Mechanical and Mechatronic Engineering Department, Faculty of Engineering, Universidad Nacional de Colombia, Carrera 30 No 45A-03, Bogotá, DC, Colombia.
Structural Engineering Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Biomech Model Mechanobiol. 2021 Aug;20(4):1519-1532. doi: 10.1007/s10237-021-01460-6. Epub 2021 Apr 24.
Cleft lip and palate is a congenital defect that affects the oral cavity. Depending on its severity, alveolar graft surgery and maxillary orthopedic therapies must be carried out as a part of the treatment. It is widely accepted that the therapies should be performed before grafting. Nevertheless, some authors have suggested that mechanical stimuli such as those from the maxillary therapies could improve the success rate of the graft. The aim of this study is to computationally determine the effect of maxillary therapies loads on the biomechanical response of an alveolar graft with different degrees of ossification. We also explore how the transverse width of the cleft affects the graft behavior and compare results with a non-cleft skull. Results suggest that stresses increase within the graft as it ossifies and are greater if maxillary expansion therapy is applied. This has consequences in the bone remodeling processes that are necessary for the graft osseointegration. Maxillary orthopedic therapies after graft surgery could be considered as a part of the treatment since they seem to act as a positive extra stimulus that can benefit the graft.
唇腭裂是一种影响口腔的先天性缺陷。根据其严重程度，牙槽突裂植骨术和上颌骨矫形治疗必须作为治疗的一部分进行。人们普遍认为，这些治疗应该在移植前进行。然而，一些作者认为，上颌骨治疗的机械刺激，如那些从上颌骨治疗，可以提高移植物的成功率。本研究的目的是通过计算来确定上颌骨治疗负荷对不同程度骨化的牙槽突裂移植的生物力学反应的影响。我们还探讨了裂隙的横向宽度如何影响移植物的行为，并将结果与非裂隙颅骨进行比较。结果表明，随着移植物的骨化，移植物内的应力增加，如果应用上颌扩张治疗，应力会更大。这对移植物骨整合所必需的骨重塑过程有影响。移植物手术后的上颌骨矫形治疗可以被认为是治疗的一部分，因为它们似乎作为一种积极的额外刺激，可以使移植物受益。
