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Wang X, Yang L, Zhu Y, Wang W, Zhou C, Cao Y, Bao B, Li J. Total mesialization of the mandibular dentition using a mini-implant-supported device : A finite element analysis. J Orofac Orthop 2024; 85:145-154. [PMID: 37962639 DOI: 10.1007/s00056-023-00502-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 08/11/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE Total mandibular arch mesialization using mini-implants is challenging due to anatomic limitations. The aim of this study was to introduce a mini-implant-supported device for total mesialization of the mandibular dentition and to analyze the biomechanical properties of the device. METHODS Finite element models were constructed to explore the effect of friction and force direction on the force transmission efficiency of the device. In addition, the three-dimensional displacement of each tooth was evaluated with two force application points (2 or 8 mm hooks) under three force conditions (symmetric: 150 g of force on both sides, or asymmetric: 100 and 200 g of force on each side). RESULTS The force transmission efficiency was 66.7% under a friction coefficient of 0.15 and parallel pushing and pulling forces. The force transmission efficiency was 65.90 and 66.63% when the pushing force was 15° away from the pulling force on the sagittal and horizontal planes, respectively. The mandibular dentition moved mesially with a greater tendency for incisor labial crown tipping, mesial molar rotation and buccal second molar crown tipping when using the 8 mm hook compared to that when using the 2 mm hook. Rigid archwires resulted in more consistent tooth mesialization than stainless steel archwires. Asymmetric forces resulted in asymmetric dental arch mesialization. CONCLUSION The forces transmitted by the presented mini-implant-supported device varied depending on the friction level and force direction. The device should be able to achieve symmetric or asymmetric total mesialization of the mandibular dentition.
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Affiliation(s)
- Xi Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou Guangdong, China.
| | - Le Yang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou Guangdong, China
| | - Yeling Zhu
- Jiazhi Dental Clinic, Shenzhen, Guangdong, China
| | - Weicai Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou Guangdong, China
| | - Chen Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou Guangdong, China
| | - Yang Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou Guangdong, China
| | - Baicheng Bao
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou Guangdong, China
| | - Jiazhi Li
- Jiazhi Dental Clinic, Shenzhen, Guangdong, China
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Backer S, Nirayath KJ. Growth modulation therapy in skeletal class II malocclusion. BMJ Case Rep 2023; 16:e249784. [PMID: 37277209 PMCID: PMC10254890 DOI: 10.1136/bcr-2022-249784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
A male child in his early adolescence was referred to the orthodontist to correct the proclined maxillary anterior teeth. Investigations concluded an excess maxilla, deficient mandible and remaining growth potential. The patient was treated with Twin Block functional appliance in combination with a high-pull headgear and later fixed pre-adjusted edgewise appliance to detail the occlusion. The total treatment duration was 18 months. The positive motivation and compliance exhibited by the patient were important.
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Affiliation(s)
| | - Kevin Joseph Nirayath
- Department of Orthodontics and Dentofacial Orthopedics, Yenepoya Dental College, Mangalore, Karnataka, India
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Mukhopadhyay M, Thakur A, Verma S, Chitra P. Evaluation of stress distribution patterns produced with the Advansync2 class II corrector - A finite element analysis. J Oral Biol Craniofac Res 2023; 13:418-423. [PMID: 37168737 PMCID: PMC10165257 DOI: 10.1016/j.jobcr.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 01/15/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023] Open
Abstract
Background This study used finite element modeling to investigate stress distribution patterns during treatment with Advan Sync 2 Class II correctors. Methods - A 3-D finite element model of the skull was constructed from images obtained from cone-beam computerized tomography images. Surface data of the AdvanSync2, brackets and archwires were derived and used to construct 3-D models. Stress distribution patterns and variations were assessed and quantified during appliance simulation and after advancement by 4 mm using spacers, on the finite element model. Results Stress levels were recorded in Megapascals (MPa) and were visualized with a color scale. Maximum stress was evident in the mandible near the neck of condyle, anterior part of ramus and medial part of the coronoid process. Maxillary and mandibular teeth experienced negligible stress. Stress levels increased on advancing the appliance with spacers, though the regions and patterns of stress concentration in the maxilla and mandible remained constant to a great extent. Conclusion The AdvanSync2 is an appropriate fixed functional appliance to correct Class II malocclusions with a retrognathic mandible, as it does not apply unnecessary and deleterious stresses on the maxillary and mandibular teeth.
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Affiliation(s)
- Meghna Mukhopadhyay
- Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, India
| | - Agrima Thakur
- Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, India
| | - Shubhnita Verma
- Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, India
| | - Prasad Chitra
- Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, India
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Keser M, Gulnar B, Baser B. Evaluation of dental and skeletal effects of the asymmetric rapid maxillary expansion appliance: A three-dimensional finite element study. Technol Health Care 2022; 31:1039-1050. [PMID: 36617801 DOI: 10.3233/thc-220538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Transverse maxillary deficiency is one of the most common skeletal anomalies. The incidence of posterior crossbite caused by maxillary deficiency is between 2.7% and 23.3%. Unilateral posterior crossbite is more common than bilateral crossbite. The most common treatment for skeletal posterior crossbite is rapid maxillary expansion (RME), in which the base of the maxillary bone is expanded by separating the midpalatal suture. OBJECTIVE This study compares the biomechanical effects of three different RME appliances, especially the effects on the midline, and evaluates the usability of the modified asymmetric RME (ARME) appliance for treating unilateral crossbites. METHODS Three scenarios were created with skull models using three different appliances: (1) conventional-bonded RME appliance; (2) full-cap splint RME appliance, with all teeth covered with acrylic; and (3) ARME, with all teeth on the right side and premolars and molars on the left side covered with acrylic. The finite element method was used to assess stress levels and displacements in all models after applying a 5-mm horizontal displacement to the RME screw. RESULTS The lateral transverse movement of the first molars was greater with the conventional RME appliance than with the full-cap splint RME appliance. The lateral transverse movement of the first molar was greater on the left than on the right side with the ARME. The lateral transverse movement of the central incisors was greater with the full-cap splint RME appliance than with the conventional RME appliance. The lateral transverse movement of the central incisor was greater on the right than on the left side with the ARME. CONCLUSION Asymmetrical RME appliance increases unilateral expansion compared to other appliances. Therefore, it should be used in cases of unilateral posterior crossbite. This appliance can also successfully treat posterior crossbite with upper midline deviation, since it corrects the shifted midline.
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Zhu C, Li R, Yuan L, Zheng Y, Jin Y, Li H, Liu C, Xia L, Fang B. Effects of the advanced mandibular spring on mandibular retrognathia treatment: a three-dimensional finite element study. BMC Oral Health 2022; 22:271. [PMID: 35790937 PMCID: PMC9254520 DOI: 10.1186/s12903-022-02308-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/29/2022] [Indexed: 12/03/2022] Open
Abstract
Background The Advanced Mandibular Spring (AMS) was newly developed as a dentofacial orthopedic appliance in conjunctive use of clear aligners to treat Class II malocclusion with mandibular retrognathia in adolescents. This study aimed to launch a biomechanical assessment and evaluate whether the stress patterns generated by AMS promote mandibular growth. Methods A three-dimensional finite element model was constructed using images of CBCT and spiral CT. The model consisted of craniomaxillofacial bones, articular discs, retrodiscal elastic stratum, masticatory muscle, teeth, periodontal ligament, aligner and AMS. Mechanical effects were analyzed in three types of models: mandibular postural position, mandibular advancement with AMS, and mandibular advancement with only muscular force. Results The stress generated by AMS was distributed to all teeth and periodontal ligament, pushing mandibular teeth forward and maxillary teeth backward. In the temporomandibular joint area, the pressure in the superior and posterior aspects of the condyle was reduced, which conformed to the stress pattern promoting condylar and mandibular growth. Stress distribution became even in the anterior aspect of the condyle and the articular disc. Significant tensile stress was generated in the posterior aspect of the glenoid fossa, which conformed to the stress pattern stimulating the remodeling of the fossa. Conclusions AMS created a favorable biomechanical environment for treating mandibular retrognathia in adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02308-w.
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Kendre B, Kumar A, Shetty KN, Hedge G, Umale V, Kulshrestha R. Evaluation of stress changes in the maxilla with fixed functional appliances-A 3D FEM study. J Orthod Sci 2021; 10:10. [PMID: 34568206 PMCID: PMC8423154 DOI: 10.4103/jos.jos_33_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/07/2020] [Accepted: 02/26/2021] [Indexed: 12/02/2022] Open
Abstract
AIM: To evaluate the stress changes in the maxilla during fixed functional appliance use using three-dimensional finite element method (FEM) stress analysis. SETTINGS AND SAMPLE POPULATION: A three-dimensional finite element model of the maxilla was constructed using the images generated from the cone-beam computed tomography of a patient treated for Class II malocclusion with a fixed functional orthodontic appliance. The FEM was used to study the stress changes seen in the maxilla, which were evaluated in the form of highest von Mises stress and maximum principal stress before and after the application of fixed functional appliance. RESULTS: Higher areas of stress were seen in the model of the maxilla with the fixed functional appliance (140 MPa) compared to that in the resting stage (58.99 MPa). CONCLUSIONS: An increase in the maximum principal stress and von Mises stress in the posterior regions of the maxilla and maxillary teeth was seen. The stresses seen were double than that without the appliance. A high distalization force on the maxilla was seen with the fixed functional appliance.
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Affiliation(s)
- Balaji Kendre
- Department of Orthodontics and Dentofacial Orthopedics, Yogita Dental College, Khed, Maharashtra, India
| | - Anil Kumar
- Department of Orthodontics and Dentofacial Orthopedics, AJ Institute of Dental Sciences, Mangalore, Karnataka, India
| | - K Nillian Shetty
- Department of Orthodontics and Dentofacial Orthopedics, AJ Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Gautham Hedge
- Department of Orthodontics and Dentofacial Orthopedics, AJ Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Vinay Umale
- Department of Orthodontics and Dentofacial Orthopedics, Yogita Dental College, Khed, Maharashtra, India
| | - Rohit Kulshrestha
- Department of Orthodontics and Dentofacial Orthopedics, Terna Dental College, Navi Mumbai, Maharashtra, India
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Duggal I, Sidhu MS, Chawla A, Dabas A, Dhimole VK. Effects of miniplate anchored Herbst appliance on skeletal, dental and masticatory structures of the craniomandibular apparatus: A finite element study. Int Orthod 2021; 19:301-309. [PMID: 33933415 DOI: 10.1016/j.ortho.2021.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To analyze the stress distribution in the hard and soft tissue structures of craniomandibular complex during mandibular advancement with miniplate anchored rigid fixed functional appliance (FFA) using Finite Element Analysis (FEA). MATERIAL AND METHODS The virtual model consisting of all the maxillofacial bones (up to calvaria), the mandible and temporomandibular joint (TMJ) was generated using the volumetric data from pre-treatment CBCT-scan of a growing patient. The masticatory muscles, other soft tissues, Herbst appliance and plate geometry were modelled mathematically. Force vectors simulating muscle contraction at rest and advanced mandibular positions, with protraction force of 8N were applied. The final model was imported into ANSYS for analysis after assigning material properties. RESULTS The maximum von Mises stress of 11.69MPa and 11.96MPa magnitude was observed in the region of pterygoid plates and at the bone-miniplate interface respectively, with the mandibular advancement of 7mm. Stress patterns were also noted at the condylar neck. The stress values observed in the medial and lateral pterygoid muscles were of 10.42MPa and 4.16MPa magnitude, respectively. Stress was noted in the bucco-cervical region of the upper posterior teeth, but negligible change was seen on the lower anterior teeth and periodontal ligament. CONCLUSION Miniplate Anchored Herbst Appliance brought about Class II skeletal correction in growing children as it was accompanied by minimal changes in the inclination of the lower incisors. Soft tissue structures like pterygoid muscles and discal ligaments exhibited increased stress whereas masseter muscle displayed reduction in stresses.
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Affiliation(s)
- Isha Duggal
- SGT University, Faculty of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, 122505 Gurugram, Haryana, India.
| | - Maninder Singh Sidhu
- SGT University, Faculty of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, 122505 Gurugram, Haryana, India
| | - Anoop Chawla
- Indian Institute of Technology, Department of Mechanical Engineering, 110016 New Delhi, India
| | - Ashish Dabas
- SGT University, Faculty of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, 122505 Gurugram, Haryana, India
| | - Vivek Kumar Dhimole
- Indian Institute of Technology, Department of Mechanical Engineering, 110016 New Delhi, India
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Ulusoy Ç, Dogan M. A new method for the treatment of unilateral posterior cross-bite: a three-dimensional finite element stress analysis study. Prog Orthod 2018; 19:31. [PMID: 30146655 PMCID: PMC6110308 DOI: 10.1186/s40510-018-0227-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/29/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Stress relieving corticoto mies during the treatment of maxillary expansion are needed in adult patients. METHODS Three-dimensional (3D) finite element model was prepared, and finite element analysis was processed to evaluate the stress distributions within the skull and maxillary teeth during surgically assisted rapid maxillary expansion (SARME) treatment. RESULTS Expansion forces generated more stress on the corticotomy-applied part of the maxilla. The stress levels decreased dramatically above the corticotomy line. CONCLUSION Asymmetric transveral maxillary expansion might be achieved from a symmetric force generating screw during SARME treatment. SARME osteotomies may concentrate the stress in the expanding maxilla and reduce the pain in other parts of the cranium.
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Affiliation(s)
- Çağrı Ulusoy
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Emek, Ankara, Turkey
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Idris G, Hajeer MY, Al-Jundi A. Soft- and hard-tissue changes following treatment of Class II division 1 malocclusion with Activator versus Trainer: a randomized controlled trial. Eur J Orthod 2018; 41:21-28. [DOI: 10.1093/ejo/cjy014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ghassan Idris
- Faculty of Dentistry, Sir John Walsh Institute, University of Otago, New Zealand
| | - Mohammad Y Hajeer
- Department of Orthodontics, School of Dentistry, University of Damascus, Syria
| | - Azzam Al-Jundi
- Department of Orthodontics, College of Dentistry at King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Patil HA, Tekale PD, Kerudi VV, Sharan JS, Lohakpure RA, Mude NN. Assessment of stress changes in dentoalveolar and skeletal structures of the mandible with the miniplate anchored Forsus: A three-dimensional finite element stress analysis study. APOS TRENDS IN ORTHODONTICS 2017. [DOI: 10.4103/apos.apos_121_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectiveThe study conducted to assess the effects of a fixed functional appliance (Forsus Fatigue Resistant Device; 3M Unitek, Monrovia, CA, USA) on the mandible with three-dimensional (3D) finite element stress analysis.Materials and MethodsA 3D finite element model of mandible with miniplate at mandibular symphysis was prepared using SolidEdge software along with the plate geometry. The changes were deliberated with the finite element method, in the form of highest von Mises stress and maximum principal stress regions.ResultsMore areas of stress were seen in the model of the mandible at cortical bone in canine region at bone and miniplate interface.ConclusionsThis fixed functional appliance studied by finite element model analysis caused more von Mises stress and principal stress in both the cortical bone and the condylar region.
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Affiliation(s)
| | - Pawankumar Dnyandeo Tekale
- Department of Orthodontics, Dr Rajesh Ramdasji Kambe Dental College and Hospital, Akola, Maharashtra, India
| | - Veerendra V. Kerudi
- Department of Orthodontics, A.C.P.M. Dental College and Hospital, Dhule, Maharashtra, India
| | - Jitendra S. Sharan
- Department of Orthodontics, Centre for Dental Education and Research, AIIMS, New Delhi, India
| | | | - Nakul N. Mude
- Department of Orthodontics, Saraswati Dhanwantari Dental College and Hospital, Parbhani, Maharashtra, India
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Rama AR, Aguilera A, Melguizo C, Caba O, Prados J. Tissue Specific Promoters in Colorectal Cancer. DISEASE MARKERS 2015; 2015:390161. [PMID: 26648599 PMCID: PMC4662999 DOI: 10.1155/2015/390161] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 10/26/2015] [Indexed: 01/29/2023]
Abstract
Colorectal carcinoma is the third most prevalent cancer in the world. In the most advanced stages, the use of chemotherapy induces a poor response and is usually accompanied by other tissue damage. Significant progress based on suicide gene therapy has demonstrated that it may potentiate the classical cytotoxic effects in colorectal cancer. The inconvenience still rests with the targeting and the specificity efficiency. The main target of gene therapy is to achieve an effective vehicle to hand over therapeutic genes safely into specific cells. One possibility is the use of tumor-specific promoters overexpressed in cancers. They could induce a specific expression of therapeutic genes in a given tumor, increasing their localized activity. Several promoters have been assayed into direct suicide genes to cancer cells. This review discusses the current status of specific tumor-promoters and their great potential in colorectal carcinoma treatment.
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Affiliation(s)
- A. R. Rama
- Department of Health Science, University of Jaen, Jaen, Spain
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Armilla, 18100 Granada, Spain
| | - A. Aguilera
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Armilla, 18100 Granada, Spain
| | - C. Melguizo
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Armilla, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, Granada, Spain
- Biosanitary Institute of Granada (ibs GRANADA), SAS-Universidad de Granada, Granada, Spain
| | - O. Caba
- Department of Health Science, University of Jaen, Jaen, Spain
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Armilla, 18100 Granada, Spain
| | - J. Prados
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Armilla, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, Granada, Spain
- Biosanitary Institute of Granada (ibs GRANADA), SAS-Universidad de Granada, Granada, Spain
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Chaudhry A, Sidhu MS, Chaudhary G, Grover S, Chaudhry N, Kaushik A. Evaluation of stress changes in the mandible with a fixed functional appliance: A finite element study. Am J Orthod Dentofacial Orthop 2015; 147:226-34. [DOI: 10.1016/j.ajodo.2014.09.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 09/01/2014] [Accepted: 09/01/2014] [Indexed: 10/24/2022]
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Facilitating mandibular horizontal growth in a Class II high-angle case with a modified functional appliance. J World Fed Orthod 2014. [DOI: 10.1016/j.ejwf.2014.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mahathi N, Azariah E, Ravindran C. Finite element analysis comparison of plate designs in managing fractures involving the mental foramen. Craniomaxillofac Trauma Reconstr 2013; 6:93-8. [PMID: 24436743 DOI: 10.1055/s-0033-1343789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 01/10/2013] [Indexed: 10/26/2022] Open
Abstract
Introduction The aim of the study was to propose an ideal plating design for fractures running through the mental foramen. Methods The study compared three plating designs-two four-hole miniplates, 2 × 2-hole three-dimensional (3D) plate, and modified 2 × 2-hole 3D plate (posterior strut removed)-using finite element analysis. Von Mises stresses generated around the plates and bone were measured, as well as the mobility that is generated between the fracture fragments by applying muscle forces to generate bite force in one test and applying a force of 500 N over the premolars and first molar region in the second test. Results Von Mises stress in bone with miniplates measured 9.24 MPa in test 1 and 131.99 MPa in test 2. The stress with unmodified 3D plates measured 34.9 MPa in test 1 and150.03 MPa in test 2. The stress with modified 3D plates measured 24.98 MPa in test 1 and 150.59 MPa in test 2. Von Mises stress on the plates and screws measured 28.23 MPa, 95.97 MPa, 72.93 MPa in test 1 and 458.63 MPa, 779.01 MPa, 742.39 MPa in test 2 on miniplates, unmodified 3D plates, and modified 3D plates, respectively. The fracture mobility generated in the model with miniplates measured 0.001 mm in test 1 and 0.01 mm in test 2 and 0.007 mm and 0.02 mm in the model with unmodified 3D plates in test 1 and in test 2, respectively. In the model with modified 3D plates, the value was 0.001 mm and 0.01 mm in tests 1 and 2, respectively. Conclusion The ideal plate design is the two-plate technique with minimal stress generation on the bone and the hardware. The modified 3D plate has adequate strength to be used in the region but needs to be studied in detail.
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Affiliation(s)
- Neralla Mahathi
- Faculty of Dental Sciences, Department of Oral and Maxillofacial Surgery, Sri Ramachandra University, Chennai, Tamilnadu, India
| | - Emmanuel Azariah
- Faculty of Dental Sciences, Department of Oral and Maxillofacial Surgery, Sri Ramachandra University, Chennai, Tamilnadu, India
| | - C Ravindran
- Faculty of Dental Sciences, Department of Oral and Maxillofacial Surgery, Sri Ramachandra University, Chennai, Tamilnadu, India
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Lv Y, Yan B, Wang L. Two-phase treatment of skeletal class II malocclusion with the combination of the twin-block appliance and high-pull headgear. Am J Orthod Dentofacial Orthop 2012; 142:246-55. [PMID: 22858335 DOI: 10.1016/j.ajodo.2010.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 12/01/2010] [Accepted: 12/01/2010] [Indexed: 11/28/2022]
Abstract
The patient was a boy with a Class II skeletal and dental relationship, a large overjet, an impinging overbite, and a steep mandibular plane angle. Treatment started with the Twin-block appliance combined with high-pull headgear to promote growth of the mandible, restrain the maxilla in the anteroposterior and vertical planes, and improve his profile. This was followed by extraction of the maxillary second premolars and the mandibular first premolars. Then fixed appliances were used to align and level the dentition. Pretreatment and posttreatment records are shown, and the treatment results are stable 2 years after debonding.
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Affiliation(s)
- Yan Lv
- Institute of Stomatology, Department of Orthodontics, Nanjing Medical University, Nanjing, China
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Stress Analysis of a Class II MO-Restored Tooth Using a 3D CT-Based Finite Element Model. Int J Biomater 2012; 2012:657519. [PMID: 22844287 PMCID: PMC3403473 DOI: 10.1155/2012/657519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 05/25/2012] [Indexed: 11/17/2022] Open
Abstract
A computational method has been developed for stress analysis of a restored tooth so that experimental effort can be minimized. The objectives of this study include (i) developing a method to create a 3D FE assembly model for a restored tooth based on CT images and (ii) conducting stress analysis of the restored tooth using the 3D FE model established. To build up a solid computational model of a tooth, a method has been proposed to construct a 3D model from 2D CT-scanned images. Facilitated with CAD tools, the 3D tooth model has been virtually incorporated with a Class II MO restoration. The tooth model is triphasic, including the enamel, dentin, and pulp phases. To mimic the natural constraint on the movement of the tooth model, its corresponding mandible model has also been generated. The relative high maximum principal stress values were computed at the surface under loading and in the marginal region of the interface between the restoration and the tooth phases.
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Hannam AG. Current computational modelling trends in craniomandibular biomechanics and their clinical implications. J Oral Rehabil 2010; 38:217-34. [PMID: 20819138 DOI: 10.1111/j.1365-2842.2010.02149.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Computational models of interactions in the craniomandibular apparatus are used with increasing frequency to study biomechanics in normal and abnormal masticatory systems. Methods and assumptions in these models can be difficult to assess by those unfamiliar with current practices in this field; health professionals are often faced with evaluating the appropriateness, validity and significance of models which are perhaps more familiar to the engineering community. This selective review offers a foundation for assessing the strength and implications of a craniomandibular modelling study. It explores different models used in general science and engineering and focuses on current best practices in biomechanics. The problem of validation is considered at some length, because this is not always fully realisable in living subjects. Rigid-body, finite element and combined approaches are discussed, with examples of their application to basic and clinically relevant problems. Some advanced software platforms currently available for modelling craniomandibular systems are mentioned. Recent studies of the face, masticatory muscles, tongue, craniomandibular skeleton, temporomandibular joint, dentition and dental implants are reviewed, and the significance of non-linear and non-isotropic material properties is emphasised. The unique challenges in clinical application are discussed, and the review concludes by posing some questions which one might reasonably expect to find answered in plausible modelling studies of the masticatory apparatus.
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Affiliation(s)
- A G Hannam
- Faculty of Dentistry, Department of Oral Health Sciences, The University of British Columbia, Vancouver, BC, Canada.
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Panigrahi P, Vineeth V. Biomechanical Effects of Fixed Functional Appliance on Craniofacial Structures. Angle Orthod 2009; 79:668-75. [DOI: 10.2319/052708-281.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Accepted: 10/01/2008] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective: To evaluate displacement and stress distribution on craniofacial structures associated with fixed functional therapy.
Materials and Methods: A finite element model of the human skull was constructed from sequential computed tomography images at 2-mm intervals using a dry adult human skull. In this study, linear, four-nodal, tetramesh and triangular shell elements were used with six degrees of freedom at each of their unstrained nodes: three translations (x, y, and z) and three rotations (around the x-, y-, and z-axes).
Results: The entire mandible moved anteroinferiorly. Maximum displacement was observed in the parasymphyseal and midsymphyseal regions. The pterygoid plate was displaced in a posterosuperior direction. The anteroinferior displacement of the mandibular dentition was most pronounced in the incisor region, while the maxillary dentition was displaced posterosuperiorly. The entire dentition experienced tensile stress except for the maxillary posterior teeth. Tensile stress was also demonstrated at point A, the pterygoid plates, and the mandible, and minimal compressive stress was demonstrated at anterior nasal spine. Maximum tensile stress and von Mises stresses occurred in the condylar neck and head.
Conclusion: Fixed functional therapy causes a posterosuperior displacement of the maxillary dentition and pterygoid plate and thus can contribute to the correction of Class II malocclusion. The displacement was more pronounced in the dentoalveolar region as compared to the skeletal displacement. All dentoalveolar structures experienced tensile stress, except for anterior nasal spine and the maxillary posterior teeth.
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Affiliation(s)
- Priyankar Panigrahi
- a Lecturer, Orthodontics, Department of General and Specialist Dental Practice, College of Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Varadarajan Vineeth
- b Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics, Coorg Institute of Dental Science, Coorg, Karnataka, India
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