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Evaluation of the effects of miniscrew incorporation in palatal expanders for young adults using finite element analysis

  • Seong, Eui-Hyang (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Choi, Sung-Hwan (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Kim, Hee-Jin (Division of Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institution, BK21 PLUS Project, College of Dentistry, Yonsei University) ;
  • Yu, Hyung-Seog (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Park, Young-Chel (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Lee, Kee-Joon (Department of Orthodontics, College of Dentistry, Yonsei University)
  • Received : 2017.04.06
  • Accepted : 2017.07.01
  • Published : 2018.03.25

Abstract

Objective: The aim of this study was to evaluate the stress distribution and displacement of various craniofacial structures after nonsurgical rapid palatal expansion (RPE) with conventional (C-RPE), bone-borne (B-RPE), and miniscrew-assisted (MARPE) expanders for young adults using three-dimensional finite element analysis (3D FEA). Methods: Conventional, bone-borne, and miniscrew-assisted palatal expanders were designed to simulate expansion in a 3D FE model created from a 20-year-old human dry skull. Stress distribution and the displacement pattern for each circumaxillary suture and anchor tooth were calculated. Results: The results showed that C-RPE induced the greatest stress along the frontal process of the maxilla and around the anchor teeth, followed by the suture area, whereas B-RPE generated the greatest stress around the miniscrew, although the area was limited within the suture. Compared with the other appliances, MARPE caused relatively even stress distribution, decreased the stress on the buccal plate of the anchor teeth, and reduced tipping of the anchor teeth. Conclusions: The findings of this study suggest that the incorporation of miniscrews in RPE devices may contribute to force delivery to the sutures and a decrease in excessive stress on the buccal plate. Thus, MARPE may serve as an effective modality for the nonsurgical treatment of transverse maxillary deficiency in young adults.

Keywords

References

  1. Angell EH. Treatment of irregularity of the permanent or adult teeth. Dental Cosmos 1860;1:540-4, 599-600.
  2. Persson M, Thilander B. Palatal suture closure in man from 15 to 35 years of age. Am J Orthod 1977; 72:42-52. https://doi.org/10.1016/0002-9416(77)90123-3
  3. Melsen B, Melsen F. The postnatal development of the palatomaxillary region studied on human autopsy material. Am J Orthod 1982;82:329-42. https://doi.org/10.1016/0002-9416(82)90467-5
  4. Lee KJ, Park YC, Park JY, Hwang WS. Miniscrewassisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. Am J Orthod Dentofacial Orthop 2010; 137:830-9. https://doi.org/10.1016/j.ajodo.2007.10.065
  5. Melsen B. Palatal growth studied on human autopsy material. A histologic microradiographic study. Am J Orthod 1975;68:42-54.
  6. Holm E, Persson RB. Radiochemical studies of 241Pu in Swedish reindeer lichens. Health Phys 1977;33:471-3.
  7. Wehrbein H, Yildizhan F. The mid-palatal suture in young adults. A radiological-histological investigation. Eur J Orthod 2001;23:105-14. https://doi.org/10.1093/ejo/23.2.105
  8. Handelman CS, Wang L, BeGole EA, Haas AJ. Nonsurgical rapid maxillary expansion in adults: report on 47 cases using the Haas expander. Angle Orthod 2000;70:129-44.
  9. Lin L, Ahn HW, Kim SJ, Moon SC, Kim SH, Nelson G. Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence. Angle Orthod 2015;85:253-62. https://doi.org/10.2319/030514-156.1
  10. Northway WM, Meade JB Jr. Surgically assisted rapid maxillary expansion: a comparison of technique, response, and stability. Angle Orthod 1997;67:309-20.
  11. Vanarsdall RL Jr. Transverse dimension and longterm stability. Semin Orthod 1999;5:171-80. https://doi.org/10.1016/S1073-8746(99)80008-5
  12. Song JW, Lim JK, Lee KJ, Sung SJ, Chun YS, Mo SS. Finite element analysis of maxillary incisor displacement during en-masse retraction according to orthodontic mini-implant position. Korean J Orthod 2016;46:242-52. https://doi.org/10.4041/kjod.2016.46.4.242
  13. Lee HK, Bayome M, Ahn CS, Kim SH, Kim KB, Mo SS, et al. Stress distribution and displacement by different bone-borne palatal expanders with micro-implants: a three-dimensional finite-element analysis. Eur J Orthod 2014;36:531-40. https://doi.org/10.1093/ejo/cjs063
  14. Tanne K, Hiraga J, Kakiuchi K, Yamagata Y, Sakuda M. Biomechanical effect of anteriorly directed extraoral forces on the craniofacial complex: a study using the finite element method. Am J Orthod Dentofacial Orthop 1989;95:200-7. https://doi.org/10.1016/0889-5406(89)90050-4
  15. Andrews LF. The six keys to normal occlusion. Am J Orthod 1972;62:296-309. https://doi.org/10.1016/S0002-9416(72)90268-0
  16. Coolidge ED. The thickness of the human periodontal membrane. J Am Dent Assoc Dent Cosm 1937;24:1260-70. https://doi.org/10.14219/jada.archive.1937.0229
  17. Kronfeld R. Histologic study of the influence of function on the human periodontal membrane. J Am Dent Assoc 1931;18:1242-74.
  18. Provatidis CG, Georgiopoulos B, Kotinas A, McDonald JP. Evaluation of craniofacial effects during rapid maxillary expansion through combined in vivo/in vitro and finite element studies. Eur J Orthod 2008;30:437-48. https://doi.org/10.1093/ejo/cjn046
  19. Guan F, Han X, Mao H, Wagner C, Yeni YN, Yang KH. Application of optimization methodology and specimen-specific finite element models for investigating material properties of rat skull. Ann Biomed Eng 2011;39:85-95. https://doi.org/10.1007/s10439-010-0125-0
  20. Zimring JF, Isaacson RJ. Forces produced by rapid maxillary expansion. 3. Forces present during retention. Angle Orthod 1965;35:178-86.
  21. Carvalho Trojan L, Andres Gonzalez-Torres L, Claudia Moreira Melo A, Barbosa de Las Casas E. Stresses and strains analysis using different palatal expander appliances in upper jaw and midpalatal Suture. Artif Organs 2017;41:E41-51. https://doi.org/10.1111/aor.12817
  22. Koo YJ, Choi SH, Keum BT, Yu HS, Hwang CJ, Melsen B, et al. Maxillomandibular arch width differences at estimated centers of resistance: comparison between normal occlusion and skeletal Class III malocclusion. Korean J Orthod 2017;47:167-75. https://doi.org/10.4041/kjod.2017.47.3.167
  23. Choi SH, Shi KK, Cha JY, Park YC, Lee KJ. Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults. Angle Orthod 2016;86:713-20. https://doi.org/10.2319/101415-689.1
  24. Pickard MB, Dechow P, Rossouw PE, Buschang PH. Effects of miniscrew orientation on implant stability and resistance to failure. Am J Orthod Dentofacial Orthop 2010;137:91-9. https://doi.org/10.1016/j.ajodo.2007.12.034
  25. Frost HM. A 2003 update of bone physiology and Wolff's Law for clinicians. Angle Orthod 2004;74:3-15.
  26. Duyck J, Ronold HJ, Van Oosterwyck H, Naert I, Vander Sloten J, Ellingsen JE. The influence of static and dynamic loading on marginal bone reactions around osseointegrated implants: an animal experimental study. Clin Oral Implants Res 2001;12:207-18. https://doi.org/10.1034/j.1600-0501.2001.012003207.x
  27. Margulies SS, Thibault KL. Infant skull and suture properties: measurements and implications for mechanisms of pediatric brain injury. J Biomech Eng 2000;122:364-71. https://doi.org/10.1115/1.1287160
  28. Radhakrishnan P, Mao JJ. Nanomechanical properties of facial sutures and sutural mineralization front. J Dent Res 2004;83:470-5. https://doi.org/10.1177/154405910408300607
  29. Verrue V, Dermaut L, Verhegghe B. Three-dimensional finite element modelling of a dog skull for the simulation of initial orthopaedic displacements. Eur J Orthod 2001;23:517-27. https://doi.org/10.1093/ejo/23.5.517
  30. Tanne K, Hiraga J, Sakuda M. Effects of directions of maxillary protraction forces on biomechanical changes in craniofacial complex. Eur J Orthod 1989;11:382-91. https://doi.org/10.1093/oxfordjournals.ejo.a036010

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