Tek Taraflı Dudak Damak Yarıklı Hastalarda Farklı Maksiller İlerletme Yöntemlerinin Maksillofasiyal Bölgede Yarattığı Stres Dağılımının Ve Olası Hareket Miktarlarının Geleneksel Yöntem Olan Diş Dektekli Yüzmaskesi Tedavisi İle Karşılaştırılması: Sonlu Elemanlar Analizi

Abstract

AKDEMIR, G. Comparison Of The Stress Distribution And Possible Amount Of Movement Created By Different Maxillary Protraction Methods In Maxillofacial Region Of The Patients With Unilateral Cleft Lip And Palate Compared To The Traditional Method Of Tooth Supported Face Mask Treatment: A Finite Element Analysis. Hacettepe University, Faculty of Dentistry, Faculty of Orthodontics, Specialty Thesis, Ankara, 2023. The aim of this study was to evaluate the stress distribution and possible amount of movement created by different maxillaryprotraction methods in the maxillofacial region of the patients with unilateral cleft lip and palate using a finite element analysis and to compare them with the traditional facemask method. Materials and Method: For this reason, a study model with unilateral cleft lip and palate (CLP model) and a group without cleft (control model) were formed by using the finite element analysis method. Three different mechanics were compared in the control and CLP groups. The first mechanic was usage of a facemask with elastics placed at a 30° angle to the occlusal plane over a conventional acrylic plate. The second mechanic was usage of a face mask with elastics placed at a 30° angle to the occlusal plane over miniplates placed in the zygomatic crest region. The third mechanic was the use of elastic over the mentoplate placed on the mandible inaddition to the infrazygomatic plates in the maxilla. A force of 500 g at each side was applied in each group. Von Misses, maximum principal and minimum principal stress and displacement values were evaluated with the finite element models obtained. In all three models, maxillary protraction was able to produce an effect on the circummaxillary sutures. Therefore, it was thought that all 3 compared mechanics could be used in the treatment of individuals with unilateral cleft lip and palate and skeletal Class III malocclusion due to maxillary retrusion. In the maxillary protraction model with a facemask over a conventional acrylic plate, the dental effects were found to be greater, whereas skeletal effects were found to be greater in the other models. The maximum amount of counterclockwise rotation of the maxilla as a result of protraction was observed in the face mask model using traditional acrylic plates, and the minimum amount was observed in the model using infrazigomatic plates and elastic over mentoplate. As a result, while clockwise rotation of the mandible occurred in the models with face mask, a counterclockwise rotation occurred in the model with infrazigomatic and mentoplate plates. In individuals with unilateral cleft lip and palate,it was observed that the miniplates and screws on the cleft side were exposed to more stress. In individuals with unilateral cleft lip and palate with a Goslon score of 4, it was observed that the skeletally supported facemask caused more skeletal impact and displacement than both the traditional acrylic plate-on-facemask model andthe pure skeletally supported maxillary protraction model.