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The effect of distraction vector orientation on the regenerate tissue during bilateral mandibular distraction

Mishra, Sanjay K., Collier, Lance R., Chen, Gongfa, Steck, Roland, Schmutz, Beat, Wullschleger, Martin E., & Schuetz, Michael (2007) The effect of distraction vector orientation on the regenerate tissue during bilateral mandibular distraction. In Haynes, David, Zreiqat, Hala, Xu, Jiake, Fazzalari, Nick, & Xiao, Yin (Eds.) Australian & New Zealand Orthopaedic Research Society- 13 Annual Scientific Meeting, 17-18 October, Auckland, New Zealand.

Abstract

Bilateral mandibular lengthening is widely accepted during mandibular distraction osteogenesis. However, distraction osteogenesis are sometimes associated with clinical complications such as open bite deformity, lateral displacement of temporo-mandibular joint, premature consolidation and pin loosening. Although distraction osteogenesis aims to develop pure tensile strain on the regenerate tissue however, in real life situation due to differences in device orientation, materials and misalignment it is often subjected to complex stress and strain regimes. The objective of this study was to characterise the mechanical environment (stress and strain) in the Finite Element Models (FEM) of regenerate tissue during two different device orientations: (a) device placed parallel to the mandibular body (b) device placed parallel to the axis of distraction. Furthermore, the influence of misalignment from above two idealised orientations was also investigated.

Methods and Materials: The distraction protocol in this study was similar to previous study of Loboa et al (2005). FE models were developed at four stages: end of latency, distraction day 2, distraction day 5 and distraction day 8. At each time period a distraction of 1mm was applied to the model as it is most widely used distraction rate. In these models two primary distraction vectors were simulated; first when the device is parallel to the body of the mandible and second when the device is parallel to the axis of distraction.

Results: indicate that when the device is placed parallel to the mandible the effect of distraction vector variation due to misalignment in transverse plane (±150 at an interval of 50 ; + indicate lateral and – indicates medial) is symmetric and variation in the stress and strain regimes on regenerative tissue are less than 3%. However, when the device is placed parallel to axis of distraction the corresponding change is asymmetric and almost double in magnitude. The greatest differences were seen when misalignment is towards lateral side (+150). Similarly in the sagittal plane variations up to 17% were developed due to 0- 400 change in the distraction vector orientation. Thus the orientation of device which determines the distraction vector plays an important role in determining the mechanical environment around regenerative tissue. The results suggest that implications of misalignment of the device and its sensitivity from the ideal situation should be well understood during clinical planning.

Impact and interest:

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ID Code: 13193
Item Type: Conference Paper
Additional Information: For more information, please refer to the publisher's website (see hypertext link) or contact the author.
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Keywords: distraction osteogensis, mandible, finite element analysis
Subjects: Australian and New Zealand Standard Research Classification > ENGINEERING (090000) > BIOMEDICAL ENGINEERING (090300) > Biomechanical Engineering (090302)
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2007 ANZORS
Deposited On: 28 Mar 2008
Last Modified: 01 Nov 2010 13:15

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