Dependence of the stress-strain state of the upper jaw on the mechanical properties of bone tissue in patients with congenital unilateral cleft lip and palate
DOI:
https://doi.org/10.11603/2311-9624.2024.1.14681Keywords:
biomechanical system, mineral density, stiffness of bone tissueAbstract
Summary. Particular importance in the treatment of children with congenital cleft lip and palate (CLP) has the study of the features of the biomechanical system, which includes the orthodontic appliance and the dentognathic apparatus, the anatomical and topographical characteristics of congenital defects and the bone`s mineral density.
The aim of the study – to study the stress-strain state and determine the maximum equivalent stresses in the bone tissue of the upper jaw under the action of loads caused by the activation of the screw of the orthodontic appliance in the process of complex treatment of patients with unilateral CLP in the mixed dentition period depending on the bone`s mineral saturation and stiffness.
Materials and Methods. A simulated computer model of the stress-strain state of the «orthodontic appliance-bone» system under the given static load conditions was created. Separation of biological structures heterogeneous in terms of biomechanical characteristics was carried out according to X-ray density. The maximum value of the equivalent stresses in the bone tissue in the areas of their maximum concentration was estimated, the obtained values were compared with the marginally acceptable for the cortical layer of the bone.
Results and Discussion. Power loads were transmitted from the orthodontic appliances to the jaw tissues. The character of the distribution of stresses and deformations in different models nature was practically independent of the stiffness of the cortical bone. The amount of stress in various areas decreased by 54–62 % with a decrease in mineral saturation and, accordingly, the stiffness of bone tissue from 8500 to 3500 MPa in the reproduced models. Overloading of areas of the cortical layer can lead to the failure of adaptive and adjustment mechanisms, violations of the process of bone reconstruction and its destruction at the micro level.
Conclusions. The established regularities indicate the need for a differentiated approach in the selection of activation modes of orthodontic appliances in patients with different biomechanical properties of bone tissue of the cleft upper jaw in order to prevent complications and optimize treatment.
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