scholarly journals Stress distribution and displacement of three different types of micro-implant assisted rapid maxillary expansion (MARME): a three-dimensional finite element study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
C. B. André ◽  
J. Rino-Neto ◽  
W. Iared ◽  
B. P. M. Pasqua ◽  
F. D. Nascimento
Keyword(s):  
Finite Element ◽  
Stress Distribution ◽  
Rapid Maxillary Expansion ◽  
The Body ◽  
Maxillary Expansion ◽  
Invasive Treatment ◽  
New Device ◽  
Periodontal Tissues ◽  
Model C ◽  
Maxillary Deficiency

Abstract Background/objective Until 2010, adults underwent surgical treatment for maxillary expansion; however, with the advent of micro-implant-assisted rapid maxillary expansion (MARME), the availability of less invasive treatment options has increased. Nevertheless, individuals with severe transverse maxillary deficiency do not benefit from this therapy. This has aroused interest in creating a new device that allows the benefit of maxillary expansion for these individuals. The aim of this study was to evaluate the efficacy of three MARME models according to tension points, force distribution, and areas of concentration in the craniofacial complex when transverse forces are applied using finite element analysis. Materials and methods Digital modeling of the three MARME models was performed. Model A comprised five components: one body screw expander and four adjustable arms with rings for mini-implant insertion. These arms have an individualized height adjustment that allows MARME positioning according to the patient’s palatal anatomy, thereby preventing body screw expander collision with the lateral mucosa in severe cases of maxillary deficiency. Model B was a maxillary expander with screw rings joined to the body, and model C was similar to model B, except that model C had open rings for the insertion of the mini-implants. Through the MEF (Ansys software), the stresses, distribution, and area of concentration of the stresses were evaluated when transverse forces of 7.85 N were applied. Results The three models maintained the following pattern: model C presented weak stress peaks with limited distribution and lower concentration area, model B obtained median stress peaks with better distribution when compared to that of model C, and model A showed better stress distribution and larger concentration area. In model A, tensions were located in the lateral lamina of the pterygoid process, which is an important site for maxillary expansion. The limitation of the present study was that it did not include the periodontal tissues and muscles in the finite element method evaluation. Conclusions Model A showed the best stress distribution conditions. In cases of severe atresia, model A seems to be an excellent option.

scholarly journals Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults

2016 ◽  
Vol 86 (5) ◽  
pp. 713-720 ◽  
Author(s):  
Sung-Hwan Choi ◽  
Kyung-Keun Shi ◽  
Jung-Yul Cha ◽  
Young-Chel Park ◽  
Kee-Joon Lee
Keyword(s):  
Young Adults ◽  
Treatment Modality ◽  
Orthodontic Treatment ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Initial Examination ◽  
The Stability ◽  
Maxillary Deficiency ◽  
Time Point

ABSTRACT Objective:  To evaluate the stability of nonsurgical miniscrew-assisted rapid maxillary expansion (MARME) in young adults with a transverse maxillary deficiency. Materials and Methods:  From a total of 69 adult patients who underwent MARME followed by orthodontic treatment with a straight-wire appliance, 20 patients (mean age, 20.9 ± 2.9 years) with follow-up records (mean, 30.2 ± 13.2 months) after debonding were selected. Posteroanterior cephalometric records and dental casts were obtained at the initial examination (T0), immediately after MARME removal (T1), immediately after debonding (T2), and at posttreatment follow-up (T3). Results:  Suture separation was observed in 86.96% of subjects (60/69). An increase in the maxillary width (J-J; 1.92 mm) accounted for 43.34% of the total expansion with regard to the intermolar width (IMW) increase (4.43 mm; P < .001) at T2. The amounts of J-J and IMW posttreatment changes were −0.07 mm (P > .05) and −0.42 mm (P  =  .01), respectively, during retention. The postexpansion change in middle alveolus width increased with age (P < .05). The postexpansion change of interpremolar width (IPMW) was positively correlated with the amount of IPMW expansion (P < .05) but not with IMW. The changes of the clinical crown heights in the maxillary canines, first premolars, and first molars were not significant at each time point. Conclusions:  Nonsurgical MARME can be a clinically acceptable and stable treatment modality for young adults with a transverse maxillary deficiency.

scholarly journals Comparison of Tooth- and Bone-Borne Appliances on the Stress Distributions and Displacement Patterns in the Facial Skeleton in Surgically Assisted Rapid Maxillary Expansion—A Finite Element Analysis (FEA) Study

Materials ◽  
2021 ◽  
Vol 14 (5) ◽  
pp. 1152
Author(s):  
Rafał Nowak ◽  
Anna Olejnik ◽  
Hanna Gerber ◽  
Roman Frątczak ◽  
Ewa Zawiślak
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Three Dimensional ◽  
Element Model ◽  
Rapid Maxillary Expansion ◽  
Stress Distributions ◽  
Maxillary Expansion ◽  
Facial Skeleton ◽  
Element Analysis ◽  
Maxillary Constriction

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.

scholarly journals Impact of Osteotomy in Surgically Assisted Rapid Maxillary Expansion Using Tooth-Borne Appliance on the Formation of Stresses and Displacement Patterns in the Facial Skeleton—A Study Using Finite Element Analysis (FEA)

2020 ◽  
Vol 10 (22) ◽  
pp. 8261
Author(s):  
Ewa Zawiślak ◽  
Anna Olejnik ◽  
Roman Frątczak ◽  
Rafał Nowak
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Facial Skeleton ◽  
Element Analysis ◽  
Skeleton Model ◽  
Skeletal Malocclusion ◽  
The Finite Element Analysis ◽  
Displacement Patterns

The analysis aimed at studying stresses reduced according to Huber’s hypothesis and displacement patterns at selected sites of the facial skeleton using a tooth-borne appliance in surgically assisted rapid maxillary expansion. Five different variants of osteotomy of the midface and a variant without surgical intervention were compared to determine the best model for making an incision in the maxilla. The finite element analysis (FEA) was used for the study. Five osteotomy variants and a variant without osteotomy were modelled using a tooth-borne appliance on a facial skeleton model of a 23-year-old woman with skeletal malocclusion. The finite element mesh was constructed based on the geometry imported into the ANSYS 15.0 (Swanson Analysis System of USA) software, in which calculations were performed using the finite element analysis. Stress distributions and displacement patterns along the X, Y and Z axes are presented for each osteotomy variant with the expansion of the tooth-borne appliance at a level of 0.5 mm. As a result of the analysis it was found that osteotomy of the palatal suture in conjunction with Le Fort I osteotomy has the biggest impact on the course of maxillary expansion. If no osteotomy is performed, an increase in stresses reduced according to Huber occurs in the entire facial skeleton with a simultaneous absence of maxillary expansion.

scholarly journals Effects of Rapid Maxillary Expansion on Conductive Hearing Loss

2008 ◽  
Vol 78 (3) ◽  
pp. 409-414 ◽  
Author(s):  
Nihat Kilic ◽  
Ali Kiki ◽  
Hüsamettin Oktay ◽  
Erol Selimoglu
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Normal Function ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Static Compliance ◽  
Fixed Appliance ◽  
Significant Difference ◽  
Conductive Hearing ◽  
Maxillary Deficiency

Abstract Objective: To test the null hypothesis that rapid maxillary expansion (RME) with a rigid bonded appliance has no effect on conductive hearing loss (CHL) in growing children. Materials and Methods: Fifteen growing subjects (mean age 13.43 ± 0.86 years) who had narrow maxillary arches and CHL participated in this study. Three pure-tone audiometric and tympanometric records were taken from each subject. The first records were taken before RME (T1), the second after maxillary expansion (T2) (mean = 0.83 months), and the third after retention (mean = 6 months) and fixed appliance treatment (approximately 2 years) periods (T3). The data were analyzed by means of analysis of variance (ANOVA) and least significant difference (LSD) tests. Results: Hearing levels of the patients were improved and air-bone gaps decreased at a statistically significant level (P < .001) during active expansion (T2–T1) and the retention and fixed appliance treatment (T2–T3) periods. Middle ear volume increased in all observation periods. However, a statistically significant increase was observed only in the T2–T3 period. No significant change was observed in the static compliance value. Conclusions: The hypothesis is rejected. RME treatment has a positive and statistically significant effect on both improvements in hearing and normal function of the eustachian tube in patients having transverse maxillary deficiency and CHL.

scholarly journals MODERN PERSPECTIVES ON RAPID PALATAL EXPANSION

2021 ◽  
Vol 9 (5) ◽  
pp. 497-500
Author(s):  
Kinnari Markana ◽  
Keyword(s):  
Transverse Dimension ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Negative Effects ◽  
Palatal Expansion ◽  
Beneficial Effects ◽  
Rapid Palatal Expansion ◽  
Mini Implants ◽  
Maxillary Deficiency ◽  
Skeletal Expansion

Maxillary deficiency in the transverse dimension is a common problem in children. The conventional management of such malocclusion is with conventional rapid maxillary expansion. The beneficial effects of such an orthodontic therapy are explained in detail in the literature. But there are also negative effects of conventional rapid maxillary expansion. Thus, the improvements in the methods of expansion has led to discovery of miniscrew assisted rapid palatal expansion. The miniscrew assisted rapid palatal expansion are supported by mini implants and thus enable better skeletal expansion of maxilla. This article will discuss the favourable effects, negative effects, and clinical uses of conventional and miniscrew assisted rapid palatal expansion.

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