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Patiño AMB, Rodrigues MDP, Pessoa RS, Rubinsky SY, Kim KB, Soares CJ, Almeida GDA. Biomechanical behavior of three maxillary expanders in cleft lip and palate: a finite element study. Braz Oral Res 2024; 38:e010. [PMID: 38597509 DOI: 10.1590/1807-3107bor-2024.vol38.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/09/2023] [Indexed: 04/11/2024] Open
Abstract
This study evaluated the stress distribution in the dentoalveolar and palatal bone structures during maxillary expansion in a 17-year-old male patient with bilateral cleft lip and palate (BCLP) using expanders with dental (HYRAX) and skeletal anchorage (MARPE). For the generation of the specific finite element models, cone-beam computed tomography was used, and the DICOM files were exported to Mimics 3-Matic (Materialise) and Patran (MSC Software) software. Three specific three-dimensional models were generated: A) HYRAX: conventional four-banded hyrax screw (9 mm); B) MARPE-DS: 3 miniscrews (1.8 mm diameter - 5.4 mm length) and four-banded dental anchorage; and C) MARPE-NoDS: 3 miniscrews without dental anchorage. Maxillary expansion was simulated by activating the expanders transversely 1 mm on the "X" axis. HYRAX resulted in higher levels of deformation predominantly in the dentoalveolar region. MARPE-DS showed stress in the dentoalveolar region and mainly in the center of the palatal region, at approximately 4,000 με. MARPE-NoDS exhibited evident stress only in the palatal region. High stress levels in the root anchoring teeth were observed for HYRAX and MARPE-DS. In contrast, MARPE-NoDS cause stress on the tooth structure. The stress distribution from the expanders used in the BLCP showed asymmetric expansive behavior. During the initial activation phase of expansion, the HYRAX and MARPE-DS models produced similarly high strain at the dentoalveolar structures and upper posterior teeth displacement. The MARPE-NoDS model showed restricted strain on the palate.
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Affiliation(s)
- Angela Maria Bautista Patiño
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Uberlândia, MG, Brazil
| | - Monise de Paula Rodrigues
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Roberto Sales Pessoa
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Uberlândia, MG, Brazil
| | - Salomón Yezioro Rubinsky
- Universidad Nacional de Colombia, School of Dentistry, Department of Orthodontics, Bogotá, Colombia
| | - Ki Beom Kim
- Saint Louis University, Center for Advanced Dental Education, Department of Orthodontics, Saint Louis, MI, USA
| | - Carlos José Soares
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Guilherme de Araújo Almeida
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Uberlândia, MG, Brazil
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Zhang J, Liu C, Dong Y. Finite element analysis of sagittal screw expander appliance in the treatment of anterior maxillary hypoplasia. Front Bioeng Biotechnol 2023; 11:1245764. [PMID: 37965052 PMCID: PMC10640993 DOI: 10.3389/fbioe.2023.1245764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023] Open
Abstract
The skeletal anterior crossbite is a common malocclusion in clinic. However, there have been no reports on the maxillary sagittal expansion to correct the premaxillary hypoplasia, which greatly influences the facial morphology and masticatory function, using finite element analysis. In the present study, a three-dimensional finite element model of craniomaxillofacial complex with maxillary sagittal hypoplasia is constructed and the treatment for premaxillary hypoplasia by the sagittal screw expander appliance is simulated. The hypoplasia of the left premaxilla is more serious than that of the right and thus the size of the left part of premaxillary expander baseplate is designed to be larger than that of the right part and the loading is applied at 10° leftward to the sagittal plane and 30° forward and downward to the maxillary occlusal plane. The displacements or equivalent stress distributions of the maxilla, teeth and their periodontal ligaments, are analyzed under the loads of 5.0 N, 10.0 N, 15.0 N, and 20.0 N. Consequently, as the load increases, the displacements or equivalent stresses of the maxilla, teeth and their periodontal ligaments all increase. Almost the whole premaxilla markedly move forward, downward, and leftward while other areas in the craniomaxillofacial complex remain almost static or have little displacement. The equivalent stress concentration zone of the maxilla mainly occurs around and in front of the incisive foramina. The displacements of left premaxilla are generally greater than those of the right under the loading forces. The maximum equivalent stress on the teeth and their periodontal ligaments are 2.34E-02 MPa and 2.98E-03 MPa, respectively. Taken together, the sagittal screw expander appliance can effectively open the premaxillary suture to promote the growth of the premaxilla. An asymmetrical design of sagittal screw expander appliance achieves the asymmetric expansion of the premaxilla to correct the uneven hypoplasia and obtains the more symmetrical aesthetic presentation. This study might provide a solid basis and theoretical guidance for the clinical application of sagittal screw expander appliance in the efficient, accurate, and personalized treatment of premaxillary hypoplasia.
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Affiliation(s)
- Jian Zhang
- College of Stomatology, Dalian Medical University, Dalian, Liaoning, China
| | - Caiyun Liu
- Affiliated Hospital of Stomatology, Dalian Medical University, Dalian, Liaoning, China
| | - Yan Dong
- College of Stomatology, Dalian Medical University, Dalian, Liaoning, China
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Marcin M, Katarzyna C. Stress and displacement patterns during orthodontic intervention in the maxilla of patients with cleft palate analyzed by finite element analysis: a systematic review. BMC Oral Health 2023; 23:93. [PMID: 36782289 PMCID: PMC9926813 DOI: 10.1186/s12903-023-02714-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 01/03/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE Rationale for the review in the context of what is already known about the evaluation of stress and displacement patterns using finite element analysis in the maxilla of patients with cleft palate after orthodontic intervention. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The protocol for this systematic review was registered with PROSPERO (CRD42020177494). The following databases were screened: Medline (via PubMed), Scopus, Embase, and Web of Science. RESULTS The search identified 31 records. 15 articles were retrieved for full texts and 11 of them were considered eligible for inclusion by 2 authors. Eventually, 11 articles were included in the qualitative analysis. CONCLUSIONS Finite element analysis is an appropriate tool for studying and predicting force application points for better controlled expansion in patients with UCLP.
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Affiliation(s)
- Mikulewicz Marcin
- Division of Facial Abnormalities, Department of Dentofacial Orthopaedics and Orthodontics, Medical University of Wroclaw, ul. Krakowska 26, 50-425, Wrocław, Poland.
| | - Chojnacka Katarzyna
- grid.7005.20000 0000 9805 3178Department of Advanced Material Technologies, Faculty of Chemistry, Wroclaw University of Technology, Wrocław, Poland
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Meng WY, Ma YQ, Shi B, Liu RK, Wang XM. The comparison of biomechanical effects of the conventional and bone-borne palatal expanders on late adolescence with unilateral cleft palate: a 3-dimensional finite element analysis. BMC Oral Health 2022; 22:600. [PMID: 36514035 PMCID: PMC9745990 DOI: 10.1186/s12903-022-02640-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patients with unilateral cleft lip and palate were associated with different nasomaxillary complex from the normal population. Although the biomechanical effects of conventional rapid palatal expansion (Hyrax expansion) and bone-borne rapid palatal expansion (micro-implant-assisted expansion) in non-cleft patients have been identified by multiple studies, little is known in patients with unilateral cleft lip and palate. The purpose of this study was to investigate and compare the biomechanical effects of the conventional and bone-borne palatal expanders in a late adolescence with unilateral cleft lip and palate. METHODS A cone beam CT scan of a late adolescence with unilateral cleft lip and palate was selected to construct the three-dimensional finite element models of teeth and craniofacial structures. The models of conventional and born-borne palatal expanders were established to simulate the clinical maxillary expansion. The geometric nonlinear theory was applied to evaluate the Von Mises stress distribution and displacements in craniofacial structures and teeth. RESULTS Bone-borne palatal expander achieved more transverse movement than conventional palatal expander in the whole mount of craniofacial regions, and the maximum amount of expansion was occurred anteriorly along the alveolar ridge on cleft-side. The expanding force from born-borne palatal expander resulted in more advancement in nasomaxillary complex than it in conventional palatal expander, especially in the anterior area of the minor segment of maxilla. Stresses from the both expanders distributed in similar patterns, but larger magnitudes and ranges were generated using the bone-borne expander around the maxillary buttresses and pterygoid plates of sphenoid bone. The maximum expanding stresses from born-borne palatal expander were concentrated on palatal slope supporting minscrews, whereas those from conventional palatal expander were concentrated on the anchoring molars. In addition, the buccal tipping effect of teeth generated using the bone-borne expander was less than it using the conventional palatal expander. CONCLUSION Bone-borne expander generated enhanced skeletal expansion at the levels of alveolar and palate in transversal direction, where the miniscrews contributed increased expanding forces to maxillary buttresses and decreased forces to buccal alveolar. Bone-borne expanders presented a superiority in correcting the asymmetric maxilla without surgical assistant in late adolescence with unilateral cleft lip and palate.
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Affiliation(s)
- Wen-yu Meng
- grid.412643.60000 0004 1757 2902Department of Ultrasound Imaging, The First Hospital of Lanzhou University, 730000 Lanzhou, The People’s Republic of China
| | - Yan-qing Ma
- grid.32566.340000 0000 8571 0482Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing (NO: 20JR10RA653 - ZDKF20210401), School of Stomatology, Lanzhou University, No. 199, Donggang West Road, Gansu Province 730000 Lanzhou, People’s Republic of China ,grid.32566.340000 0000 8571 0482Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000 Gansu Province People’s Republic of China
| | - Bing Shi
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 The People’s Republic of China
| | - Ren-kai Liu
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 The People’s Republic of China ,grid.413200.40000 0001 1276 6562Department of Orthodontics and Pediatric Dentistry, West China Stomatological Hospital, West China College of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041 People’s Republic of China
| | - Xiao-ming Wang
- grid.32566.340000 0000 8571 0482Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing (NO: 20JR10RA653 - ZDKF20210401), School of Stomatology, Lanzhou University, No. 199, Donggang West Road, Gansu Province 730000 Lanzhou, People’s Republic of China ,grid.32566.340000 0000 8571 0482Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000 Gansu Province People’s Republic of China
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Huqh MZU, Abdullah JY, Wong LS, Jamayet NB, Alam MK, Rashid QF, Husein A, Ahmad WMAW, Eusufzai SZ, Prasadh S, Subramaniyan V, Fuloria NK, Fuloria S, Sekar M, Selvaraj S. Clinical Applications of Artificial Intelligence and Machine Learning in Children with Cleft Lip and Palate-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710860. [PMID: 36078576 PMCID: PMC9518587 DOI: 10.3390/ijerph191710860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/22/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE The objective of this systematic review was (a) to explore the current clinical applications of AI/ML (Artificial intelligence and Machine learning) techniques in diagnosis and treatment prediction in children with CLP (Cleft lip and palate), (b) to create a qualitative summary of results of the studies retrieved. MATERIALS AND METHODS An electronic search was carried out using databases such as PubMed, Scopus, and the Web of Science Core Collection. Two reviewers searched the databases separately and concurrently. The initial search was conducted on 6 July 2021. The publishing period was unrestricted; however, the search was limited to articles involving human participants and published in English. Combinations of Medical Subject Headings (MeSH) phrases and free text terms were used as search keywords in each database. The following data was taken from the methods and results sections of the selected papers: The amount of AI training datasets utilized to train the intelligent system, as well as their conditional properties; Unilateral CLP, Bilateral CLP, Unilateral Cleft lip and alveolus, Unilateral cleft lip, Hypernasality, Dental characteristics, and sagittal jaw relationship in children with CLP are among the problems studied. RESULTS Based on the predefined search strings with accompanying database keywords, a total of 44 articles were found in Scopus, PubMed, and Web of Science search results. After reading the full articles, 12 papers were included for systematic analysis. CONCLUSIONS Artificial intelligence provides an advanced technology that can be employed in AI-enabled computerized programming software for accurate landmark detection, rapid digital cephalometric analysis, clinical decision-making, and treatment prediction. In children with corrected unilateral cleft lip and palate, ML can help detect cephalometric predictors of future need for orthognathic surgery.
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Affiliation(s)
- Mohamed Zahoor Ul Huqh
- Orthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Johari Yap Abdullah
- Craniofacial Imaging Lab, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
| | - Ling Shing Wong
- Faculty of Health and Life Sciences, INTI International University, Nilai 71800, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
| | - Nafij Bin Jamayet
- Division of Clinical Dentistry (Prosthodontics), School of Dentistry, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia
| | - Mohammad Khursheed Alam
- Orthodontic Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Qazi Farah Rashid
- Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Adam Husein
- Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Wan Muhamad Amir W. Ahmad
- Department of Biostatistics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Sumaiya Zabin Eusufzai
- Department of Biostatistics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Somasundaram Prasadh
- National Dental Center Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore
| | | | | | | | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh 30450, Malaysia
| | - Siddharthan Selvaraj
- Faculty of Dentistry, AIMST University, Bedong 08100, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
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Tian T, Huang HY, Wang W, Shi B, Zheng Q, Li CH. Three-dimensional finite element analysis of the effect of alveolar cleft bone graft on the maxillofacial biomechanical stabilities of unilateral complete cleft lip and palate. Biomed Eng Online 2022; 21:31. [PMID: 35596229 PMCID: PMC9123812 DOI: 10.1186/s12938-022-01000-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 05/16/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The objective is to clarify the effect of alveolar cleft bone graft on maxillofacial biomechanical stabilities, the key areas when bone grafting and in which should be supplemented with bone graft once bone resorption occurred in UCCLP (unilateral complete cleft lip and palate). METHODS Maxillofacial CAD (computer aided design) models of non-bone graft and full maxilla cleft, full alveolar cleft bone graft, bone graft in other sites of the alveolar cleft were acquired by processing the UCCLP maxillofacial CT data in three-dimensional modeling software. The maxillofacial bone EQV (equivalent) stresses and bone suture EQV strains under occlusal states were obtained in the finite element analysis software. RESULTS Under corresponding occlusal states, the EQV stresses of maxilla, pterygoid process of sphenoid bone on the corresponding side and anterior alveolar arch on the non-cleft side were higher than other maxillofacial bones, the EQV strains of nasomaxillary, zygomaticomaxillary and pterygomaxillary suture on the corresponding side were higher than other maxillofacial bone sutures. The mean EQV strains of nasal raphe, the maximum EQV stresses of posterior alveolar arch on the non-cleft side, the mean and maximum EQV strains of nasomaxillary suture on the non-cleft side in full alveolar cleft bone graft model were all significantly lower than those in non-bone graft model. The mean EQV stresses of bilateral anterior alveolar arches, the maximum EQV stresses of maxilla and its alveolar arch on the cleft side in the model with bone graft in lower 1/3 of the alveolar cleft were significantly higher than those in full alveolar cleft bone graft model. CONCLUSIONS For UCCLP, bilateral maxillae, pterygoid processes of sphenoid bones and bilateral nasomaxillary, zygomaticomaxillary, pterygomaxillary sutures, anterior alveolar arch on the non-cleft side are the main occlusal load-bearing structures before and after alveolar cleft bone graft. Alveolar cleft bone graft mainly affects biomechanical stabilities of nasal raphe and posterior alveolar arch, nasomaxillary suture on the non-cleft side. The areas near nasal floor and in the middle of the alveolar cleft are the key sites when bone grafting, and should be supplemented with bone graft when the bone resorbed in these areas.
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Affiliation(s)
- Tao Tian
- West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, The People's Republic of China
| | - Han-Yao Huang
- West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, The People's Republic of China.,West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, The People's Republic of China
| | - Wei Wang
- Urumql DW Innovation InfoTech Co., Ltd., Urumqi, 830000, Xinjiang Uygur Autonomous Region, The People's Republic of China
| | - Bing Shi
- West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, The People's Republic of China.,West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, The People's Republic of China
| | - Qian Zheng
- West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, The People's Republic of China. .,West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, The People's Republic of China.
| | - Cheng-Hao Li
- West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, The People's Republic of China. .,West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan Province, The People's Republic of China.
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Bölükbaşı E, Yılmaz B, İlhan Ramoğlu S. Stress Distribution and Displacement of Craniofacial Structures Following Rapid Maxillary Expansion in Different Types of Cleft Palate: A Three-Dimensional FEM Study. Turk J Orthod 2021; 34:77-85. [PMID: 35110155 PMCID: PMC8939300 DOI: 10.5152/turkjorthod.2021.20007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 10/18/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate displacements and stress distributions in finite element models (FEMs) of the craniofacial complex of 13-yearold male patient with complete unilateral cleft palate (UCP), a 15-year-old female patient with complete bilateral cleft palate (BCP), and a 15-year-old female patient with isolated cleft palate (ICP), which may respond differently to expansive forces. METHODS The FEMs were based on computed tomography scans of patients with UCP, BCP, and ICP who needed maxillary expansion. Von Mises stress distribution after 0.2 mm of expansion and displacements after 5 mm of expansion were investigated. RESULTS The highest amount of stress was observed in the ICP model. Surprisingly, no stress was noted around the nose in the BCP model. The amount of dentoalveolar expansion decreased from anterior to posterior on the cleft side of the UCP, BCP, and ICP models. In contrast, on the non-cleft side of the UCP model, the maximum dentoalveolar expansion occurred at the molar area, decreasing toward the anterior parts. Anatomical structures expressed posterior displacement in the UCP model. In the ICP model, structures close to midline showed anterior displacement, while structures in the lateral parts showed posterior displacement. In contrast with the other 2 models, the structures in the BCP model showed anterior displacement. Vertically, all the anatomic structures in the BCP model showed inferior displacement, while in the ICP and UCP models, only the structures close to the midline showed inferior displacement. CONCLUSION Maxillary expansion caused different patterns of stress distribution and displacement in different types of clefts. Clinicians should consider the type of the cleft, and may expect differing patterns of widening following maxillary expansion.
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Affiliation(s)
- Esra Bölükbaşı
- Specialist in Orthodontics, Private Practice, İstanbul, Turkey
| | - Berza Yılmaz
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University, İstanbul, Turkey
| | - Sabri İlhan Ramoğlu
- Department of Orthodontics, Faculty of Dentistry, Altinbas University, İstanbul, Turkey
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Sucu M, Yilmaz B, Ramoğlu Sİ. Evaluation of Initial Stress Distribution and Displacement Pattern of Craniofacial Structures with 3 Different Rapid Maxillary Expansion Appliance Models: A 3-dimensional Finite Element Analysis. Turk J Orthod 2021; 34:18-25. [PMID: 33828874 DOI: 10.5152/turkjorthod.2021.20006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022]
Abstract
Objective This study aimed to describe the displacement of anatomical structures and the stress distributions caused by the Hyrax, fan-type, and double-hinged expansion screws via the 3-dimensional (3D) finite element method (FEM). Methods The 3D FEM was based on the computed tomography data of a 12-year-old patient with a constricted maxilla. The Hyrax model included 1,800,981 tetrahedral elements with 2,758,217 nodes. The fan-type model included 1,787,558 tetrahedral elements with 2,737,358 nodes. The double-hinged model included 1,777,080 tetrahedral elements with 2,722,771 nodes. The von Mises stress distributions after 0.2 mm of expansion and displacement patterns after 5 mm of expansion were evaluated. Results The highest stress accumulation was observed in the sutura zygomatico maxillaris area with all 3 appliances. An increase in stress was noted at the pterygomaxillary fissure, the medial and lateral pterygoid process of the sphenoid bone, and the nasal areas. The wedge-shaped skeletal opening was observed with all 3 appliances. In the transverse plane, maximum posterior expansion was achieved with the Hyrax appliance, whereas the maximum anterior expansion was observed with the double-hinged appliance. The maxilla moved inferiorly and anteriorly with all the 3 appliances. The greatest inferior displacement of the maxilla was recorded with the Hyrax appliance, whereas anterior maxillary displacement was the greatest with the double-hinged appliance. Conclusion All the appliances showed similar stress distributions. The use of double-hinged screw caused a slight anterior displacement of point A. The fan-type and double-hinged appliances were shown to be more effective on anterior maxillary constriction, whereas the Hyrax appliance might be chosen for resolving maxillary posterior constriction.
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Affiliation(s)
- Merve Sucu
- Specialist in Orthodontics, Private practice, Istanbul, Turkey
| | - Berza Yilmaz
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Sabri İlhan Ramoğlu
- Department of Orthodontics, Faculty of Dentistry, Altinbas University, Istanbul, Turkey
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A prospective cohort study on the effects of RME in the mandibular dentition of cleft subjects. J Oral Biol Craniofac Res 2020; 10:738-742. [DOI: 10.1016/j.jobcr.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/16/2020] [Accepted: 10/08/2020] [Indexed: 11/17/2022] Open
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Ceuninck K, Starbuck JM. A morphometric analysis of developmental instability in children born with unilateral cleft lip and palate. Clin Anat 2018; 32:206-211. [PMID: 30252164 DOI: 10.1002/ca.23281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/09/2018] [Accepted: 09/18/2018] [Indexed: 11/10/2022]
Abstract
Unilateral cleft lip and palate (UCLP) is a congenital deformity that occurs due to inadequate merging of the nasal and maxillary prominences during fetal development. Randomly distributed bilateral asymmetries known as fluctuating asymmetry (FA) occur in normally symmetric organisms when evolved mechanisms of developmental stability or equilibrium are disturbed by genetic, environmental, or unknown factors. Here, we hypothesize that facial skeleton FA will be increased in a sample of individuals born with UCLP (n = 24) relative to sex- and age-matched controls (n = 24). To test this hypothesis, 23 anatomical landmarks were measured on individual anonymized cone-beam computerized tomography (CBCT) images in children and adolescents (7-17 years). For each individual, 81 pairs of linear distances were used to estimate FAs across the face. To explore sample variation and statistical differences, a principal components analysis and Euclidean Distance Matrix Analysis multivariate bootstrap approach were carried out. Samples show some separation in multivariate space with 44.44% of FA differences being significantly different. The magnitude of FA was larger in the UCLP sample for every significant measurement. The magnitude of significant FA is highest near regions derived from the maxillary and nasal prominences, such as the nasal aperture. These results are useful for medical and dental practitioners when developing treatment options for children and adolescents with UCLP. Clin. Anat. 32:206-211, 2019. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Kristyna Ceuninck
- Department of Anthropology, University of Central Florida, Orlando, Florida
| | - John M Starbuck
- Department of Anthropology, University of Central Florida, Orlando, Florida
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