Finite Element Analysis of Bone Stress After SARPE

Assis, Diogo Souza Ferreira Rubim de; Xavier, Tathy Aparecida; Noritomi, Pedro Yoshito; Gonçales, Eduardo Sánches

doi:10.1016/j.joms.2013.06.210

Cited by 25 publications

(39 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After the surgical procedure, maxillary expansion itself is accomplished by gradual, periodic and successive activation of the expander device that results in distribution of forces through the maxillas and adjacencies, which lead to the separation and enlargement of them 17,18 . The occurrence of TMJ pain was evidenced in 3% of the cases of individuals subjected to SAPE…”

Section: Discussionmentioning

confidence: 99%

Comparative dimensional tomographic study of the mandibular condyle of individuals with transverse maxillary deficiency

et al. 2017

Self Cite

View full text Add to dashboard Cite

Transverse maxillary deficiency is characterized by posterior uni or bilateral crossbite, crowded and rotated teeth, as well as high palate. Its treatment in adult individuals is surgically assisted rapid palatal expansion. The aim of this study was to verify the occurrence of dimensional alterations in the mandibular condyles of patients with TMD submitted to surgically assisted maxillary expansion. Measurements of the mandibular condyles using the DISTANCE tool in cone beam computed tomography iCat software were performed. The values obtained were submitted to statistical analysis by the paired t-test and the results showed statistically significant dimensional reduction in the axial posterior-anterior lateral (-0.74mm), axial posterior-anterior lateral left (-0.90mm) and coronal medium right (-1.24mm) dimensions. The coronal inferior (1.13mm), coronal inferior left (1.78mm) and coronal superior-inferior right (0.76mm) measurements showed statistically significant dimensional increase. The results allowed us to conclude that dimensional alterations occurred in the mandibular condyles in individuals with maxillary transversal deficiency that underwent surgically assisted rapid palatal expansion (SAPE), which can be understood by remodeling, since they are characterized by dimensional increase or reduction, depending on the location where the measurement was performed.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative dimensional tomographic study of the mandibular condyle of individuals with transverse maxillary deficiency

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Mais recentemente, Assis et al (2014) realizaram um estudo utilizando o método de análise de elementos finitos para avaliar a distribuição das tensões nos dentes de apoio do distrator palatino dento-muco-suportado, produzidas durante a EMCA, variando a técnica de osteotomia em 5 modelos virtuais. Em todos os modelos analisados, ocorreu a concentração de tensões, traduzidas por compressão e tração, nos dentes pilares do aparelho.…”

Section: Discussão 63unclassified

“…O estudo mostrou que a osteotomia Le Fort I subtotal com osteotomia da sutura intermaxilar e da sutura pterigomaxilar bilateralmente, deve ser a técnica de escolha quando busca-se reduzir tensões aos dentes. Portanto, a osteotomia subtotal Le Fort I linear, combinada com a osteotomia da sutura intermaxilar e disjunção pterigomaxilar parece ser a técnica de escolha para reduzir tensões nos dentes de suporte (ASSIS et al 2014). O presente estudo procurou então avaliar a mesma dissipação de tensão em um modelo adaptado de Assis et al 2011 relacionando o aparelho ósseo-suportado a osteotomia reta, descendente e disjunção da sutura pterigomaxilar.…”

Section: Discussão 63unclassified

“…Preferencialmente, realiza-se a técnica da osteotomia Le Fort I subtotal, no qual faz-se a osteotomia de todas as suturas da maxila, sem, entretanto, mobilizá-la completamente (BELL;EPKER 1976;GONÇALES, 2011;ASSIS et al, 2014).…”

Section: Discussão 63unclassified

“…Portanto, pode-se enfatizar a dificuldade em compreender as alterações produzidas pela EMCA sem o auxílio da uma avaliação tecnológica associada. (VERSTRAATEN, et al 2010) Outro componente avaliado nessa pesquisa foi a distribuição das tensões ao longo do aparelho ósseo-suportado, por meio da tensão 2011;ASSIS et al, 2014;GONÇALES, 2011). A aplicação do método permite determinar os efeitos localizados da concentração de tensões, por meio da representação precisa e controlada de geometrias complexas, considerando as propriedades distintas presentes em materiais diferentes.…”

Section: Discussão 67unclassified

See 2 more Smart Citations

Análise da distribuição das tensões em maxila submetida à expansão cirurgicamente assistida com aparelho ósseo-suportado

Neto¹

View full text Add to dashboard Cite

região anterior e as tensões resultantes de forças transmitidas ao osso alveolar dos dentes adjacentes ao aparelho, parecem não ser suficientes para deslocar os dentes. Palavras-chave: Técnica de Expansão Palatina, Análise de Elemento Finito, Análise do Estresse Dentário ABSTRACTAnalysis of the distribution of maxillary stresses submitted to surgically assisted maxillary expansion with a bone-supported device Surgically assisted maxillary expansion (SARME) is the modality of treatment that aims to weaken the points of maxillary reinforcement allowing its gradual expansion. Such movement can be performed at the expense of dento-supported, dento-muco-supported, implanto-supported or bony-backed devices. The effects produced by the treatment range from skeletal changes (increase of nasal base, cavity and nasal air space) to dental inclinations (mainly in the supporting teeth of the expander apparatus), among others. The objective of the present research was to evaluate the distribution of stress produced by SARME in the maxillary structures using the bone-supported expander apparatus by the Finite Element Method (FEM). Material and methods:A three-dimensional hemi-maxilla model was simulated for SARME with a non-step descending LeFort I osteotomy with pterygomaxillary disjunction using a bone-supported device model for the 1mm aperture simulation test. The results showed a greater opening of the maxilla in the anterior region of the incisors to the premolar (1 mm) and smaller (0.6 mm) in the molar region. The principal maximal stress (TMXP) showed the concentration of the tension forces mainly in all the palatine face of the pre-molar maxilla to the maxillary tuft. Due to the lateral aspect, the TMXP was more evident in the posterior alveolar bone region, the molars and tuber, as well as in the epilating zygomatic region above the osteotomy.From the transversal plane, it was possible to observe the transmission of stress along the bony structures showing little dissipation for the roots of the molar.Meanwhile, the forces of compression (Principal Minimum Tension) evidenced by the principal minimal stress, were manifested in the areas of the zygomatic pillar adjacent to the osteotomies, as well as in the areas of contact of the support of the apparatus with the palatine bone. Tension and compression forces were also evidenced in the pterygoid process region. Von Mises' stress analysis showed that the most stressed part is the rod connecting the device module to the support platform. Conclusion:There was a greater opening of the maxilla in the anterior region and the resulting forces of tension transmitted to the alveolar bone of the teeth adjacent to the appliance did not seem to be sufficient to displace the teeth.

show abstract

Posterior Palatal Expansion via Subnasal Endoscopy (2PENN) for Maxillary Deficiency: A Pilot Study

Jara,

Thuler,

Hutz

et al. 2023

The Laryngoscope

View full text Add to dashboard Cite

ObjectiveSurgically assisted rapid palatal expansion (SARPE) addresses transverse maxillary deficiency, a known contributor to nasal obstruction. The purpose of this study was to assess the feasibility, preliminary outcomes, and safety of posterior palatal expansion via subnasal endoscopy (2PENN), a modified SARPE procedure, aimed at achieving anterior and posterior maxillary expansion.MethodsThis prospective case series included consecutive adult patients with findings of transverse maxillary deficiency that underwent the 2PENN procedure from 4/2021 to 4/2022. Patients completed pre‐ and post‐operative clinical evaluations, Nasal Obstruction and Septoplasty Effectiveness (NOSE) questionnaires, and computed tomography (CT), with measures including expansion at the level of the posterior nasal spine (PNS), first maxillary inter‐molar distance (IMD), and anterior nasal spine (ANS).ResultsThe cohort (N = 20) was middle‐aged (39 ± 11 years), predominantly male (80%), and overweight (BMI 28 ± 4 kg/m2). The majority (85%) of patients had sleep breathing issues, of which 10 (59%) had polysomnography‐confirmed obstructive sleep apnea (OSA). Full anterior–posterior separation of the mid‐palatal suture line was evident on all post‐operative CT scans, with mean expansion at the PNS of 3.6 ± 1.3 mm, IMD of 6.1 ± 1.6 mm and ANS of 7.0 ± 1.6 mm (p < 0.001). Following surgery, mean NOSE scores improved from 57 ± 23 to 14 ± 13 (p < 0.001). One patient required maxillary antrostomy for post‐operative sinusitis.Conclusion2PENN is an effective and safe technique for achieving both anterior and posterior maxillary expansion in patients with transverse maxillary deficiency. Further study is warranted to better understand the effect of 2PENN in patients with OSA, particularly as it relates to improving pharyngeal patency.Level of Evidence4 Laryngoscope, 2023

show abstract

Finite Element Analysis of Bone Stress After SARPE

Cited by 25 publications

References 25 publications

Comparative dimensional tomographic study of the mandibular condyle of individuals with transverse maxillary deficiency

Comparative dimensional tomographic study of the mandibular condyle of individuals with transverse maxillary deficiency

Análise da distribuição das tensões em maxila submetida à expansão cirurgicamente assistida com aparelho ósseo-suportado

Posterior Palatal Expansion via Subnasal Endoscopy (2PENN) for Maxillary Deficiency: A Pilot Study

Contact Info

Product

Resources

About