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CC BY 4.0 · Eur J Dent
DOI: 10.1055/s-0045-1810017
Original Article

Three-Dimensional Finite-Element Study into the Effect of Scar Tissue on the Displacement of the Maxillary Segments by Rapid Palatal Expansion in Unilateral Cleft Lip, Alveolus, and Palate

Irene Sanita Lanny
1   Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
,
Cendrawasih Andusyana Farmasyanti
2   Department of Orthodontics, University Medical Centre Groningen (UMCG), Groningen, The Netherlands
,
Anne Marie Kuijpers-Jagtman 
2   Department of Orthodontics, University Medical Centre Groningen (UMCG), Groningen, The Netherlands
3   Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Bern, Switzerland
4   Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
,
Paramita Noviasari
1   Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
,
Ananto Ali Alhasyimi 
1   Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Abstract

Objectives

Scar tissue tension may potentially influence the effectiveness of rapid palatal expansion (RPE) in patients with unilateral cleft lip and palate (UCLP). Comprehending the biomechanics of expansion appliances in individuals with UCLP is crucial in determining the suitable RPE design to rectify the asymmetric arch. This study used finite-element analysis (FEA) to investigate how scar contractures affect maxillary segments displacement during RPE in UCLP patients.

Materials and Methods

A three-dimensional model of the maxilla was constructed from cone beam computed tomography images of an 11-year-old boy with UCLP who received RPE. ANSYS 2022 R2 software was employed to conduct FEA simulations with this model. Three forces were considered: expansion force, upper lip tension, and scar tension. Two simulation conditions were analyzed: a control scenario with only the expansion force and a second scenario with all three forces applied. Displacement was assessed in transversal (x-axis), vertical (y-axis), and sagittal (z-axis) directions at 14 reference points located across the palate and dentition.

Results

Both simulations exhibited similar patterns of maxillary displacement, but the magnitude of displacement was reduced when scar and lip tension were included. The minor segment exhibited a greater displacement than the major segment, with the largest movement occurring in the anterior region along the x- and z-axes, which gradually decreased posteriorly. The displacement pattern was as follows: x-axis > z-axis > y-axis for the major segment and z-axis > x-axis > y-axis for the minor segment.

Conclusion

The FEA model demonstrated that RPE in UCLP produces an asymmetrical expansion with a pyramid-shaped displacement pattern. However, when scar tension from the palate and the upper lip is included, the extent of the segmental movement is reduced. These findings suggest that scar tissue tension may potentially influence the effectiveness of RPE in patients with UCLP.

Keywords

rapid palatal expander - finite-element analysis - scar - unilateral cleft lip and palate - medicine

Data Availability Statement

Derived data supporting the findings of this study are available from the corresponding author on request.


Ethical Approval

Ethical clearance was given by the ethics committee of the Faculty of Dentistry, UGM (No. 71/UN1/KEP/FKG-RSGM/EC/2023). Written informed consent was obtained from the patient's parents for CBCT data.




Publikationsverlauf

Artikel online veröffentlicht:
18. Juli 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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