Determination of expander apparatus displacements and contact pressures on the mucosa using FEM modelling considering mandibular asymmetries

This paper presents a method for prediction of forces and displacements in the expansion screw of a modified mandibular Schwarz appliance and the contact pressure distributions on the mucosa during malocclusions treatment. A 3D finite element biomechanical model of the complete mandible–mucosa–apparatus set was built using computerised tomographic images of a patient's mandible and constructive solid geometry by computer software. An iterative procedure was developed to handle a boundary condition that takes into account the mandibular asymmetries. The results showed asymmetries in the contact pressure distributions that indicated with precision the patient's malocclusion diagnosis. In vivo measurements of contact pressure using piezoelectric sensors agreed with the computational results. It was shown that the left and right ends of the expansion screw move differently with respect to the patient mandible, even though the expansion screw has an opening mechanism to ensure equal stretching at both ends. The contact pressures between the apparatus and the mucosa vary linearly with applied forces, which can simplify the analysis of the biomechanical behaviour of the expander mandible apparatus. The biomechanical modelling proposed in this paper can be a useful tool to improve malocclusions treatment, safely avoiding the use of forces acting on live structures beyond the biological tolerance, which could result in traumatic effects.