Abstract
The aim of this study was to compare the reduced stresses according to Huber’s hypothesis and the displacement pattern in the region of the facial skeleton using a tooth- or bone-borne appliance in surgically assisted rapid maxillary expansion (SARME). In the current literature, the lack of updated reports about biomechanical effects in bone-borne appliances used in SARME is noticeable. Finite element analysis (FEA) was used for this study. Six facial skeleton models were created, five with various variants of osteotomy and one without osteotomy. Two different appliances for maxillary expansion were used for each model. The three-dimensional (3D) model of the facial skeleton was created on the basis of spiral computed tomography (CT) scans of a 32-year-old patient with maxillary constriction. The finite element model was built using ANSYS 15.0 software, in which the computations were carried out. Stress distributions and displacement values along the 3D axes were found for each osteotomy variant with the expansion of the tooth- and the bone-borne devices at a level of 0.5 mm. The investigation showed that in the case of a full osteotomy of the maxilla, as described by Bell and Epker in 1976, the method of fixing the appliance for maxillary expansion had no impact on the distribution of the reduced stresses according to Huber’s hypothesis in the facial skeleton. In the case of the bone-borne appliance, the load on the teeth, which may lead to periodontal and orthodontic complications, was eliminated. In the case of a full osteotomy of the maxilla, displacements in the buccolingual direction for all the variables of the bone-borne appliance were slightly bigger than for the tooth-borne appliance.
Highlights
Maxillary transverse extension is the method of choice in the treatment of disproportions in the transverse dimensions of both the maxilla and the mandible, which are, among others, distinguished by crossbite [1]
The researchers conducted a study on a group of 25 patients treated with surgically assisted rapid maxillary expansion (SARME) using the same osteotomy as in Mommaerts, without nasal septum separation
Our analysis revealed that the reduction of stresses on teeth onto which the appliance was fixed requires an osteotomy of the pterygopalatine suture in SARME therapy
Summary
Maxillary transverse extension is the method of choice in the treatment of disproportions in the transverse dimensions of both the maxilla and the mandible, which are, among others, distinguished by crossbite [1]. The maxillary and palatine bones are separated in the palatal suture, which increases the upper arch width. After their separation, the goal of treatment is to increase the bone base of the maxilla by providing stimulation to form new bone. According to the “functional matrix hypothesis” formulated by Moss in the 1960s, the proper function and growth of the facial skeleton are determined by proper breathing, swallowing and chewing [4,5]. The absence of appropriate functional stimuli results in the disordered morphology of the facial skeleton and the occurrence of malocclusion
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
