Stress and displacement patterns in the craniofacial skeleton with rapid maxillary expansion: A finite element method study

Gautam, Pawan; Valiathan, Ashima; Adhikari, Raviraja

doi:10.1016/j.ajodo.2006.09.044

Cited by 113 publications

(81 citation statements)

References 43 publications

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“…RME is known to affect nasal aperture width, 2,20 which is consistent with finite element modeling. 40 Previous CBCT studies reported that RME produced a 1.6-mm increase in the width of the nasal floor; this is comparable to 1.3 -1.4 mm of expansion for bonded and banded RME, respectively (Table 1). In 9-to 11-year-old patients, the banded appliance produced ,0.5 mm more nasal floor expansion than the bonded appliance.…”

Section: Discussionmentioning

confidence: 63%

“…Finite element analysis of the stress distribution with RME shows high tensile stress at the zygomaticomaxillary suture, except along its anteromedial surface. 40 For this reason, the zygomaticomaxillary buttress is a primary osteotomy site in surgical expansion. 41,42 Bell and Epker 43 confirmed this surgical strategy based on skeletal resistance to expansion within the zygomaticomaxillary sutures.…”

Section: Discussionmentioning

confidence: 99%

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CBCT of skeletal changes following rapid maxillary expansion to increase arch-length with a development-dependent bonded or banded appliance

Kanomi

Deguchi

Kakuno

et al. 2013

The Angle Orthodontist

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Objective: To assess the three-dimensional (3D) skeletal response to a standardized 5 mm of rapid maxillary expansion (RME) in growing children (6-15 years) with maxillary width deficiency and crowding. Materials and Methods: A bonded appliance was used prior to the eruption of the maxillary first premolars (Mx4s), and a banded appliance was used thereafter. A consecutive sample of 89 patients (29 boys and 60 girls) from a large pediatric dentistry and orthodontics practice was divided into four groups: 1) 6-8 years old (n 5 26), 2) 9-11 years old with unerupted Mx4s (n 5 21), 3) 9-11 years with erupted Mx4s (n 5 23), and 4) 12-15 years (n 5 19). For all patients, the 3D evaluation of dental and skeletal effects was performed with cone-beam computed tomography (CBCT). Results: For both appliances in all patients, CBCT confirmed a triangular pattern of expansion in both the frontal and sagittal planes. Overall, both appliances produced significant maxillary expansion (.80% of the 5-mm activation), but older children showed a progressively more dental (less skeletal) response. Comparison of the two types of expanders in the crossover sample, children aged 9-11 years, showed that the bonded RME produced the most efficient skeletal expansion in the preadolescent sample. Increased maxillary width at the level of the zygomaticomaxillary suture was the best indicator for development of maxillary arch circumference. Conclusion: Development-dependent appliances (bonded RPE before Mx4s erupt, and a banded device thereafter) provided optimal RME treatment for all children from age 6-15 years. (Angle Orthod. 2013;83:851-857.)

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

CBCT of skeletal changes following rapid maxillary expansion to increase arch-length with a development-dependent bonded or banded appliance

Kanomi

Deguchi

Kakuno

et al. 2013

The Angle Orthodontist

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“…[2][3][4] Both clinical [5][6][7] and FEM 8,9 studies on clefts have shown asymmetric response of the cleft and non-cleft segments with expansion forces. Previous in vitro studies in non-cleft patients have shown that the primary anatomical sites of resistance to expansion forces were the midpalatal area and the zygomatic buttress.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical response of the maxillofacial skeleton to transpalatal orthopedic force in a unilateral palatal cleft

Gautam¹,

Zhao²,

Patel³

2011

The Angle Orthodontist

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Objectives: To assess the skeletal and dental effects of rapid maxillary expansion in a patient with unilateral cleft deformity of secondary palate and alveolus using the finite element method. Materials and Methods: A patient-specific composite skull model was developed from a patient computed tomographic scan and a surface scan of the patient's maxillary cast using MIMICS imaging analysis software. For volumetric meshing and the finite element analysis, Abaqus (6.7) was used. Results: The typical wedge-shaped opening that occurs after RME, seen in non-cleft patients, is not seen in cleft patients. A clockwise rotation of the maxilla as a result of maxillary expansion was evident. The areas of maximum stress were the intact primary palate region, inferior orbital foramen of the non-cleft and the cleft sides, and the zygomatic buttress of the cleft side. During expansion, the intact primary palate showed high stress and acted as a region of major resistance, followed by the zygomatic buttress on the cleft side. Conclusions: Clinicians should consider a need for customization of expansion therapy for cleft patients depending on the patient's age, the type of cleft present (primary or secondary palate), and the desired area of expansion (anterior or posterior). (Angle Orthod. 2011;81:503-509.)

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“…Finite element method (FEM) is one of the basic tools used for mechanical investigations of a skull, a pelvic bone, eye-socket and in reconstruction of a bony face deformed by congenital defects or injuries. For example, it was applied for modelling of a skull with gnathothisis (Boryor et al, 2008), for investigation of infant head injuries caused by impact (Roth et al, 2009) and for examination of facial skull dystosis of a child (Gautam et al, 2007). FEM served also for an radiological and mathematical analysis of facial deformation provoked by curved central axis of the skull (Iannetti et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Modeling and Simulation of Biomechanical Systems - An Orbital Cavity, a Pelvic Bone and Coupled DNA Bases

Awrejcewicz¹,

Mrozowski²,

Młynarska³

et al. 2011

Numerical Analysis - Theory and Application

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Stress and displacement patterns in the craniofacial skeleton with rapid maxillary expansion: A finite element method study

Cited by 113 publications

References 43 publications

CBCT of skeletal changes following rapid maxillary expansion to increase arch-length with a development-dependent bonded or banded appliance

CBCT of skeletal changes following rapid maxillary expansion to increase arch-length with a development-dependent bonded or banded appliance

Biomechanical response of the maxillofacial skeleton to transpalatal orthopedic force in a unilateral palatal cleft

Modeling and Simulation of Biomechanical Systems - An Orbital Cavity, a Pelvic Bone and Coupled DNA Bases

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