title: Biomechanical evaluation of sagittal maxillary internal distraction osteogenesis in unilateral cleft lip and palate patient and noncleft patients: a three-dimensional finite element analysis.
abstract: OBJECTIVE
  To compare the pattern and amount of stress and displacement during maxillary sagittal distraction osteogenesis (DO) between a patient with unilateral cleft lip and palate (UCLP) and a noncleft patient.
  
  
  METHODS
  Three-dimensional finite element models for both skulls were constructed. Displacements of the surface landmarks and stress distributions in the circummaxillary sutures were analyzed after an anterior displacement of 6 mm was loaded to the elements where the inferior plates of the distractor were assumed to be fixed and were below the Le Fort I osteotomy line.
  
  
  RESULTS
  In sagittal plane, more forward movement was found on the noncleft side in the UCLP model (-6.401 mm on cleft side and -6.651 mm on noncleft side for the central incisor region). However, similar amounts of forward movement were seen in the control model. In the vertical plane, a clockwise rotation occurred in the UCLP model, whereas a counterclockwise rotation was seen in the control model. The mathematical UCLP model also showed higher stress values on the sutura nasomaxillaris, frontonasalis, and zygomatiomaxillaris on the cleft side than on the normal side.
  
  
  CONCLUSIONS
  Not only did the sagittal distraction forces produce advancement forces at the intermaxillary sutures, but more stress was also present on the sutura nasomaxillaris, sutura frontonasalis, and sutura zygomaticomaxillaris on the cleft side than on the noncleft side.
authors.affiliation: a  Private Practice, Izmir, Turkey.
authors.forename: Sultan
authors.initials: S
authors.lastname: Olmez
authors.forename: Servet
authors.initials: S
authors.lastname: Dogan
authors.forename: Mahmut
authors.initials: M
authors.lastname: Pekedis
authors.forename: Hasan
authors.initials: H
authors.lastname: Yildiz
mesh_terms: D059925:Anatomic Landmarks / Q000473:pathology / Q000601:surgery; D001696:Biomechanical Phenomena; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D003198:Computer Simulation; D003393:Cranial Sutures / Q000473:pathology / Q000601:surgery; D020342:Finite Element Analysis; D005624:Frontal Bone / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008437:Maxilla / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D008954:Models, Biological; D009295:Nasal Bone / Q000473:pathology; D019857:Osteogenesis, Distraction / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D012399:Rotation; D013314:Stress, Mechanical; D055815:Young Adult; D015050:Zygoma / Q000473:pathology
keywords: Distraction osteogenesis; Finite element analysis; Maxillary advancement; UCLP