Comparison of the Effects of Different Palatal Morphology on Maxillary Expansion via RME and MSE: A Finite Element Analysis

Abstract

Objectives: This study aims to compare and analyze the biomechanical effect and the displacement trend of RME and MSE on the maxillofacial complex under different palatal shapes by using finite element analysis.

Methods: The three-dimensional model of maxillofacial complex was obtained from a computed tomography image of a person with a normal palate. Then, we modified the shape of the palate to obtain the model with a high palate. Additionally, two expander devices were considered. MSE and RME were created and four models were made: Model 1: Normal-palate craniomaxillofacial complex with RME expander; Model 2: Normal-palate craniomaxillofacial complex with MSE expander; Model 3: High-palate craniomaxillofacial complex with RME expander; Model 4: High-palate craniomaxillofacial complex with MSE expander. Then, lateral forced displacement was applied and the analysis results were obtained.

Results: The lateral displacement of the palatal suture of Model 3 is greater than that of Model 1, and the maxilla has more rotation. The crown/root ratio of Model 1 is significantly greater than that of the other three groups. Compared with Model 1, Model 3 has greater stress concentration in the superstructure of the craniomaxillofacial complex. Both of them have greater stress in the anchorage area than Model 2 and Model 4.

Conclusion: Different shapes of the palate interfere with the effects of RME and MSE, and its influence on the stress distribution and displacement of the craniomaxillary complex when using RME is greater than MSE. The lateral displacement of the palatal suture of MSE is significantly larger than that of RME. It is more prone to tipping movement of the anchor teeth using RME under normal palate, and MSE may manage the vertical control better due to the smaller crown/root ratio than RME and intrusive movement of molars.

Keywords: MSE; RME; finite element analysis; maxillary expansion; palatal morphology.

Figure 1

Comparison of palatal morphology in two models.

Figure 2

Location of RME and MSE ([A]: normal palate + RME, [B]: normal palate + MSE, [C]: high palate + RME, [D]: high palate + MSE).

Figure 3

Establishment of mesh models in Ansys 19.0.

Figure 4

Palatal landmarks.

Figure 5

Occlusal and radicular dental landmarks.

Figure 6

Von Mises stress comparison on craniofacial complex (frontal view). (A) Normal palate + RME, (B) normal palate + MSE, (C) high palate + RME, and (D) high palate + MSE.

Figure 7

Von Mises stress comparison on craniofacial complex (occlusal view). (A) Normal palate + RME, (B) normal palate + MSE, (C) high palate + RME, and (D) high palate + MSE.

Figure 8

Von Mises stress comparison on alveolar bone. (A) Normal palate + RME, (B) normal palate + MSE, (C) high palate + RME, and (D) high palate + MSE.

Figure 9

Maximum principal stresses on sutures (mid‐palatal suture, frontomaxillary suture, zygomatico‐maxillary suture, zygomaticotemporal suture, pterygopalatal suture). (A) Normal palate + RME, (B) normal palate + MSE, (C) high palate + RME, and (D) high palate + MSE.

Figure 10

Transverse displacements of palatal sutures. (A) Normal palate + RME, (B) normal palate + MSE, (C) high palate + RME, and (D) high palate + MSE.

Figure 11

Comparison of displacements of maxillary (occlusal view). (A) Normal palate + RME, (B) normal palate + MSE, (C) high palate + RME, and (D) high palate + MSE.

Figure 12

Comparison of displacements of maxillary (lateral view). (A) Normal palate + RME, (B) normal palate + MSE, (C) high palate + RME, and (D) high palate + MSE.

Figure 13

Comparison of crown‐to‐root ratio in the X‐axis direction.