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      Evaluation of the effects of miniscrew incorporation in palatal expanders for young adults using finite element analysis

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          Abstract

          Objective

          The aim of this study was to evaluate the stress distribution and displacement of various craniofacial structures after nonsurgical rapid palatal expansion (RPE) with conventional (C-RPE), bone-borne (B-RPE), and miniscrew-assisted (MARPE) expanders for young adults using three-dimensional finite element analysis (3D FEA).

          Methods

          Conventional, bone-borne, and miniscrew-assisted palatal expanders were designed to simulate expansion in a 3D FE model created from a 20-year-old human dry skull. Stress distribution and the displacement pattern for each circumaxillary suture and anchor tooth were calculated.

          Results

          The results showed that C-RPE induced the greatest stress along the frontal process of the maxilla and around the anchor teeth, followed by the suture area, whereas B-RPE generated the greatest stress around the miniscrew, although the area was limited within the suture. Compared with the other appliances, MARPE caused relatively even stress distribution, decreased the stress on the buccal plate of the anchor teeth, and reduced tipping of the anchor teeth.

          Conclusions

          The findings of this study suggest that the incorporation of miniscrews in RPE devices may contribute to force delivery to the sutures and a decrease in excessive stress on the buccal plate. Thus, MARPE may serve as an effective modality for the nonsurgical treatment of transverse maxillary deficiency in young adults.

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          Most cited references30

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          The six keys to normal occlusion.

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            A 2003 update of bone physiology and Wolff's Law for clinicians.

            By 1892, Julius Wolff and others realized that mechanical loads can affect bone architecture in living beings, but the mechanisms responsible for this effect were unknown, and it had no known clinical applications. In 2003 we know how this effect occurs and some of its applications. Our load-bearing bones (LBBs) include tibias, femurs, humeri, vertebrae, radii, mandibles, maxillae, wrists, hips, etc (so LBBs are not limited to weight-bearing ones). The strength of such bones and their trabeculae would represent their most important physiologic feature but in the special sense of relative to the size of the typical peak voluntary loads on them. The biologic "machinery" that determines whole-bone strength forms a tissue-level negative feedback system called the mechanostat. Two thresholds make a bone's strains determine its strength by switching on and off the biologic mechanisms that increase or decrease its strength. Equally, two thermostats can determine a room's temperature by switching on and off the room's heating and cooling systems. General features show that the largest voluntary loads on LBBs determine most of their strength after birth. These loads come from muscle forces so muscle strength strongly influences the strength of our LBBs. This process affects, in part, the healing of fractures, bone grafts, osteotomies, and arthrodeses; the bone's ability to endure load-bearing joint and dental endoprostheses; why healthy bones are stronger than the minimum needed to keep voluntary loads from breaking them suddenly or from fatigue; some general functions and disorders of bone modeling and basic multicellular unit-based bone remodeling; some limitations of in vitro data and of pharmaceutical actions; and the fact that many bone-active humoral and local agents have permissive roles in a bone's adaptations and healing, instead of forcing them to occur.
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              Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence.

              To evaluate the immediate effects of rapid maxillary expansion (RME) on the transverse skeletal and dentoalveolar changes with bone-borne (C-expander) and tooth-borne type expanders using cone-beam computed tomography (CBCT) in late adolescents.
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                Author and article information

                Journal
                Korean J Orthod
                Korean J Orthod
                KJOD
                Korean Journal of Orthodontics
                Korean Association of Orthodontists
                2234-7518
                2005-372X
                March 2018
                06 February 2018
                : 48
                : 2
                : 81-89
                Affiliations
                [a ]Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea.
                [b ]Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.
                [c ]Division of Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institution, BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea.
                Author notes
                Corresponding author: Kee-Joon Lee. Professor, Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel +82-2-2228-3105, orthojn@ 123456yuhs.ac
                Article
                10.4041/kjod.2018.48.2.81
                5854885
                29564217
                7f146ef0-934d-4084-bd1a-7ce4d0dc795c
                © 2018 The Korean Association of Orthodontists.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 April 2017
                : 21 June 2017
                : 01 July 2017
                Funding
                Funded by: National Research Foundation of Korea, CrossRef ;
                Award ID: 2017R1D1A1B03035435
                Categories
                Original Article

                Dentistry
                marpe,finite element analysis,circumaxillary sutures,buccal plate
                Dentistry
                marpe, finite element analysis, circumaxillary sutures, buccal plate

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