Evaluation of the effect of different osteotomy techniques on maxillary expansion by finite element analysis

Rapid upper jaw expansion is providing the mid-palatal suture expansion with the help of the apparatus placed on the palate by various methods in individuals of growth and developmental age. After the development of the facial bones, sutures show resistance to this expansion. Resistance to expansion develops in the bones around the maxilla after the completion of ossification of the sutures. To break the resistance against the expansion effect applied by the apparatuses, a surgical upper jaw expansion method has been developed. The rapid maxillary expansion procedure aims to eliminate resistance to expansion by performing osteotomy on the maxilla and palatine bone at certain sites. This procedure is a combination of surgical and orthodontic methods. Surgical assisted rapid upper jaw expansion procedure is a type of distraction osteogenesis. In the surgical procedure, corticotomy is performed on the areas of the pyriform rim and zygomatic buttress where the resistance to expansion is high. Since the palatine bone is an important point of resistance in the posterior region, it is separated with the help of osteotomy. After this separation, expansion devices placed on the palate are activated at certain intervals as in distraction osteogenesis. Several surgical techniques have been described in the literature such as high le fort approach for surgical assisted rapid maxillary enlargement procedure, rapid maxillary expansion with modified surgical support, rapid maxillary expansion with 2 and 3 segments, Glassman, stepped osteotomy, unilateral corticotomy. This study aimed to compare the effect of surgical assisted maxillary expansion techniques on the maxilla and facial bones and the efficacy of dilatation by using finite element analysis (SEA) method. Finite element analysis is a frequently used method, especially in engineering applications.