Biomechanical Effects Of Novel Osteotomy Approaches On Mandibular Expansion:A 3D Finite Element Analysis

Surgically assisted mandibular arch expansion has proven to be an effective treatment modality in alleviating constriction and crowding issues. However, only mandibular symphyseal distraction osteogenesis has been in favor for the purpose of mandibular arch expansion. Besides, there is no relevant study to compare biomechanical response of different osteotomy designs on mandibular expansion. Therefore, this study is aimed to evaluate the effect of different osteotomy approaches and modes of loading on the expansion of adult mandible using biomechanics. To address the research purpose, a total of 9 Finite Element models including two novel osteotomy designs were simulated. Stress, strain and displacement of crown, root and bone were calculated and compared under different osteotomy approaches and loading conditions. The biomechanical response envisaged by the FE models in terms of displacement on X axis, was consistent from anterior to posterior teeth with parasymphyseal step osteotomy and hybrid mode of force application. In addition the amount of displacement predicted by parasymphyseal step osteotomy with hybrid mode was more, compared to other models. In conclusion, the results of our study suggest, parasymphyseal step osteotomy with hybrid mode to be a viable treatment option for true bony expansion in adult mandible.