在单侧唇腭裂模型中使用面罩和Maxgym对横向位移进行三维评估。
Three-dimensional assessment of transverse displacement with Facemask and Maxgym in unilateral cleft lip and palate model.
作者信息
Parveen Shahistha, Husain Akhter, Reddy Srinivas Gosla, Mascarenhas Rohan, Shenoy Satish, Reddy Mallikarjuna
机构信息
Department of Orthodontics and Dentofacial Orthopedics, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India.
Craniofacial Center, GSR Institute of Craniofacial Surgery, Hyderabad, Andhra Pradesh, India.
出版信息
J Indian Soc Pedod Prev Dent. 2019 Apr-Jun;37(2):177-184. doi: 10.4103/JISPPD.JISPPD_207_18.
BACKGROUND
Growing patients with cleft lip and palate (CLP) exhibit maxillary deficiency due to early surgical intervention. Maxillary protraction with expansion is the recommended treatment modality for deficient maxilla. Facemask is a conventional protraction appliance, and Maxgym is a new protraction appliance. The purpose of this study is to compare the efficacy of Maxgym with Facemask using finite-element analysis.
METHODS
A three-dimensional finite-element model consisting of 49,807 nodes and 185,620 tetrahedral-shaped elements was created using computed tomography scan of a patient with unilateral CLP. F1, F2, and F3 represent different protraction forces of facemask, and M1, M2, and M3 represent different protraction forces of Maxgym. E1 represents slow maxillary expansion (SME) force, and E2 represents rapid maxillary expansion (RME) force. Facemask and Maxgym forces were applied parallel to the occlusal plane from the middle of the clinical crown on the buccal side of the first premolars. The forces E1 and E2 were also applied on the middle of the crown height on the lingual side of the first premolars and the first molars to simulate expansion. The amount of displacement for Maxgym and Facemask forces in transverse direction was analyzed designating specific nodes to represent dental and skeletal structures.
RESULTS
The dental and skeletal structures were displaced in transverse direction under all loading conditions. Only expansion or protraction force resulted in transverse displacement of nodes. RME produces greater transverse displacement as compared to SME. Maxgym forces produce greater transverse displacement as compared to facemask. Maxgym with RME produces greater transverse displacement as compared to Maxgym with SME, whereas facemask with RME produces greater transverse displacement as compared to facemask with SME.
CONCLUSIONS
Maxgym forces produce greater transverse displacement as compared to facemask with or without expansion.
背景
由于早期手术干预，患有唇腭裂（CLP）的生长发育期患者表现出上颌骨发育不足。上颌骨牵张成骨术是治疗上颌骨发育不足的推荐治疗方式。面罩是一种传统的牵张矫治器，而Maxgym是一种新型牵张矫治器。本研究的目的是使用有限元分析比较Maxgym与面罩的疗效。
方法
利用一名单侧唇腭裂患者的计算机断层扫描创建了一个由49,807个节点和185,620个四面体单元组成 的三维有限元模型。F1、F2和F3代表面罩的不同牵张力，M1、M2和M3代表Maxgym的不同牵张力。E1代表上颌骨慢速扩弓（SME）力，E2代表上颌骨快速扩弓（RME）力。将面罩和Maxgym的力从第一前磨牙颊侧临床冠中部平行于咬合平面施加。还将力E1和E2施加于第一前磨牙和第一磨牙舌侧冠高度的中部以模拟扩弓。指定特定节点以代表牙齿和骨骼结构，分析Maxgym和面罩力在横向方向上的位移量。
结果
在所有加载条件下，牙齿和骨骼结构均在横向方向上发生位移。仅扩弓力或牵张力会导致节点的横向位移。与SME相比，RME产生更大的横向位移。与面罩相比，Maxgym力产生更大的横向位移。与采用SME的Maxgym相比，采用RME的Maxgym产生更大的横向位移，而与采用SME的面罩相比，采用RME的面罩产生更大的横向位移。
结论
无论有无扩弓，与面罩相比，Maxgym力都会产生更大的横向位移。
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