title: Analysis of the performance of different orthodontic devices for mandibular symphyseal distraction osteogenesis.
abstract: The aim of this study was to investigate the performance of different orthodontic devices for mandibular symphyseal distraction osteogenesis (MSDO). Two performance parameters were analysed, the first of which concerned the stability guaranteed by a distractor in the fracture gap under mastication loads and the second the level of reliability with which a distractor transfers a given expansion to the mandibular bone, inasmuch as the more reliable the device the smaller the difference between the degree of expansion provided to the device and the displacement achieved on the mandibular arch. Hence, a non-linear finite element (FE) model of a human mandible with different devices (tooth-borne, bone-borne, and hybrid) was constructed and then utilized to assess the structural behaviour of the mandibular bone under distraction and mastication loads. An ad hoc algorithm was developed to simulate progressive expansion of the devices; a distraction protocol comprising a 10 day latency period and a 6 day distraction period was hypothesized. The first hypothetical expansion given to the device was 2 mm, and the five subsequent expansions were 1 mm. The results showed that the hybrid device was the most stable appliance under mastication loads, followed by the tooth- and bone-borne devices. However, parasitic rotations of the mandibular arms caused by mastication might counteract the benefits of distraction. The tooth-borne device was found to have the highest reliability in transferring expansion to the mandibular bone. For this device, mandibular expansion was less than the nominal aperture of the distractor by no more than 15 per cent. Lower values of reliability were achieved with the bone-borne device. As the values of the aperture of the appliances increased, the stability guaranteed in the fracture gap increased while the reliability in transferring expansion to the mandibular arch decreased.
authors: Dipartimento di Ingegneria Meccanica e Gestionale, Politecnico di Bari, Viale Japigia 182, 70126 Bari, Italy. a.boccaccio@poliba.it
authors: A
authors: A
authors: Boccaccio
authors: M
authors: M
authors: Cozzani
authors: C
authors: C
authors: Pappalettere
mesh_terms: D000465:Algorithms; D001696:Biomechanical Phenomena; D002146:Bony Callus / Q000502:physiology; D003198:Computer Simulation; D017076:Computer-Aided Design; D003724:Dental Arch / Q000502:physiology / Q000601:surgery; D055119:Elastic Modulus; D020342:Finite Element Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008334:Mandible / Q000502:physiology / Q000601:surgery*; D008335:Mandibular Condyle / Q000502:physiology; D008409:Mastication / Q000502:physiology; D008954:Models, Biological; D017711:Nonlinear Dynamics; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods; D010027:Osteotomy / Q000379:methods; D015203:Reproducibility of Results; D012399:Rotation; D013314:Stress, Mechanical; D013997:Time Factors; D014070:Tooth / Q000502:physiology