Three-dimensional finite element analysis for internal maxillary distraction with fixation between cleft palate

Abstract

Objective To investigate the biomechanical changes of internal maxillary distraction with fixation between cleft palate.Methods Three-dimensional FEM models of LeFort Ⅰ osteotomy and soft tissue in CLP maxillary complex were established.Two different conditions were simulated:one was the cleft palate connected by a titanium plate,and the other was the cleft retained.Internal midface distraction which applied in clinic were simulated.Fixation points of the distraction devices on the LeFort Ⅰ osteotomy complex were advanced by 10 mm in the direction of frontage.Biomechanical changes for different conditions were investigated by means of finite element analyses.Results LeFort Ⅰ osteotomy of maxillary complex area in CLP was advanced.Constrictions occurred in alveolar crest and palate,when the cleft was retained.Constriction of alveolar crest and palate was not obvious,when the cleft palate was connected by a titanium plate.There were no differences between sagittal and vertical displacement to internal distraction in LeFort Ⅰ osteotomy.Clockwise rotation occurred in vertical direction.Conclusions Internal maxillary distraction with fixation between cleft palate could avoid constriction of alveolar crest and palate.It provides the options and reference to the surgical plans. Key words: Cleft lip and palate (CLP); Biomechanics; Finite element method; Distraction osteogenesis