Sutural deformation during bone-anchored maxillary protraction

Introduction: Bone-anchored maxillary protraction (BAMP) is an emerging treatment option for orthopedic correction of maxillary deficiency in young patients. Compared to reverse pull headgear (RPHG), it is believed that forces generated during BAMP result in greater circum-maxillary sutural separati...

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Main Authors: Taylor Rae Vracar, Wanda Claro, Michael Eli Vracar, II, Randall Stetson Jenkins, Lane Bland, Ayman al Dayeh
Format: Article
Language:English
Published: Elsevier 2021-07-01
Series:Journal of Oral Biology and Craniofacial Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2212426821000592
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author Taylor Rae Vracar
Wanda Claro
Michael Eli Vracar, II
Randall Stetson Jenkins
Lane Bland
Ayman al Dayeh
author_facet Taylor Rae Vracar
Wanda Claro
Michael Eli Vracar, II
Randall Stetson Jenkins
Lane Bland
Ayman al Dayeh
author_sort Taylor Rae Vracar
collection DOAJ
description Introduction: Bone-anchored maxillary protraction (BAMP) is an emerging treatment option for orthopedic correction of maxillary deficiency in young patients. Compared to reverse pull headgear (RPHG), it is believed that forces generated during BAMP result in greater circum-maxillary sutural separation, mandibular retrusion, and improved maxillary protraction. Mechanical loading of the circum-maxillary sutures during BAMP is still poorly understood. Methods: 20 ex-vivo pig heads were used. Miniplates and molar tubes were installed like clinical procedures. A series of five 200 ​g-force (gf) elastics were applied on the right and left side until 1000gf were reached. Strain gauges were installed across the zygomatico-maxillary (ZMS), zygomatico-temporal (ZTS), and nasofrontal suture (NFS). Differential variable reluctance transducers (DVRTs) were installed across the ZTS. Deformation of the sutures during BAMP and RPHG was measured and compared. Results: Higher average sutural deformation of the ZTS and ZMS was seen in BAMP than RPHG: 36.6 ​± ​20.6με vs 18.0 ​± ​12.4με and 54.7 ​± ​28.5με vs 12.5 ​± ​14.8με, respectively. Similarly, higher NFS deformation was seen in BAMP (18.4 ​± ​12.9με vs. −0.8 ​± ​12.0με). DVRT data showed higher ZTS separation in BAMP than RPHG (6.3 ​± ​5.2 ​μm vs. 1.7 ​± ​2.1 ​μm). These differences were all statistically significant using the Wilcoxon-signed rank test. Conclusion: Both RPHG and BAMP forces separate the ZTS and ZMS. BAMP resulted in higher levels of sutural separation at the ZTS and ZMS by 2- and 5-fold, respectively.
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spelling doaj-art-9b76a3eed2c440efb817fc2c72643af42025-08-20T02:01:56ZengElsevierJournal of Oral Biology and Craniofacial Research2212-42682021-07-0111344745010.1016/j.jobcr.2021.05.008Sutural deformation during bone-anchored maxillary protractionTaylor Rae Vracar0Wanda Claro1Michael Eli Vracar, II2Randall Stetson Jenkins3Lane Bland4Ayman al Dayeh5Department of Orthodontics, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, 38163, USA; Corresponding author.Department of Orthodontics, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, 38163, USADepartment of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, 38163, USADepartment of Orthodontics, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, 38163, USADepartment of Orthodontics, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, 38163, USADepartment of Orthodontics, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, 38163, USAIntroduction: Bone-anchored maxillary protraction (BAMP) is an emerging treatment option for orthopedic correction of maxillary deficiency in young patients. Compared to reverse pull headgear (RPHG), it is believed that forces generated during BAMP result in greater circum-maxillary sutural separation, mandibular retrusion, and improved maxillary protraction. Mechanical loading of the circum-maxillary sutures during BAMP is still poorly understood. Methods: 20 ex-vivo pig heads were used. Miniplates and molar tubes were installed like clinical procedures. A series of five 200 ​g-force (gf) elastics were applied on the right and left side until 1000gf were reached. Strain gauges were installed across the zygomatico-maxillary (ZMS), zygomatico-temporal (ZTS), and nasofrontal suture (NFS). Differential variable reluctance transducers (DVRTs) were installed across the ZTS. Deformation of the sutures during BAMP and RPHG was measured and compared. Results: Higher average sutural deformation of the ZTS and ZMS was seen in BAMP than RPHG: 36.6 ​± ​20.6με vs 18.0 ​± ​12.4με and 54.7 ​± ​28.5με vs 12.5 ​± ​14.8με, respectively. Similarly, higher NFS deformation was seen in BAMP (18.4 ​± ​12.9με vs. −0.8 ​± ​12.0με). DVRT data showed higher ZTS separation in BAMP than RPHG (6.3 ​± ​5.2 ​μm vs. 1.7 ​± ​2.1 ​μm). These differences were all statistically significant using the Wilcoxon-signed rank test. Conclusion: Both RPHG and BAMP forces separate the ZTS and ZMS. BAMP resulted in higher levels of sutural separation at the ZTS and ZMS by 2- and 5-fold, respectively.http://www.sciencedirect.com/science/article/pii/S2212426821000592Maxillary protractionMaxillary deficiencyBone-anchored maxillary protractionReverse-pull headgearClass III
spellingShingle Taylor Rae Vracar
Wanda Claro
Michael Eli Vracar, II
Randall Stetson Jenkins
Lane Bland
Ayman al Dayeh
Sutural deformation during bone-anchored maxillary protraction
Journal of Oral Biology and Craniofacial Research
Maxillary protraction
Maxillary deficiency
Bone-anchored maxillary protraction
Reverse-pull headgear
Class III
title Sutural deformation during bone-anchored maxillary protraction
title_full Sutural deformation during bone-anchored maxillary protraction
title_fullStr Sutural deformation during bone-anchored maxillary protraction
title_full_unstemmed Sutural deformation during bone-anchored maxillary protraction
title_short Sutural deformation during bone-anchored maxillary protraction
title_sort sutural deformation during bone anchored maxillary protraction
topic Maxillary protraction
Maxillary deficiency
Bone-anchored maxillary protraction
Reverse-pull headgear
Class III
url http://www.sciencedirect.com/science/article/pii/S2212426821000592
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