Numerical study of the impact of osteotomies and distractor location in surgically assisted rapid palatal expansion for transverse maxillary deficiency.
J Stomatol Oral Maxillofac Surg
; : 101916, 2024 May 17.
Article
in En
| MEDLINE
| ID: mdl-38763267
ABSTRACT
INTRODUCTION:
This paper employs finite element analysis to assess the biomechanical behavior of surgically assisted rapid palatal expansion (SARPE) with a bone-borne transpalatal distractor (TPD) by varying surgical parameters. MATERIAL ANDMETHODS:
Nine models were constructed to scrutinize the effects of pterygomaxillary disjunction (PMD), lateral osteotomy positioning, and TPD placement on displacement profiles and Von Mises stresses. These models encompassed variations such as no, unilateral or bilateral PMD, asymmetrical lateral osteotomy, and five TPD locations.RESULTS:
Performing a PMD reduces posterior resistance to transverse expansion, resulting in 10-20 % stress reduction around the maxillofacial complex. No significant changes in horizontal tipping were observed post-PMD. The asymmetric lateral osteotomy model exhibited larger displacements on the side with a more superiorly positioned osteotomy. Reduced stresses were observed at the maxillary body and medial pterygoid plate (superiorly), while increased stresses were observed at the medial (inferiorly) and lateral pterygoid plates. More posterior TPD placement facilitated more parallel expansion thus less horizontal tipping, albeit with increased vertical tipping.DISCUSSION:
SARPE procedures (distractor and osteotomy positions) can be tailored based on desired outcomes. PMD reduces stress within the maxillofacial complex but doesn't significantly affect tipping. Higher lateral osteotomies lead to increased displacements, more posterior distractors to more parallel expansion.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
J Stomatol Oral Maxillofac Surg
Year:
2024
Document type:
Article
Affiliation country: