Finite element simulations of the effects of an extraoral device, RAMPA, on anterosuperior protraction of the maxilla and comparison with gHu-1 intraoral device

Angle Orthod. 2021 Nov 1;91(6):804-814. doi: 10.2319/020521-106.1.

Abstract

Objectives: To investigate the effects of an extraoral device, right-angle maxillary protraction appliance (RAMPA), combined with a semi-rapid maxillary expansion intraoral device (gHu-1) on the anterosuperior protraction of maxillary bone.

Materials and methods: The finite element (FE) model included craniofacial bones and all sutures. The linear assumption was assumed for the FE simulations and the material properties of bones and sutures. The gHu-1 was simulated under screw activations equal to Δx = 0.25 and 0.5 mm in the lateral direction with and without RAMPA under a set of external forces {F1 = 2.94, F2 = 1.47, F3 = 4.44} N.

Results: Displacement contours, nodal displacements of 12 landmarks, and von Mises stresses were compared. Combining RAMPA and gHu-1 (with Δx = 0.25 mm) resulted in changes in the displacement of the front part of the maxilla near the mid-palatal suture from (0.02, -0.1, -0.02) mm to (0.02, 0.3, 0.8) mm. For gHu-1 with Δx = 0.5 mm, the displacement of the same part changed from (0.04, -0.04, -0.2) mm to (0.04, 0.3, 0) mm. Similar trends were found in other locations.

Conclusions: The findings are in agreement with the previous cephalometric clinical data of an 8-year-old patient and prove the positive effects of RAMPA on the anterosuperior protraction of the maxilla when it is combined with the intraoral device gHu-1. In addition, RAMPA does not interfere with the lateral expansion generated by the intraoral device.

Keywords: Anterosuperior displacement; Craniofacial bones; Finite element method; RAMPA; Suture; gHu-1.

Publication types

  • Case Reports

MeSH terms

  • Biomechanical Phenomena
  • Child
  • Extraoral Traction Appliances
  • Finite Element Analysis
  • Humans
  • Imaging, Three-Dimensional*
  • Maxilla*
  • Palatal Expansion Technique
  • Stress, Mechanical