West China Journal of Stomatology ›› 2022, Vol. 40 ›› Issue (4): 451-456.doi: 10.7518/hxkq.2022.04.013

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Comparative study on the effect of maxillary expansion on the displacement of maxillary alveolar bone before and after alveolar bone graft: a three-dimensional finite element analysis

Yuan Wei1(), Hou Yan2, Song Peng2, Zhang Xiaohuan3, Huang Wei2()   

  1. 1.Handan Stomatological Hospital, Handan 056000, China
    2.School and Hospital of Stomatology, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Disease, Shijiazhuang 050017, China
    3.Dept. of Stomatology, Luannan County Hospital in Tangshan, Tangshan 063500, China
  • Received:2021-11-10 Revised:2022-06-16 Online:2022-07-25 Published:2022-07-27
  • Contact: Huang Wei E-mail:417131721@qq.com;505060770@qq.com
  • Supported by:
    Medical Science Research Project in Hebei Province(20211075);Correspondence: Huang Wei, E-mail: 505060770@qq.com

Abstract:

Objective This paper aimed to simulate and compare the effect of maxillary expansion on the displacement of maxillary alveolar bone before and after alveolar bone graft. Methods On the established finite element model of the maxilla before bone grafting, ANSYS was used to simulate alveolar bone graft to form the model of maxilla after bone grafting. The same expansion force was applied to the two models, and the three-dimensional displacement of alveolar bone was observed and compared between them. Results Comparison of the three-dimensional displacement showed that expansion before bone grafting was significantly larger than that after bone grafting (P<0.05). For horizontal displacement, in the expansion group before bone grafting, the displacement was gradually decreased from anterior to posterior alveolar bone. In the expansion group after bone grafting, the displacement was gradually increased from anterior to posterior alveolar bone. Displacement of noncleft side alveolar bone was significantly larger than that of cleft side alveolar bone with maxillary expansion before and after alveolar bone graft (P<0.05). In terms of vertical displacement, the anteromedial alveolar bone moved downward and the posterolateral alveolar bone moved upward with maxillary expansion before and after alveolar bone graft. For sagittal displacement, the anteromedial alveolar bone moved forward and the posterolateral alveolar bone moved backward with maxillary expansion before alveolar bone graft. However, the movement trend was opposite with maxillary expansion after alveolar bone graft. Conclusion The three-dimensional movement with maxillary expansion before alveolar bone graft is more obvious than that after bone grafting for patients with unilateral complete cleft lip and palate. Expander should be moved backward properly with maxillary expansion before alveolar bone graft and moved forward properly and cooperated with maxillary protraction with maxillary expansion after alveolar bone graft. Meanwhile, precaution must be taken in terms of asymmetric expansion and anterior open bite in operation.

Key words: alveolar bone graft, maxillary expansion, three dimensional displacement of alveolar bone, finite e-lement analysis

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