Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis
Background:. The purpose of this study was to evaluate the stress distribution patterns within the viscero- and neurocranium of neonates during nasoalveolar molding. Methods:. Finite element models of 3 different healthy neonates at different times of life (date of birth, 4 weeks, and 3.5 months) we...
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Wolters Kluwer
2018-07-01
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Series: | Plastic and Reconstructive Surgery, Global Open |
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doaj-7b03b7023869499782cac7c4ebd5b46a2020-11-24T20:49:49ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742018-07-0167e183210.1097/GOX.0000000000001832201807000-00006Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element AnalysisLucas M. Ritschl, MD, DMD0Veronika Heinrich, MSc1Florian D. Grill, MD2Maximilian Roth, MD3Dennis M. Hedderich, MD4Andrea Rau, MD, DDS, PhD5Klaus-Dietrich Wolff, MD, DDS, PhD6Franz X. Bauer, MSc7Denys J. Loeffelbein, MD, DDS, PhD8From the * Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Germany† Institute of Medical and Polymer Engineering, Technische Universität München, GermanyFrom the * Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, GermanyFrom the * Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Germany§ Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Germany.From the * Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, GermanyFrom the * Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Germany† Institute of Medical and Polymer Engineering, Technische Universität München, GermanyFrom the * Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, GermanyBackground:. The purpose of this study was to evaluate the stress distribution patterns within the viscero- and neurocranium of neonates during nasoalveolar molding. Methods:. Finite element models of 3 different healthy neonates at different times of life (date of birth, 4 weeks, and 3.5 months) were generated on the basis of computed tomography scans. A validated workflow, including segmentation, meshing, setting of boundary conditions, and implementation of a bone density–dependent material model, was carried out for each model. A small and a large unilateral alveolar and hard palatal cleft were virtually cut in each model. The stress distribution pattern in each model was then analyzed by using Ansys APDL. Results:. Convergence analysis validated the results. The virtual experiments at the date of birth showed a stress pattern above a previously defined threshold value of 30,000 Pa in the ipsilateral naso-orbital-complex, frontal sinus, and the anterior fossa of the base of the skull, with von Mises values > 35,000 Pa. Stress patterns at the age of 4 weeks and 3.5 months showed reduced von Mises values at < 15,000 Pa. Conclusions:. Nasoalveolar molding therapy is a safe presurgical treatment modality without significant influence on the viscero- and neurocranium of neonates. Treatment, considering the stress distribution at the naso-orbital-complex and anterior fossa of the base of the skull, should begin in the second week of life, and treatment initiation of preterm infants should be adapted respectively.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001832 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lucas M. Ritschl, MD, DMD Veronika Heinrich, MSc Florian D. Grill, MD Maximilian Roth, MD Dennis M. Hedderich, MD Andrea Rau, MD, DDS, PhD Klaus-Dietrich Wolff, MD, DDS, PhD Franz X. Bauer, MSc Denys J. Loeffelbein, MD, DDS, PhD |
spellingShingle |
Lucas M. Ritschl, MD, DMD Veronika Heinrich, MSc Florian D. Grill, MD Maximilian Roth, MD Dennis M. Hedderich, MD Andrea Rau, MD, DDS, PhD Klaus-Dietrich Wolff, MD, DDS, PhD Franz X. Bauer, MSc Denys J. Loeffelbein, MD, DDS, PhD Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis Plastic and Reconstructive Surgery, Global Open |
author_facet |
Lucas M. Ritschl, MD, DMD Veronika Heinrich, MSc Florian D. Grill, MD Maximilian Roth, MD Dennis M. Hedderich, MD Andrea Rau, MD, DDS, PhD Klaus-Dietrich Wolff, MD, DDS, PhD Franz X. Bauer, MSc Denys J. Loeffelbein, MD, DDS, PhD |
author_sort |
Lucas M. Ritschl, MD, DMD |
title |
Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis |
title_short |
Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis |
title_full |
Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis |
title_fullStr |
Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis |
title_full_unstemmed |
Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis |
title_sort |
stress distribution patterns within viscero- and neurocranium during nasoalveolar molding: a finite element analysis |
publisher |
Wolters Kluwer |
series |
Plastic and Reconstructive Surgery, Global Open |
issn |
2169-7574 |
publishDate |
2018-07-01 |
description |
Background:. The purpose of this study was to evaluate the stress distribution patterns within the viscero- and neurocranium of neonates during nasoalveolar molding.
Methods:. Finite element models of 3 different healthy neonates at different times of life (date of birth, 4 weeks, and 3.5 months) were generated on the basis of computed tomography scans. A validated workflow, including segmentation, meshing, setting of boundary conditions, and implementation of a bone density–dependent material model, was carried out for each model. A small and a large unilateral alveolar and hard palatal cleft were virtually cut in each model. The stress distribution pattern in each model was then analyzed by using Ansys APDL.
Results:. Convergence analysis validated the results. The virtual experiments at the date of birth showed a stress pattern above a previously defined threshold value of 30,000 Pa in the ipsilateral naso-orbital-complex, frontal sinus, and the anterior fossa of the base of the skull, with von Mises values > 35,000 Pa. Stress patterns at the age of 4 weeks and 3.5 months showed reduced von Mises values at < 15,000 Pa.
Conclusions:. Nasoalveolar molding therapy is a safe presurgical treatment modality without significant influence on the viscero- and neurocranium of neonates. Treatment, considering the stress distribution at the naso-orbital-complex and anterior fossa of the base of the skull, should begin in the second week of life, and treatment initiation of preterm infants should be adapted respectively. |
url |
http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001832 |
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