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Faria SRD, Andrade TRD, André CB, Montalli VAM, Barbosa JA, Basting RT. MARPE expander activation load with different configurations of extender arms heights: in-vitro evaluation. Dental Press J Orthod 2024; 29:e242458. [PMID: 39230114 PMCID: PMC11368235 DOI: 10.1590/2177-6709.29.4.e242458.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/03/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVE Evaluate the load mini-implants exert on the artificial bone when expanding the MARPE EX in three different extension arm configurations. METHODS A device simulating the human palate was fabricated and attached to a universal testing machine, for conducting tests with different MARPE expanders (n=5): non-adjustable/control (MARPE SL, Peclab) or with low, intermediate, and high extender arms (MARPE EX, Peclab). The expanders were manually activated until failure of the device occurred, and maximum load values were recorded. Load averages were also calculated for every five activations until the twentieth activation. RESULTS The generalized linear mixed model for repeated measures over time showed that there was significant increase in load with activations for all expanders (p=0.0004). Up to the twentieth activation, the expander with low extender arms presented higher load than the others, while the expander with high extender arms showed lower load values (p<0.05). There was no significant difference among expanders regarding the number of activations (p=0.0586), although there was a trend towards fewer activations until fracture for the control expander. It was observed that the higher the configuration, the lower the force the mini-implants delivered to the bone. The control expander provided a force magnitude similar to that of the adjustable expander when positioned at the intermediate height. CONCLUSIONS The activation load of MARPE expanders is influenced by the type of presentation of the extensor arms, with higher configurations resulting in lower force delivered by the mini-implants to the bone.
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Dong L, Huang W, Wu H, Yu S, Zheng Y, Zhang Q, Ren D, Wu W, Yan X, Lv T, Yuan X. Evaluating stress and displacement in the craniomandibular complex using Twin Block appliances at varied angles: A finite element study. J Mech Behav Biomed Mater 2024; 156:106603. [PMID: 38815434 DOI: 10.1016/j.jmbbm.2024.106603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/07/2024] [Accepted: 05/25/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES The objective of this investigation was to assess the stress and displacement pattern of the craniomandibular complex by employing finite element methodology to simulate diverse angulations of inclined planes that are incorporated in the Twin Block appliance. METHODS A 3D finite element representation was established by use of Cone Beam Computed Tomography (CBCT) scans. This comprehensive structure included craniofacial skeletal components, the articular disc, a posterior disc elastic layer, dental elements, periodontal ligaments, and a Twin Block appliance. This investigation is the first to incorporated inclined planes featuring three distinct angulations (45, 60, and 70°) as the study models. Mechanical impacts were evaluated within the glenoid fossa, tooth, condylar, and articular disc regions. RESULTS In all simulations, the stress generated by the Twin Block appliance was distributed across teeth and periodontal ligament, facilitating the anterior movement of mandibular teeth and the posterior displacement of maxillary teeth. Within the temporomandibular joint region, compressive forces on the superior and posterior facets of the condyle diminished, coinciding with the stress configuration that fosters condylar and mandibular growth. Stress dispersion homogenized in the condylar anterior facet and articular disc, with considerable tensile stress in the glenoid fossa's posterior aspect conforming to stress distribution that promote fossa reconfiguration. The 70° inclined plane exerts the highest force on the tissues. The condyle's maximum and minimum principal stresses are 0.36 MPa and -0.15 MPa, respectively, while those of the glenoid fossa are 0.54 MPa and -0.23 MPa. CONCLUSION Three angled appliances serve the purpose of advancing the mandible. A 45° inclined plane relative to the occlusal plane exerts balanced anteroposterior and vertical forces on the mandibular arch. Steeper angles yield greater horizontal forces, which may enhance forward growth and efficient repositioning.
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Affiliation(s)
- Lirong Dong
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Wenli Huang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Haoting Wu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Shaoyang Yu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Yao Zheng
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Qiang Zhang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - DaPeng Ren
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Wei Wu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Xiao Yan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China
| | - Tao Lv
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China.
| | - Xiao Yuan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China; School of Stomatology, Qingdao University, Qingdao, 266023, China.
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Okuhashi S, Kobayashi M, Tanaka E. Severe Maxillary Protrusion Treated with Surgically Assisted Rapid Maxillary Expansion. J Clin Med 2024; 13:4149. [PMID: 39064189 PMCID: PMC11278214 DOI: 10.3390/jcm13144149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/09/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
In this case, surgically assisted rapid maxillary expansion (SARME) was successfully adopted to treat a skeletal maxillary protrusion with large overjet and severe crowding. The female patient, aged 25 years and 11 months, was diagnosed with skeletal maxillary protrusion with severe crowding and excessive overjet associated with labially inclined maxillary central incisors. After achieving sufficient space for surgical incision between bilateral maxillary central incisors, the SARME was performed. A total of 8.0 mm lateral expansion of the maxilla was completed. At 48 days after surgery, the Hyrax appliance was replaced with an Anchor-Lock system used as an external surgical stent and skeletal anchorage for maxillary group distalization, and the distal movement of the maxillary molars was initiated without waiting for bone healing of the separated midpalatal suture by SARME. Twenty-five months' treatment, including surgical preparation, achieved an acceptable and stable occlusion with adequate interincisal relationship. The occlusion was much more stable with a little relapse through more than 4 years' retention period. In conclusion, SARME followed by the Anchor-Lock system might lead to favorable occlusal outcome in the long term without any relapses.
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Affiliation(s)
- Sonoko Okuhashi
- Department of Craniofacial Growth and Development Dentistry, Division of Orthodontics, Kanagawa Dental University, Yokosuka 238-8580, Japan;
- Private Practice of Orthodontics, Sagamihara 252-0303, Japan
| | - Masaru Kobayashi
- Department of Oral and Maxillofacial Surgery, Kanagawa Dental University, Yokosuka 238-8580, Japan;
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8504, Japan
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Leeisaramas C, Chantarapanich N, Inglam S, Insee K. Analysis of Stress Distribution and Displacement Based on the Miniscrew Positions of the Palatal Slope Bone-borne Expander: A Finite Element Study. Eur J Dent 2024. [PMID: 38555643 DOI: 10.1055/s-0043-1777823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the stress distribution pattern of the palatal slope bone-borne expander on the maxillary area according to a different anteroposterior position of anchored miniscrews using finite element analysis. MATERIALS AND METHODS Nasomaxillary stereolithography files with three different anteroposterior anchored miniscrew positions of the palatal slope bone-borne expander were determined as model A, B, and C. Each model consists of four supported miniscrews. Model A: two anterior miniscrews were located between the maxillary canine and the first premolar, and two posteriors between the second premolar and the first molar. Model B: two anteriors were between the lateral incisor and the canine, and two posteriors were the same as in model A. Model C: two anteriors were the same as in model A, and two posteriors were distal to the first molar. One turn of expander screws was applied. Maximum principal stress, equivalent elastic strain, equivalent von Mises stress, and transverse displacement were evaluated. RESULTS The maximum principal stress was mostly found at the bone-miniscrew interface. Model A exhibited an intersecting area of stress between the supported miniscrews. The highest value of principal stress was in model B, while model C showed a uniform distribution pattern. The elastic strain pattern was similar to the principal stress in all models. The highest value of equivalent von Mises stress was located on the expander screw. The largest amount of transverse displacement of teeth was in model A, while model C exhibited a more consistent transverse displacement than other models. Vertical displacement of posterior teeth was also noticed. CONCLUSION Based on the result, it revealed that the various anteroposterior miniscrew placements of the palatal slope bone-borne expander had various patterns of stress distribution and resulted in various outcomes. It may be inferred that model A's miniscrew location was advantageous for obtaining expansion quantities, but model C's miniscrew position was advantageous for maintaining consistent biomechanics.
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Affiliation(s)
- Chakree Leeisaramas
- Division of Orthodontics, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Nattapon Chantarapanich
- Digital Industrial Design and Manufacturing Research Unit and Department of Mechanical Engineering, Faculty of Engineering at Sriracha, Kasetsart University, Chonburi, Thailand
- Thammasat University Research Unit in Dental Biomechanics, Thammasat University, Pathum Thani, Thailand
| | - Samroeng Inglam
- Division of Oral Diagnostic Sciences, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
- Thammasat University Research Unit in Dental Biomechanics, Thammasat University, Pathum Thani, Thailand
| | - Kanlaya Insee
- Division of Orthodontics, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
- Thammasat University Research Unit in Dental Biomechanics, Thammasat University, Pathum Thani, Thailand
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Zhao Z, Zhang S, Zhang F, Duan Z, Wang Y. Monitoring the Opening of Rapid Palatal Expansion (RPE) in a 3D-Printed Skull Model Using Fiber Optic F-P Sensors. SENSORS (BASEL, SWITZERLAND) 2023; 23:7168. [PMID: 37631702 PMCID: PMC10458582 DOI: 10.3390/s23167168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
We present a novel method for the online measurement of multi-point opening distances of midpalatal sutures during a rapid palatal expansion (RPE) using fiber optic Fabry-Perot (F-P) sensors. The sensor consists of an optical fiber with a cut flat end face and an optical reflector, which are implanted into the palatal base structure of an expander and is capable of measuring the precise distance between two optical reflective surfaces. As a demonstration, a 3D-printed skull model containing the maxilla and zygomaticomaxillary complex (ZMC) was produced and a miniscrew-assisted rapid palatal expander (MARPE) with two guide rods was used to generate the midpalatal suture expansion. The reflected spectrums of the sensors were used to dynamically extract cavity length information for full process monitoring of expansion. The dynamic opening of the midpalatal suture during the gradual activation of the expander was measured, and a displacement resolution of 2.5 μm was demonstrated. The angle of expansion was derived and the results suggested that the midpalatal suture was opened with a slight V-type expansion of 0.03 rad at the first loading and subsequently expanded in parallel. This finding might be useful for understanding the mechanical mechanisms that lead to different types of expansion. The use of a fiber optic sensor for mounting the rapid palatal expander facilitates biomechanical studies and experimental and clinical evaluation of the effects of RPE.
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Affiliation(s)
- Zhen Zhao
- Institute of Stomatology, Shandong University, Jinan 250012, China
- Department of Orthodontics, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Shijie Zhang
- Institute of Stomatology, Shandong University, Jinan 250012, China
- Department of Orthodontics, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Faxiang Zhang
- Faculty of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250014, China
| | - Zhenhui Duan
- Faculty of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250014, China
| | - Yingying Wang
- Institute of Automation, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250014, China
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Cozzani M, Nucci L, Lupini D, Tripodi D, Noori N, Hasani M, Jamilian A. Two different designs of mini-screw assisted maxillary expanders, using FEM to analyse stress distribution in craniofacial structures and anchor teeth. Int Orthod 2022; 20:100607. [DOI: 10.1016/j.ortho.2022.100607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]
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