4.5 Article

Biomechanical behavior of an alveolar graft under maxillary therapies

Journal

BIOMECHANICS AND MODELING IN MECHANOBIOLOGY
Volume 20, Issue 4, Pages 1519-1532

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s10237-021-01460-6

Keywords

Alveolar graft; Finite element method; Maxillary therapies; Maxillary expansion; Maxillary protraction

Funding

  1. Universidad Nacional de Colombia

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Cleft lip and palate is a congenital defect requiring alveolar graft surgery and maxillary orthopedic therapies as part of the treatment. Research suggests that maxillary therapies can impact the biomechanical response of the graft and bone remodeling processes.
Cleft lip and palate is a congenital defect that affects the oral cavity. Depending on its severity, alveolar graft surgery and maxillary orthopedic therapies must be carried out as a part of the treatment. It is widely accepted that the therapies should be performed before grafting. Nevertheless, some authors have suggested that mechanical stimuli such as those from the maxillary therapies could improve the success rate of the graft. The aim of this study is to computationally determine the effect of maxillary therapies loads on the biomechanical response of an alveolar graft with different degrees of ossification. We also explore how the transverse width of the cleft affects the graft behavior and compare results with a non-cleft skull. Results suggest that stresses increase within the graft as it ossifies and are greater if maxillary expansion therapy is applied. This has consequences in the bone remodeling processes that are necessary for the graft osseointegration. Maxillary orthopedic therapies after graft surgery could be considered as a part of the treatment since they seem to act as a positive extra stimulus that can benefit the graft.

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