Three-dimensional finite element analysis of stress distribution and displacement of the maxilla following surgically assisted rapid maxillary expansion.

J Craniomaxillofac Surg

Department of Craniomaxillofacial surgery, Kangnam St Mary's Hospital, Medical College, the Catholic University of Korea, Seocho-gu, Seoul, Republic of Korea.

Published: April 2009

Purpose: The aim of this study was to investigate the displacement and stress distributions during surgically assisted rapid maxillary expansion under different surgical conditions.

Materials And Methods: 3-dimensional finite element model of a maxilla with a Hyrax appliance was constructed and an expansion force of 6000 grams was applied using the expansion screw. According to the surgical procedures, 5 groups including a control group without surgery (Group I) were simulated. The experimental groups were as follows; Group II (Le Fort I osteotomy), Group III (Le Fort I osteotomy and paramedian osteotomy), Group IV (Le Fort I osteotomy and pterygomaxillary separation), and Group V (Le Fort I osteotomy, paramedian osteotomy, and pterygomaxillary separation).

Results: Displacement of the maxilla gradually increased from Group 1 to Group 5 in all three planes of space, indicating that combination of the Le Fort I osteotomy with paramedian osteotomy and pterygomaxillary separation produce greatest displacement of the maxilla. By surgical relief, the stress exerted on anchor teeth was significantly reduced.

Conclusion: The results suggested that the combination of Le Fort I and paramedian osteotomy with pterygomaxillary separation is an effective procedure for increasing the expansion of the maxilla with lower side effects caused by excessive stresses around the anchor teeth.

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http://dx.doi.org/10.1016/j.jcms.2008.10.002DOI Listing

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