This study examined the effects of palate depth, modifications of the arm shape, and anchor screw placement in the mid-palatal area on rapid maxillary expansion (RME) using finite element (FE) analysis. Three-dimensional FE models were constructed that included the maxilla (cortical and cancellous bone), maxillary sinus, maxillary first molar and first premolar, periodontal membrane, and an RME appliance with arms, bands, and anchor screws. The expansion screws were activated 0.2mm transversely. The deepest palate model had the smallest lateral displacement of the tooth and expansion of the mid-palatal suture and the greatest strain of the arm among the models with different palate heights. The model with a larger diameter arm had the smallest arm strain among the models with various arm shapes. The model with an anchor screw had the greatest lateral displacement of the tooth and expansion of the mid-palatal suture among all models. For a deeper palate, the arm strain increased and the effect of RME decreased. Modified arm shapes such as a larger diameter arm, arms connected by a diagonal wire, a straight arm, and a shorter arm efficiently expanded the maxillary dental arch. Anchor screws increased the effect of RME, generated more and closer bodily movement of the tooth, and parallel expansion of the mid-palatal suture. The model with an anchor screw without arms decreased the displacement of the teeth compared to the models with arms, so the arms are necessary for effective RME.
23 September 2013 in European Journal of Orthodontics
Orthodontic miniscrews placed in growing subjects often loosen during orthodontic treatment. The ability to place miniscrews, regardless of age, would be clinically beneficial. To assess the effects of low-intensity pulsed ultrasound (LIPUS) on the stability of orthodontic miniscrews in growing rats. The mobility of miniscrews after placement was recorded and the miniscrew–bone interface was examined histomorphometrically using tibiae of seven male Sprague-Dawley rats (aged 6 weeks). Field-emission scanning electron microscopic images were used to evaluate the bone–miniscrew interface, and a mobility test device was used to assess the stiffness of miniscrew placement. Fourteen custom-made miniscrews with 1.4mm diameters and 4.0mm lengths were placed in the right and left tibiae. LIPUS was used to stimulate right tibiae at the sites of miniscrew placement, and left tibiae were left untreated as controls. Significantly lower mobility was observed in the LIPUS-treated group compared with the control group (P < 0.05). Histomorphometric evaluation indicated that bone–miniscrew adhesion was significantly better in the LIPUS-treated group than in the control group (P < 0.05). This in vivo study used tibiae rather than jaw bones because the jaw bones of 6-week-old rats were too small to allow miniscrew placement. LIPUS was able to increase the bone–miniscrew contact and reduce the mobility of miniscrews in growing subjects. LIPUS may accelerate the bone healing process after miniscrew placement in growing subjects and can reduce the latent period.