply force at different locations; therefore, they are predicted to produce varying amounts of skeletal and dental expansion. [9][10][11] The bone-borne and hybrid distractors are predicted to provide more parallel expansion of basal and alveolar bone, while the tooth-borne distractor should create a disproportionately bony regenerate with greater expansion of alveolar bone. 12 Past research has identified the differences in the bony regenerate produced by different appliances.…”

Section: Introductionmentioning

confidence: 99%

Skeletal and dental effects of tooth-borne versus hybrid devices for mandibular symphyseal distraction osteogenesis

Niculescu

King

Lindauer

2013

The Angle Orthodontist

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Objective: To evaluate and compare, retrospectively, the skeletal and dental effects of mandibular symphyseal distraction osteogenesis (MSDO) achieved through the use of tooth-borne versus hybrid distractors. Materials and Methods: Pretreatment (T1), predistraction (T2), postdistraction (T3), and posttreatment (T4) orthodontic records were collected and analyzed for 47 patients (20 toothborne, 27 hybrid). At each time point, records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Submental vertex radiographs were taken at T2, T3, and T4. Changes in a total of 18 measurements were analyzed to compare patients undergoing tooth-borne versus hybrid distraction. Results: The cumulative effects of orthodontics and MSDO produced similar gains in measured arch widths, with a decreased irregularity index in both groups (P . .05). However, there were differences in the timing during which the expansion was achieved. The hybrid distractor group gained space during the distraction phase of treatment. The tooth-borne group showed greater gains during pre-and postdistraction orthodontics. Comparisons of intercanine and interbone marker widths demonstrated a more parallel separation of bone during distraction with the hybrid distractor (P , .001). Distraction with the tooth-borne distractor was disproportionate, with greater separation of the canines in alveolar bone than of the bone markers in basal bone. During postdistraction orthodontics, the tooth-borne distractor group showed statistically greater increases in measurements. Conclusion: Both skeletal and dental expansion was achieved with both appliances. Greater skeletal expansion was achieved with a hybrid distractor. Greater dental expansion was achieved with a tooth-borne distractor. (Angle Orthod. 2014;84:68-75.)

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Comparison of different orthodontic devices for mandibular symphyseal distraction osteogenesis: A finite element study

Cited by 32 publications

References 16 publications

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

The Influence of Expansion Rates on Mandibular Distraction Osteogenesis: A Computational Analysis

Skeletal and dental effects of tooth-borne versus hybrid devices for mandibular symphyseal distraction osteogenesis

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