Name: Finite Element Analysis Model: Osteotomy Design to Detect Palatal Expansion
Uploaded: 2023-10-20T13:00:00
Description: Watch this Scientific Journal Video about Finite Element Analysis Model: Osteotomy Design to Detect Palatal Expansion at JoVE.com

finite element analysis model: osteotomy design to detect palatal expansion

Анализ шаблонов расширения из SARPE с использованием конечно-элементных моделей

Surgically assisted rapid palatal expansion (SARPE) is a commonly used technique for transversely expanding the maxillary bony structure and the dental arch in skeletally mature patients1. The surgery involves a LeFort I osteotomy, a mid-palatal corticotomy, and, optionally, the release of the pterygoid-maxillary fissure2. However, undesired expansion patterns from SARPE, such as uneven expansion between left and right hemimaxillae3 and dentoalveolar process buccal tipping/rotation4, have been reported, which could lead to failure of SARPE, and sometimes, even requiring additional surgeries for correction5. Previous studies have indicated that the variation in circum-maxillary osteotomies may play a significant role in post-SARPE expansion pattern2,3, as the collisions between the bone blocks at the Le Fort I osteotomy sites can contribute to the uneven resisting force of lateral expansion of the hemimaxillae and to the rotation of the hemimaxillae with the alveolar edges below the cut moving inwards while the dentoalveolar process expands3,4. Therefore, there is a need to investigate the effects of different osteotomy directions, especially the buccal osteotomy, on post-SARPE expansion patterns.
Several finite element analysis (FEA) models have been set up to evaluate the force distribution during SARPE. However, the amount of expansion set in these models is limited to up to 1 mm, which is far below the required clinical amount6,7,8,9,10,11,12. Inadequate expansion in FEA models can lead to erroneous predictions of post-SARPE outcomes. More specifically, the collision between the bones at the osteotomy site, as reported by Chamberland and Proffit4, may not be demonstrated if the expander is not adequately turned, which may not reflect the true clinical reality. With the limited amount of expansion built in the previous models, the outcome evaluations of these models were focused on stress analysis. However, the stress analysis of FEA in dentistry is usually conducted under static loading with the mechanical properties of materials set as isotropic and linearly elastic, which further restricts the clinical relevance of the FEA studies13.
Furthermore, most of these studies did not consider the thickness of the surgical instrument at the osteotomy site6,7,8,10,11,12, often setting friction to zero at the cuts as part of the boundary conditions. However, this setting oversimplifies the contacts between the hard and soft tissues. It may significantly impact the distribution of force and the resulting expansion pattern of the hemimaxillae.
Nevertheless, no available literature has investigated the effect of osteotomy on post-SARPE asymmetry using finite element analysis (FEA) models. All the current studies employed models with symmetrical osteotomy patterns6,7,8,9,10,11,12,14, which do not reflect the reality of clinical practice where the osteotomies may differ on each side of the skull. The lack of literature examining the effect of asymmetrical osteotomies on post-SARPE asymmetry represents a significant knowledge gap that must be addressed.
Therefore, the goal of this study is to develop a novel FEA model of SARPE that can truly mimic the clinical conditions, including the expansion amount and osteotomy gap, and investigate the expansion patterns of the hemimaxillae in all three dimensions with various designs of the osteotomy. Such an approach would provide valuable insight into the mechanics underlying post-SARPE expansion patterns and serve as a useful tool for clinicians in the planning and execution of SARPE procedures.

В центре внимания автора: Разработка новой модели анализа методом конечных элементов для усовершенствованных ортогнатических хирургических техник 

Модель анализа методом конечных элементов для оценки паттернов расширения при хирургическом быстром расширении неба

SARPE is commonly used for maxillary expansion in skeletal immature patients. However, asymmetric expansion has been reported with unknown etiologies. This study aims to develop a novel FEA model of SARPE that can truly mimic the clinical conditions, and to investigate the expansion patterns of the hemi-maxilla in all three dimensions.Finite element analysis has been used in the dental and bioengineering field to allow in vitro simulation of surgeries, such as SARPE. In this study, four software were utilized to set up the FEA model and to predict expansion pattern. The most challenging part, which most previous studies link, is to simulate forces at the wound healing site across osteotomy surface.To achieve this, springs were set in our pilot study and is considered a novel design for SARPE FEA. This unified element model focused on its patient patterns, making it more realistic SARPE simulation through osteotomy gap creation and experience inclusion. It presents significant potential as the clinical tool for branding and its guiding SARPE procedures.Our interdisciplinary group will work diligently to develop cutting-edge 3D models that can provide valuable insights into personalized treatment strategies to analyze and improve orthognatic surgical technique by utilizing an engineering-assisted approach and to improve communication and collaboration between orthodontists and oral maxillofacial surgeons through engineering-assisted 3D imaging system.

Watch this Scientific Journal Video about Finite Element Analysis Model: Osteotomy Design to Detect Palatal Expansion at JoVE.com

Finite Element Analysis Model: Osteotomy Design to Detect Palatal Expansion  

Модель анализа методом конечных элементов: дизайн остеотомии для обнаружения расширения неба

Для начала запустите программное обеспечение SolidWorks, чтобы создать плоскость толщиной в один миллиметр от грушевидного отверстия к скуловому гребню. Теперь откройте меню «Вставка» и выберите «Опорная геометрия» и «Плоскость». В плоскости остеотомии выберите три характерные точки и нажмите кнопку ОК, чтобы создать плоскость O1.Снова перейдите к плоскости, щелкнув по кнопке "Вставить и справочную геометрию". На этот раз выберите плоскость остеотомии и установите расстояние смещения в один миллиметр. Нажмите кнопку ОК, чтобы создать нижнюю секущую плоскость, помеченную как O2. Теперь перейдите к разделу, выбрав "Вставка", а затем "Элементы", и выберите плоскости O1 и O2 в окне "Инструменты обрезки".Выберите целевые тела и нажмите кнопку "Вырезанные тела" для создания предварительного просмотра вырезки. Далее поставьте галочки в разделе «Результирующие тела» и нажмите «ОК», чтобы отделить верхнечелюстной комплекс. Затем щёлкните по телу между плоскостями O1 и O2, щёлкните правой кнопкой мыши и нажмите Delete в разделе Body.Чтобы экспортировать модели с различными углами буккальной остеотомии, сначала нажмите «Файл», затем «Сохранить как» и выберите «Parasolid x_t» из списка типов файлов. Наконец, нажмите кнопку Сохранить, чтобы экспортировать модели для анализа методом конечных элементов. В продемонстрированном анализе для создания модели использовали конусно-лучевой компьютерный томографический снимок 47-летней женщины с верхнечелюстной недостаточностью.Для точного моделирования операции были разделены носовая перегородка, боковые стенки полости носа и крылочелюстная щель.

Research

JoVE Journal

Bioengineering

Finite Element Analysis Model: Osteotomy Design to Detect Palatal Expansion

Finite Element Analysis Model for Assessing Expansion Patterns from Surgically Assisted Rapid Palatal Expansion

Surgically assisted rapid palatal expansion (SARPE) was introduced to release bony resistance to facilitate skeletal expansion in skeletally mature ...