Biomechanical Analysis of Maxillary Expansion in CLP Patients

Holberg, Christof; Holberg, Nikola; Schwenzer, K.; Wichelhaus, Andrea; Rudzki-Janson, Ingrid

doi:10.2319/0003-3219(2007)077[0280:baomei]2.0.co;2

Cited by 35 publications

(50 citation statements)

References 16 publications

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“…This result agrees with the findings of previous studies. 8,9 The medial pterygo-maxillary articulation also showed high stress. The lateral pterygomaxillary articulation, on the other hand, demonstrated negligible stress.…”

Section: Discussionmentioning

confidence: 99%

“…This asymmetric response to expansion in unilateral cleft patients has been demonstrated in previous studies. 8,9,15 The expansion was simulated in a patient model with unilateral cleft deformity of the secondary palate and alveolus. The typical wedgeshaped opening in the antero-posterior plane, seen in non-cleft patients, as a result of RME was not seen in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Both clinical [5][6][7] and FEM 8,9 studies on clefts have shown asymmetric response of the cleft and non-cleft segments with expansion forces. Previous in vitro studies in non-cleft patients have shown that the primary anatomical sites of resistance to expansion forces were the midpalatal area and the zygomatic buttress.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical response of the maxillofacial skeleton to transpalatal orthopedic force in a unilateral palatal cleft

Gautam¹,

Zhao²,

Patel³

2011

The Angle Orthodontist

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Objectives: To assess the skeletal and dental effects of rapid maxillary expansion in a patient with unilateral cleft deformity of secondary palate and alveolus using the finite element method. Materials and Methods: A patient-specific composite skull model was developed from a patient computed tomographic scan and a surface scan of the patient's maxillary cast using MIMICS imaging analysis software. For volumetric meshing and the finite element analysis, Abaqus (6.7) was used. Results: The typical wedge-shaped opening that occurs after RME, seen in non-cleft patients, is not seen in cleft patients. A clockwise rotation of the maxilla as a result of maxillary expansion was evident. The areas of maximum stress were the intact primary palate region, inferior orbital foramen of the non-cleft and the cleft sides, and the zygomatic buttress of the cleft side. During expansion, the intact primary palate showed high stress and acted as a region of major resistance, followed by the zygomatic buttress on the cleft side. Conclusions: Clinicians should consider a need for customization of expansion therapy for cleft patients depending on the patient's age, the type of cleft present (primary or secondary palate), and the desired area of expansion (anterior or posterior). (Angle Orthod. 2011;81:503-509.)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Biomechanical response of the maxillofacial skeleton to transpalatal orthopedic force in a unilateral palatal cleft

Gautam¹,

Zhao²,

Patel³

2011

The Angle Orthodontist

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“…In accordance with [21] this may be caused by an asymmetrical disposition of the skull bone structures. One of the few FE studies on the comparative analysis of the stress distributions in the skull without cleft, in the skull with unilateral cleft and with bilateral cleft is [5]. In [5] action of the orthodontic appliance Quad-Helix on the maxilla was simulated without periodontal ligament.…”

Section: Introductionmentioning

confidence: 99%

“…In [5] action of the orthodontic appliance Quad-Helix on the maxilla was simulated without periodontal ligament. According to [5], the smallest expansion is observed between the control points for the skull without palate cleft, and the difference between the stress distributions in the skull without cleft and in the skull with cleft (unilateral or bilateral) during RME is quite substantial.…”

Section: Introductionmentioning

confidence: 99%

Craniofacial Stress Patterns and Displacements After Activation of Hyrax Device: Finite Element Modelling

2017

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Breaking Symmetry: A Quantitative Analysis of Facial Skeleton Disharmony in Children Born with Bilateral Cleft Lip and Palate

Santana

Starbuck

2019

The Anatomical Record

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Bilateral cleft lip and palate (BCLP) occurs when craniofacial precursors fail to form or fuse properly during development. The aim of this retrospective, cross‐sectional investigation was to quantify directional asymmetry (DA) of the facial skeleton of children born with Veau Class IV nonsyndromic BCLP. To accomplish this goal, coordinate values of anatomical landmarks were acquired from three‐dimensional cone beam computed tomographic images of the craniofacial skeleton of middle‐ to late‐aged children born with BCLP and age‐ and sex‐matched controls and used to compare patterns of asymmetry variation. Multivariate analyses revealed different patterns of DA variation across samples and identified approximately 30% of DA measures as significantly different. Magnitudes of statistically significant linear distances differ in the craniofacial region, with most smaller DA differences located near the orbits and frontal bone, while larger differences were localized mostly to the midface, alveolar ridge, and nasal borders. Generally, areas of the craniofacial skeleton derived from the maxillary and nasal prominences demonstrated the highest magnitudes of DA. The methods and results presented will be useful to biomedical researchers when identifying the extent to which patients with BCLP diverge from typical developmental expectations. Quantifying DA and assessing local differences across the craniofacial complex can aid medical practitioners when developing treatments to improve BCLP surgical algorithms and outcomes. Anat Rec, 302:1726–1732, 2019. © 2019 American Association for Anatomy

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Biomechanical Analysis of Maxillary Expansion in CLP Patients

Cited by 35 publications

References 16 publications

Biomechanical response of the maxillofacial skeleton to transpalatal orthopedic force in a unilateral palatal cleft

Biomechanical response of the maxillofacial skeleton to transpalatal orthopedic force in a unilateral palatal cleft

Craniofacial Stress Patterns and Displacements After Activation of Hyrax Device: Finite Element Modelling

Breaking Symmetry: A Quantitative Analysis of Facial Skeleton Disharmony in Children Born with Bilateral Cleft Lip and Palate

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