Evaluation of bone stresses arising from different techniques used in surgically assisted rapid maxillary expansion by finite element analysis

Transverse maxillary deficiency is an important maxillary anomaly that is very common in society and remains current in orthodontics. Since 1860, maxillary expansion has been used in its treatment. While maxillary expansion can be performed with rapid maxillary expansion (RME) in young adults, it is performed with surgically assisted rapid maxillary expansion (SARME) in individuals who have reached skeletal maturity. In addition to midpalatal osteotomy and Le Fort I corticotomy applied in SARME operations, pterygomaxillary osteotomy can be performed according to the surgeon's preference. Tooth-supported, bone-supported and hybrid-supported appliances are used in orthodontics in the expansion treatment. Today, when artificial intelligence has become widespread, the stresses occurring in the bone and teeth in the treatment of maxillary expansion can be measured in vitro with finite element analysis (FEM). In this study, it was aimed to determine the most ideal and atraumatic treatment protocol in the treatment of transverse maxillary deficiency. The results of the study showed that when the pterygomaxillary plates are separated, there will be less stress on the bone and teeth. Although hybrid-supported appliances create less stress on the teeth than tooth-supported appliances and no significant difference was found between bone-supported appliances, it was found that hybrid-supported appliances create much less stress on the bone than the other appliances. As a result, it is thought that the separation of the pterygomaxillary junction in the SARME operation and the use of a bone-supported or hybrid-supported appliance will occur much less stress on the bone and teeth.