Three-dimensional finite element analysis of initial displacement and stress on the craniofacial structures of unilateral cleft lip and palate model during protraction therapy with variable forces and directions

Parveen, Shahista; Husain, Akhter; Reddy, Srinivas Gosla; Mascarenhas, Rohan; Shenoy, Bhaskar

doi:10.1080/10255842.2020.1803844

Cited by 6 publications

(13 citation statements)

References 23 publications

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“…Interestingly, the effect and efficiency of the X-displacement were greater in the unilateral cleft model in the cleft bone than in the bilateral cleft model. This result is in line with the results investigated by previous finite element analysis studies [ 46 ].…”

Section: Discussionsupporting

confidence: 93%

A Three-Dimensional Finite Element Analysis of Displacement and Stress Distributions of Unilateral and Bilateral Cleft Lips by Using Developed Pre-Surgical Treatment Architecture

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Erçelebi

2021

Children

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Cleft lips and cleft palates are the most common birth defects in newborns. Pre-surgical correction of unilateral and bilateral cleft lips and palates has been the subject of interest of many previous works. This condition has necessitated the evolution of many surgical and non-surgical techniques to mitigate the problem of this deformity in children. In this study, we proposed a new architecture that can be used instead of the conventional pre-surgical treatment. The proposed architecture has mechanical and electronic parts. This architecture was adopted to apply external stress to the cleft bones and cleft edges using an airbag that is located in the mechanical part. The amount of air in the airbag can be controlled by an available control unit in the electronic part. The effect of external stress on the cleft bones and the cleft edges was analyzed by using the finite element analysis (FEA) method. The FEA study aimed to analyze the displacement, amount of tensile and compressive forces, and Von Mises stress distributions on the cleft bones, cleft edges, nasal septum, and superior alveolar part of the maxillary jaw of unilateral and bilateral cleft models during pre-surgical treatment with the novel architecture. The results show that displacement and stress affected the clefts of both models. Displacement had a significant effect of gradually bringing the clefts closer to each other and returning them to the posterior. The analysis also investigated the effects of stress on the cleft bone and cleft edge. It was found from the results that the stresses helped to bring the incisions closer to the most appropriate position for plastic surgeons. The results prove that the positive and negative X-displacements move in the opposite direction, which means that the cleft edges gradually converge toward each other. Moreover, the negative Z-displacement affected the movement of cleft bones and cleft edges from outside to inside and gradually returned them to a suitable position. The findings show that the proposed architecture can be contributed to the pre-surgical treatment of the unilateral and bilateral clefts as an alternative to the traditional method.

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Section: Discussionsupporting

confidence: 93%

A Three-Dimensional Finite Element Analysis of Displacement and Stress Distributions of Unilateral and Bilateral Cleft Lips by Using Developed Pre-Surgical Treatment Architecture

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Erçelebi

2021

Children

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“…The greatest effects expected regarding the maxillary protraction are forward movement of maxilla and superior teeth and backward and downward rotation of the mandible 2,15 . In our study we observed this craniometric effect considering that the SNA, ANB and AO-BO measures significantly increased at the immediate post-treatment period.…”

Section: Discussionmentioning

confidence: 99%

“…The main characteristic of the craniofacial deformities in cleft lip and palate patients is the deficient growth of the middle face caused by an inherited growth pattern or by early surgeries [1][2][3] . This retrusion usually leads to not only functional (occlusion, speech, breathing, swallowing), but also aesthetic and psychological issues that are easily identified in patients at the development phase 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Immediate and late follow-up effects of class III early correction in cleft lip and palate patients treated with maxillary protraction

Miranda

Souza²,

Venezian

et al. 2020

Rev. odontol. UNESP

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Introduction There is no consensus about the immediate and latte follow-up effects of maxillary protraction in cleft lip and palate patients. Objective To evaluate the stability of Class III early treatment in cleft lip and palate patients through maxillary expansion and protraction. Material and method The sample consists in three lateral cephalometric radiographs of 28 patients (mean pre-treatment age of 6.7±1.8 years) who presented cleft lip and palate and were treated with maxillary expansion and Petit facial mask. The angular (SNA, SNB, ANB, SN.GoGn, FMA, Z Angle) and linear (overjet, Co-A, Co-Gn, Nperp-A, Nperp-Pg, AO-BO) cephalometric measures were evaluated through the Dolphin® software, in three moments: T0 (initial), T1 (after treatment), and T2 (follow-up). Data were submitted to the analysis of variance (ANOVA) and Tukey-Kramer test. The correlation between cephalometric measures and patient’s age was determined by Pearson’s chi-squared test. Result The SNA, ANB, and AO-BO measures increased considerably (p<0.05), and they did not present any differences compared to the initial ones after the follow-up time. The overjet measure increased (p<0.05) after treatment and, even with its decrease at the follow-up time, it was still higher than at the beginning (p<0.05). The Z angle showed improvement with treatment and remained stable at the follow-up time. Conclusion After treatment (maxillary expansion associated with protraction), there was a skeletal pattern improvement. During the follow-up period, those alterations decreased to a measure close to the beginning. There was an improvement in the dental pattern and facial profile that continued in the follow-up period.

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“…Com base no tipo e local a fissura pode ser classificada como pré-forame incisivo, que pode ser unilateral, bilateral ou mediana e também sendo subclassificada como completa ou incompleta. Sendo completa quando acomete os tecidos moles, rebordo alveolar e assoalho nasal e incompleta quando acomete apenas os tecidos moles (MOREIRA, 2011;PARVEEN et al, 2020).…”

Section: Introdução E Revisão De Literaturaunclassified

“…Essa característica facial prejudica a estética além de que se não for tratada se agrava com o passar dos anos. Esse fato confirma a necessidade de uma intervenção precoce com o tratamento ortopédico buscando promover um crescimento da maxila, melhorando as relações oclusais e podendo reduzir a morbidade da cirurgia ortognática ou, por vezes, evitando a indicação de realizá-la (HUPP et al, 2015;HATHAWAY et al, 2011;PARVEEN et al, 2020).…”

Section: Introdução E Revisão De Literaturaunclassified

Tratamento ortopédico de expansão rápida da maxila e protração maxilar com máscara facial em paciente com fissura labiopalatina unilateral completa – Caso clínico / Orthopedic treatment of rapid maxillary expansion and maxillary protraction with facial mask in patient with complete unilateral cleft lip - Clinical case

Lopes¹,

Costa²,

Rodrigues³

et al. 2021

BJDV

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Pacientes portadores de fissura labiopalatina unilateral completa (FLUC) costumam apresentar deficiência maxilar como uma consequência das cirurgias primárias de correção da fissura que são realizadas no primeiro ano de vida. Apesar de ser o tipo de fissura oral não-sindrômica mais frequente, é comum que o cirurgião-dentista ao se deparar com esse tipo de paciente não saiba realizar o manejo correto e encaminhamento para tratamento. O objetivo desse trabalho é relatar o manejo clínico de um paciente com fissura labiopalatina unilateral completa através do tratamento ortopédico de expansão rápida da maxila e tração reversa da maxila com máscara facial, avaliando sua eficiência na correção do padrão esquelético de classe III. A expansão rápida da maxila foi realizada utilizando o aparelho dento-muco-suportado do tipo Haas, após uma semana de ativação, deu-se início a protração maxilar com a máscara facial que durou onze meses e três semanas, totalizando um ano de tratamento. Foram realizadas tomografias computadorizadas cone beam antes de inciar o tratamento (T1) e ao seu término (T2), apresentando variáveis cefalométricas. Ao analisar o ângulo SNA em conjunto com a medida linear Co-A ambos sofreram um aumento de T1 para T2, sendo possível notar que a protrusão maxilar proposta pela terapêutica adotada foi significativa. O protocolo de tratamento precoce utilizado trouxe grandes benefícios ao paciente, promovendo a correção do padrão esquelético de classe III e melhorando a estética facial.

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Three-dimensional finite element analysis of initial displacement and stress on the craniofacial structures of unilateral cleft lip and palate model during protraction therapy with variable forces and directions

Cited by 6 publications

References 23 publications

A Three-Dimensional Finite Element Analysis of Displacement and Stress Distributions of Unilateral and Bilateral Cleft Lips by Using Developed Pre-Surgical Treatment Architecture

A Three-Dimensional Finite Element Analysis of Displacement and Stress Distributions of Unilateral and Bilateral Cleft Lips by Using Developed Pre-Surgical Treatment Architecture

Immediate and late follow-up effects of class III early correction in cleft lip and palate patients treated with maxillary protraction

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