Evaluation of Initial Stress Distribution and Displacement Pattern of Craniofacial Structures with 3 Different Rapid Maxillary Expansion Appliance Models: A 3-dimensional Finite Element Analysis

Objective: This study aimed to describe the displacement of anatomical structures and the stress distributions caused by the Hyrax, fan-type, and double-hinged expansion screws via the 3-dimensional (3D) finite element method (FEM). Methods: The 3D FEM was based on the computed tomography data of a 12-year-old patient with a constricted maxilla. The Hyrax model included 1,800,981 tetrahedral elements with 2,758,217 nodes. The fan-type model included 1,787,558 tetrahedral elements with 2,737,358 nodes. The double-hinged model included 1,777,080 tetrahedral elements with 2,722,771 nodes. The von Mises stress distributions after 0.2 mm of expansion and displacement patterns after 5 mm of expansion were evaluated. Results: The highest stress accumulation was observed in the sutura zygomatico maxillaris area with all 3 appliances. An increase in stress was noted at the pterygomaxillary fissure, the medial and lateral pterygoid process of the sphenoid bone, and the nasal areas. The wedge-shaped skeletal opening was observed with all 3 appliances. In the transverse plane, maximum posterior expansion was achieved with the Hyrax appliance, whereas the maximum anterior expansion was observed with the double-hinged appliance. The maxilla moved inferiorly and anteriorly with all the 3 appliances. The greatest inferior displacement of the maxilla was recorded with the Hyrax appliance, whereas anterior maxillary displacement was the greatest with the double-hinged appliance. Conclusion: All the appliances showed similar stress distributions. The use of double-hinged screw caused a slight anterior displace- ment of point A. The fan-type and double-hinged appliances were shown to be more effective on anterior maxillary constriction, whereas the Hyrax appliance might be chosen for resolving maxillary posterior constriction


1. McNamara JA, Brudon WL, Kokich VG. Orthodontics and dentofacial orthopedics 2001: Needham Press.

2. Wertz RA. Skeletal and dental changes accompanying rapid mid- palatal suture opening. Am J Orthod Dentofacial Orthop 970; 58: 41-66. [Crossref]

3. Timms DJ. A study of basal movement with rapid maxillary expan- sion. Am J Orthod Dentofacial Orthop 1980; 77: 500-7. [Crossref]

4. Haas AJ. The treatment of maxillary deficiency by opening the mid- palatal suture. Angle Orthod 1965; 35: 200-17.

5. Starnbach H, Bayne D, Cleall J, Subtelny JD. Facioskeletal And Den- tal Changes Resulting From Rapid Maxillary Expansion. Angle Orth- od 1966; 36: 152-64.

6. Isaacson R, Wood J, Ingram A. Forces produced by rapid maxillary expansion. Part I. Design of the force measuring system. Angle Or- thod 1964; 34: 256-60.

7. Işeri H, Tekkaya AE, Öztan Ö, Bilgic S. Biomechanical effects of rapid maxillary expansion on the craniofacial skeleton, studied by the finite element method. Eur J Orthod 1998; 20: 347-56. [Crossref]

8. Jafari A, Shetty KS, Kumar M. Study of stress distribution and dis - placement of various craniofacial structures following application of transverse orthopedic forces-a three-dimensional FEM study. Angle Orthod 2003; 73: 12-20.

9. de Sousa Araugio RM, Landre Jr J, Silva DDLA, Pacheco W, Pithon MM, Oliveira DD. Influence of the expansion screw height on the dental effects of the hyrax expander: a study with finite elements. Am J Orthod Dentofacial Orthop 2013; 143: 221-7. [Crossref]

10. Doruk C, Bicakci AA, Basciftci FA, Agar U, Babacan H. A comparison of the effects of rapid maxillary expansion and fan-type rapid max- illary expansion on dentofacial structures. Angle Orthod 2004; 74: 184-94.

11. Çörekçi B, Göyenç YB. Dentofacial changes from fan-type rapid maxillary expansion vs traditional rapid maxillary expansion in ear- ly mixed dentition: A prospective clinical trial. Angle Orthod 2013; 83: 842-50. [Crossref]

12. Huang C, Wang Y, Huang C, Liou E. Maxillary displacement after rap- id maxillary expansions: An animal study. J. Taiwan Assoc. Orthod Taipei 2008; 20: 19-31.

13. EJ. L. Interview. Rev Dent Press Orthodon Ortop Facial. 2009; 14.

14. Bishara SE, Staley RN. Maxillary expansion: clinical implications. Am J Orthod Dentofacial Orthop 1987; 91: 3-14. [Crossref]

15. Lee H, Nguyen A, Hong C, Hoang P, Pham J, Ting K. Biomechanical effects of maxillary expansion on a patient with cleft palate: A finite element analysis. Am J Orthod Dentofacial Orthop 2016; 150: 313- 23. [Crossref]

16. Ludwig B, Baumgaertel S, Zorkun B, Bonitz L, Glasl B, Wilmes B, et al. Application of a new viscoelastic finite element method model and analysis of miniscrew-supported hybrid hyrax treatment. Am J Orthod Dentofacial Orthop 2013; 143: 426-35. [Crossref

17. Tanne K, Yoshida S, Kawata T, Sasaki A, Knox J, Jones ML. An evaluation of the biomechanical response of the tooth and periodontium to orthodontic forces in adolescent and adult subjects. British Journal of Orthodontics 1998; 25: 109-15. [Crossref]

18. Gupta A, Kohli VS, Hazarey PV, Kharbanda OP, Gunjal A. Stress distribution in the temporomandibular joint after mandibu - lar protraction: a 3-dimensional finite element method study. Part 1. Am J Orthod Dentofacial Orthop 2009; 135: 737-48. [Crossref]

19. Vásquez M, Calao E, Becerra F, Ossa J, Enríquez C, Fresneda E. Initial stress differences between sliding and sectional mechanics with an endosseous implant as anchorage: a 3-dimensional finite element analysis. Angle Orthod 2001; 71: 247-56.

20. Henderson JH, Longaker MT, Carter DR. Sutural bone deposition rate and strain magnitude during cranial development. Bone 2004; 34: 271-80. [Crossref]

21. Lee H, Tin K, Nelson M, Sun N, Sung SJ. Maxillary expansion in cus- tomized finite element method models. Am J Orthod Dentofacial Orthop 2009; 136: 367-74. [Crossref]

22. Gautam P, Valiathan A, Adhikari R. Stress and displacement patterns in the craniofacial skeleton with rapid maxillary expansion: a finite element method study. Am J Orthod Dentofacial Orthop 2007; 132: 5. e1-5. e11. [Crossref]

23. Gardner GE, Kronman JH. Cranioskeletal displacements caused by rapid palatal expansion in the rhesus monkey. Am J Orthod Dento- facial Orthop 1971; 59: 146-55. [Crossref]

24. Sicher H. Oral anatomy. 1965: CV Mosby Company.

25. de Silva Fo OG, Boas CV, Capelozza LF. Rapid maxillary expansion in the primary and mixed dentitions: a cephalometric evaluation. Am J Orthod Dentofacial Orthop 1991; 100: 171-9. [Crossref]

26. Velázquez P, Benito E, Bravo LA. Rapid maxillary expansion. A study of the long-term effects. Am J Orthod Dentofacial Orthop 1996; 109: 361-7. [Crossref]

27. Lagravere MO, Major PW, Flores-Mir C. Skeletal and dental changes with fixed slow maxillary expansion treatment: a systematic review. J Am Dent Assoc 2005; 136: 194-9. [Crossref]

28. Matsuyama Y, Motoyoshi M, Tsurumachi N, Shimizu N. Effects of palate depth, modified arm shape, and anchor screw on rapid maxillary expan- sion: a finite element analysis. Eur J Orthod 2015: 188-93. [Crossref]

29. Lee SC, Park JH, Bayome M, Kim KB, Araujo EA, Kook YA. Effect of bone-borne rapid maxillary expanders with and without surgical assistance on the craniofacial structures using finite element analy- sis. Am J Orthod Dentofacial Orthop 2014; 145: 638-48. [Crossref]

30. MacGinnis M, Chu H, Youssef G, Wu KW, Machado AW, Moon W. The effects of micro-implant assisted rapid palatal expansion (marpe) on the nasomaxillary complex-a finite element method (FEM) anal- ysis. Prog Orthod 2014; 15: 52. [Crossref]


Turkish Journal of Orthodontics
  • ISSN: 2528-9659
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1988
  • Yayıncı: AVES Yayıncılık


Sayıdaki Diğer Makaleler

Evaluation of Initial Stress Distribution and Displacement Pattern of Craniofacial Structures with 3 Different Rapid Maxillary Expansion Appliance Models: A 3-dimensional Finite Element Analysis

Merve SUCU, Berza YİLMAZ, Sabri İlhan RAMOĞLU

Coronavirus Disease 2019- Challenges Today and Tomorrow in Orthodontic Practice: A Review

Rony Tomy KONDODY, Safiya SANA, Rekha REDDY, Asma FATİMA, Sayeeda Laeque BANGİ

Occlusal Plane Changes After Molar Distalization With a Pendulum Appliance in Growing Patients with Class II Malocclusion: A Retrospective Cephalometric Study


Comparison of Genial Tubercule Anatomy Based on Age and Gender

Beyza Karadede ÜNAL, İsmail Hamit HANCI, Emre AYTUĞAR, Ferhan ELMALI, Berşan KARADEDE, Özkan BÜYÜK, Nuri ÜNAL, Mehmet İrfan KARADEDE

Assessment of the Relationship between Skeletal Maturity and the Calcifications Stages of Permanent Canines and Second Premolars

Emel ONCAN, Seden AKAN

Effect of Low-Level Laser Therapy on Peri-Miniscrew Fluid Prostaglandin E2 and Substance P Levels: A Controlled Clinical Trial


The Relationship between Posttreatment Smile Esthetics and the ABO Objective Grading System: Class I Extraction versus Non-Extraction Cases


Evaluation of the Artificial Neural Network and Naive Bayes Models Trained with Vertebra Ratios for Growth and Development Determination

Hatice KÖK, Mehmet Said İZGİ, Ayşe Merve ACILAR

The Influence of Abnormalities in the Profile and Overjet on Psychological Well-Being


Mini-implant and Modified Nance Button Assisted Alignment of a Horizontally Impacted Maxillary Canine - A Case Report