Korean J Orthod.  2018 Sep;48(5):304-315. 10.4041/kjod.2018.48.5.304.

Displacement and stress distribution of the maxillofacial complex during maxillary protraction using palatal plates: A three-dimensional finite element analysis

• Eom J
• Bayome M
• Park JH
• Lim HJ
• Kook YA
• Han SH

• KMID: 2421315
• DOI: http://doi.org/10.4041/kjod.2018.48.5.304

Abstract

OBJECTIVE
The purpose of this study was to analyze initial displacement and stress distribution of the maxillofacial complex during dentoskeletal maxillary protraction with various appliance designs placed on the palatal region by using three-dimensional finite element analysis.
METHODS
Six models of maxillary protraction were developed: conventional facemask (Type A), facemask with dentoskeletal hybrid anchorage (Type B), facemask with a palatal plate (Type C), intraoral traction using a Class III palatal plate (Type D), facemask with a palatal plate combined with rapid maxillary expansion (RME; Type E), and Class III palatal plate intraoral traction with RME (Type F). In Types A, B, C, and D, maxillary protraction alone was performed, whereas in Types E and F, transverse expansion was performed simultaneously with maxillary protraction.
RESULTS
Type C displayed the greatest amount of anterior dentoskeletal displacement in the sagittal plane. Types A and B resulted in similar amounts of anterior displacement of all the maxillofacial landmarks. Type D showed little movement, but Type E with expansion and the palatal plate displayed a larger range of movement of the maxillofacial landmarks in all directions.
CONCLUSIONS
The palatal plate served as an effective skeletal anchor for use with the facemask in maxillary protraction. In contrast, the intraoral use of Class III palatal plates showed minimal skeletal and dental effects in maxillary protraction. In addition, palatal expansion with the protraction force showed minimal effect on the forward movement of the maxillary complex.

Keyword

Finite element model; Facemask; Expansion; Palatal plate

MeSH Terms

Finite Element Analysis*
Palatal Expansion Technique
Traction

Figure

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  Figure 1 Illustrations of the skeletal and dental landmarks. A, Skeletal landmarks; B, Landmarks at the midpalatal suture; C, Occlusal dental landmarks; and D, Radicular dental landmarks.

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  Figure 2 Schematic illustration of the appliance designs. Type A: conventional tooth-borne facemask; Type B: hybrid-hyrax appliance with facemask; Type C: modified C-palatal plate (MCPP) with facemask; Type D: Class III MCPP anchorage with intraoral traction to a transpalatal arch; Type E: MCPP with rapid maxillary expansion (RME) and facemask; Type F: Class III MCPP with RME and intraoral traction to a transpalatal arch. Figure on the right summarizes application of RME and facemask in each appliance type.

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  Figure 3 Displacement of the skull and maxillary complex along the X, Y, and Z axes.

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  Figure 4 Displacement of the maxillary dentition along the X, Y, and Z axes.

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  Figure 5 Stress distribution of the skull and maxillary complex.

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