Ghasemianpour Majid, Ehsani Sara, Tahmasbi Soodeh, Bayat Mohammad, Ghorbanpour Maedeh, Safavi Seyed Mohammadreza, Mirhashemi Fatemeh Sadat
Dental Research center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Orthodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Dent Res J (Isfahan). 2014 Jan;11(1):92-9.
Current methods of closure of the cleft palate result in the formation of scars and impairment of growth. Distraction osteogenesis (DO) might be an effective means to repair or at least reduce the size of wide clefts. This study investigates the biomechanical aspects of this process.
DO simulation was applied to reduce the size of a unilateral hard palate cleft on a three-dimensional (3D) model of the maxilla. For the position of osteotomy lines, two different models were assumed, with the osteotomy line on the affected side in model A and on the intact side in model B. In each model, DO screws were placed on two different positions, anteriorly (models A1 and B1) and posteriorly (models A2 and B2). Displacement pattern of the bony island in each of the four models, reaction forces at DO locations, and von Mises stress were estimated. Mesh generation and data processing were carried out in the 3D finite element analysis package (ABAQUS V6.7-1; Simulia Corp., Providence, RI, USA).
In model B2, the island moved almost evenly, assuring a more complete closure of the cleft. The most uniform stress distribution was found in model B1.
The results suggest that the best positions for the DO screw and the osteotomy line for closure of the cleft palate are posteriorly and on the intact side, respectively.
目前腭裂修复方法会导致瘢痕形成和生长障碍。牵张成骨术（DO）可能是修复或至少减小宽大腭裂尺寸的有效方法。本研究探讨该过程的生物力学方面。
在三维（3D）上颌骨模型上应用DO模拟来减小单侧硬腭裂的尺寸。对于截骨线位置，假设了两种不同模型，模型A中截骨线位于患侧，模型B中截骨线位于健侧。在每个模型中，DO螺钉放置在两个不同位置，前方（模型A1和B1）和后方（模型A2和B2）。估计了四个模型中每个模型的骨岛位移模式、DO位置处的反作用力和冯·米塞斯应力。在3D有限元分析软件包（ABAQUS V6.7 - 1；美国罗德岛州普罗维登斯市Simulia公司）中进行网格生成和数据处理。
在模型B2中，骨岛移动几乎均匀，确保腭裂更完全闭合。在模型B1中发现应力分布最均匀。
结果表明，用于腭裂闭合的DO螺钉和截骨线的最佳位置分别是后方和健侧。
