Haofu Lee1, Alan Nguyen2, Christine Hong1, Paul Hoang3, John Pham2, Kang Ting4. 1. Assistant professor, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif. 2. Dental student, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif. 3. Orthodontic resident, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif. 4. Professor and chair, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif. Electronic address: haofulee@ucla.edu.
Abstract
INTRODUCTION: The aims of this study were to evaluate the effects of rapid palatal expansion on the craniofacial skeleton of a patient with unilateral cleft lip and palate (UCLP) and to predict the points of force application for optimal expansion using a 3-dimensional finite element model. METHODS: A 3-dimensional finite element model of the craniofacial complex with UCLP was generated from spiral computed tomographic scans with imaging software (Mimics, version 13.1; Materialise, Leuven, Belgium). This model was imported into the finite element solver (version 12.0; ANSYS, Canonsburg, Pa) to evaluate transverse expansion forces from rapid palatal expansion. Finite element analysis was performed with transverse expansion to achieve 5 mm of anterolateral expansion of the collapsed minor segment to simulate correction of the anterior crossbite in a patient with UCLP. RESULTS: High-stress concentrations were observed at the body of the sphenoid, medial to the orbit, and at the inferior area of the zygomatic process of the maxilla. The craniofacial stress distribution was asymmetric, with higher stress levels on the cleft side. When forces were applied more anteriorly on the collapsed minor segment and more posteriorly on the major segment, there was greater expansion of the anterior region of the minor segment with minimal expansion of the major segment. CONCLUSIONS: The transverse expansion forces from rapid palatal expansion are distributed to the 3 maxillary buttresses. Finite element analysis is an appropriate tool to study and predict the points of force application for better controlled expansion in patients with UCLP.
INTRODUCTION: The aims of this study were to evaluate the effects of rapid palatal expansion on the craniofacial skeleton of a patient with unilateral cleft lip and palate (UCLP) and to predict the points of force application for optimal expansion using a 3-dimensional finite element model. METHODS: A 3-dimensional finite element model of the craniofacial complex with UCLP was generated from spiral computed tomographic scans with imaging software (Mimics, version 13.1; Materialise, Leuven, Belgium). This model was imported into the finite element solver (version 12.0; ANSYS, Canonsburg, Pa) to evaluate transverse expansion forces from rapid palatal expansion. Finite element analysis was performed with transverse expansion to achieve 5 mm of anterolateral expansion of the collapsed minor segment to simulate correction of the anterior crossbite in a patient with UCLP. RESULTS: High-stress concentrations were observed at the body of the sphenoid, medial to the orbit, and at the inferior area of the zygomatic process of the maxilla. The craniofacial stress distribution was asymmetric, with higher stress levels on the cleft side. When forces were applied more anteriorly on the collapsed minor segment and more posteriorly on the major segment, there was greater expansion of the anterior region of the minor segment with minimal expansion of the major segment. CONCLUSIONS: The transverse expansion forces from rapid palatal expansion are distributed to the 3 maxillary buttresses. Finite element analysis is an appropriate tool to study and predict the points of force application for better controlled expansion in patients with UCLP.
Authors: Mohamed Zahoor Ul Huqh; Johari Yap Abdullah; Ling Shing Wong; Nafij Bin Jamayet; Mohammad Khursheed Alam; Qazi Farah Rashid; Adam Husein; Wan Muhamad Amir W Ahmad; Sumaiya Zabin Eusufzai; Somasundaram Prasadh; Vetriselvan Subramaniyan; Neeraj Kumar Fuloria; Shivkanya Fuloria; Mahendran Sekar; Siddharthan Selvaraj Journal: Int J Environ Res Public Health Date: 2022-08-31 Impact factor: 4.614