Comparative evaluation of arch length and palatal depth between four different bone borne rapid palatal expanders in bilateral cleft lip and palate patients: A three -dimensional finite element analysis

Authors

  • Sakshi Bajpai
  • Rajesh Kumar Balani
  • Amitabh Kallury
  • Chandrika Dubey
  • Aakriti Katiyar
  • Utkarsha Chavan

Keywords:

N/A

Abstract

Background: Bilateral cleft lip and palate (BCLP) patients commonly exhibit maxillary transverse deficiency, reduced arch dimensions, and altered palatal morphology. Bone-borne rapid palatal expanders have been introduced to achieve greater skeletal effects with fewer dentoalveolar side effects. However, limited evidence exists comparing their effects on arch length and palatal depth in cleft patients using three-dimensional finite element analysis (FEA).

Aim: To comparatively evaluate arch length and palatal depth among four different bone-borne rapid palatal expanders in bilateral cleft lip and palate patients using three-dimensional finite element analysis.

Materials and Methods: A three-dimensional finite element model of a bilateral cleft lip and palate maxilla was constructed from cone-beam computed tomography data. Four different bone-borne rapid palatal expander designs were virtually adapted to the model. Standardized expansion forces were applied under identical simulation conditions.

Result: All four bone-borne expanders produced measurable changes in arch length and palatal depth, though the magnitude and pattern of change varied among the designs. Expanders with greater skeletal anchorage demonstrated more favorable and controlled alterations, indicating differences in biomechanical efficiency between appliances.


Conclusion: Bone-borne rapid palatal expanders showed differing effects on arch length and palatal depth in BCLP patients. Three-dimensional FEA is a valuable tool for comparing appliance biomechanics and may aid in selecting the most effective expander design

Downloads

Download data is not yet available.

References

[1] Koudstaal MJ, Poort LJ, Van der Wal KG, Wolvius EB, Prahl-Andersen B, Schulten AJ. Surgically assisted rapid maxillary expansion (SARME): a review of the literature. International journal of oral and maxillofacial surgery. 2005;34(7):709-14.

[2] Suri L, Taneja P. Surgically assisted rapid palatal expansion: a literature review. American journal of orthodontics and dentofacial orthopedics. 2008;133(2):290-302.

[3] Zhang D, Zheng L, Wang Q, Lu L, Ma J. Displacements prediction from 3D finite element model of maxillary protraction with and without rapid maxillary expansion in a patient with unilateral cleft palate and alveolus. Biomedical engineering online. 2015;14(1):80.

[4] Tian T, Huang HY, Wang W, Shi B, Zheng Q, Li CH. Three-dimensional finite element analysis of the effect of alveolar cleft bone graft on the maxillofacial biomechanical stabilities of unilateral complete cleft lip and palate. Biomedical engineering online. 2022;21(1):31.

[5] Işeri H, Tekkaya AE, Öztan Ö, Bilgic S. Biomechanical effects of rapid maxillary expansion on the craniofacial skeleton, studied by the finite element method. The European Journal of Orthodontics. 1998;20(4):347-56.

[6] Sarin S. Study of Stress Distribution in Craniofacial Structures Following Implant Assisted Maxillary Protraction-A Three Dimensional Fem Study (Master's thesis, Rajiv Gandhi University of Health Sciences (India)).

[7] Pan X, Qian Y, Yu J, Wang D, Tang Y, Shen G. Biomechanical effects of rapid palatal expansion on the craniofacial skeleton with cleft palate: a three-dimensional finite element analysis. The Cleft palate-craniofacial journal. 2007;44(2):149-54.

[8] Jafari A, Shetty KS, Kumar M. Study of stress distribution and displacement of various craniofacial structures following application of transverse orthopedic forces—a three-dimensional FEM study. The Angle Orthodontist. 2003;73(1):12-20.

[9] Provatidis CG, Georgiopoulos B, Kotinas AA, McDonald JP. Evaluation of craniofacial effects during rapid maxillary expansion through combined in vivo/in vitro and finite element studies. The European Journal of Orthodontics. 2008;30(5):437-48.

[10] Holberg C, Rudzki-Janson I. Stresses at the cranial base induced by rapid maxillary expansion. The Angle Orthodontist. 2006;76(4):543-50.

[11] 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. American journal of orthodontics and dentofacial orthopedics. 2016;150(2):313-23.

[12] Mathew A, Nagachandran KS, Vijayalakshmi D. Stress and displacement pattern evaluation using two different palatal expanders in unilateral cleft lip and palate: a three-dimensional finite element analysis. Progress in Orthodontics. 2016;17(1):38.

[13] Meng WY, Ma YQ, Shi B, Liu RK, Wang XM. The comparison of biomechanical effects of the conventional and bone-borne palatal expanders on late adolescence with unilateral cleft palate: a 3-dimensional finite element analysis. BMC Oral Health. 2022;22(1):600.

[14] Garib DG, Henriques JF, Janson G, de Freitas MR, Fernandes AY. Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation. American journal of orthodontics and dentofacial orthopedics. 2006;129(6):749-58.

[15] Carlson C, Sung J, McComb RW, Machado AW, Moon W. Microimplant-assisted rapid palatal expansion appliance to orthopedically correct transverse maxillary deficiency in an adult. American Journal of Orthodontics and Dentofacial Orthopedics. 2016;149(5):716-28.

[16] Lee KJ, Park YC, Park JY, Hwang WS. Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. American Journal of Orthodontics and Dentofacial Orthopedics. 2010;137(6):830-9.

[17] Choi SH, Shi KK, Cha JY, Park YC, Lee KJ. Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults. The Angle Orthodontist. 2016;86(5):713-20.

[18] de Oliveira CB, Ayub P, Ledra IM, Murata WH, Suzuki SS, Ravelli DB, Santos-Pinto A. Microimplant assisted rapid palatal expansion vs surgically assisted rapid palatal expansion for maxillary transverse discrepancy treatment. American Journal of Orthodontics and Dentofacial Orthopedics. 2021;159(6):733-42.

[19] Patiño AM, Rodrigues MD, Pessoa RS, Rubinsky SY, Kim KB, Soares CJ, Almeida GD. Biomechanical behavior of three maxillary expanders in cleft lip and palate: a finite element study. Brazilian Oral Research. 2024;38:e010.

[20] Hui S, Liu J, Zhang Y, Ning Q, Jin F, Wang L. Comparative biomechanical analysis of three rapid maxillary expanders in BCLP patients: A three-dimensional finite element study. Journal of Cranio-Maxillofacial Surgery. 2025 Oct 1.

[21] Bishara SE, Staley RN. Maxillary expansion: clinical implications. American journal of orthodontics and dentofacial orthopedics. 1987;91(1):3-14.

[22] Haas AJ. Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. The Angle Orthodontist. 1961;31(2):73-90.

[23] Wertz RA. Skeletal and dental changes accompanying rapid midpalatal suture opening. American journal of orthodontics. 1970;58(1):41-66.

[24] Lagravère MO, Heo G, Major PW, Flores-Mir C. Meta-analysis of immediate changes with rapid maxillary expansion treatment. The Journal of the American Dental Association. 2006;137(1):44-53.

[25] Garrett BJ, Caruso JM, Rungcharassaeng K, Farrage JR, Kim JS, Taylor GD. Skeletal effects to the maxilla after rapid maxillary expansion assessed with cone-beam computed tomography. American journal of orthodontics and dentofacial orthopedics. 2008;134(1):8-e1.

[26] Clarenbach TH, Wilmes B, Ihssen B, Vasudavan S, Drescher D. Hybrid hyrax distalizer and mentoplate for rapid palatal expansion, class III treatment, and upper molar distalization. Journal of clinical orthodontics: JCO. 2017;51(6):317-25.

[27] Mehta S, Wang D, Kuo CL, Mu J, Vich ML, Allareddy V, Tadinada A, Yadav S. Long-term effects of mini-screw–assisted rapid palatal expansion on airway. The Angle Orthodontist. 2021;91(2):195-205.

Downloads

Published

2025-10-20

How to Cite

1.
Bajpai S, Balani RK, Kallury A, Dubey C, Katiyar A, Chavan U. Comparative evaluation of arch length and palatal depth between four different bone borne rapid palatal expanders in bilateral cleft lip and palate patients: A three -dimensional finite element analysis. J Neonatal Surg [Internet]. 2025 Oct. 20 [cited 2026 May 22];14(32S):10809-18. Available from: https://jneonatalsurg.com/index.php/jns/article/view/10186

Issue

Vol. 14 No. 32S (2025): Journal of Neonatal Surgery

Section

Original Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

You are free to:

  • Adapt — remix, transform, and build upon the material for any purpose, even commercially.

Terms:

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.