Evaluation of Stress and Displacement in Maxillary Protraction in Facemask, Save (Biomedical Grade Peek) and Save (Stainless Steel) in Cleft Lip and Palate- An FEM Study
1 Dr. Kiran Saju; 2 Dr. Sandeep Shetty; 3 Dr. Srinidhee M KIntroduction: Maxillary deficiency is frequently observed in patients with operated unilateral complete cleft of the lip and palate. Orthopedic appliances such as facemask are commonly used in the correction of skeletal Class III in growing patients with maxillary deficiency. However, these appliances require patient compliance and social acceptance of wearing which affect the overall success rate. To overcome the limitations of Facemask therapy in skeletal Class III malocclusion, a novel device called "SAVE" has been developed. SAVE being a prototype, required a FEM study to understand the intricacies of the device. The present FEM study is conducted to assess the efficiency of SAVE in cleft lip and palate patients by comparing its device properties with the currently available gold standard, facemask appliance. Methodology: Three different forces were applied (600 grams, 800 grams and 900 grams) to the Finite Element Models (FEM) of three appliances (SAVE SS (Stainless Steel), SAVE (Biomedical Grade PEEK), and Facemask) used for maxillary protraction. The equivalent stress and Deformation on the appliance and the maxilla were measured and analyzed. Results: The result of the analysis revealed that the SAVE SS appliance generated lower stress at the anchorage head, moderate stress at the stents, and the highest stress at the main frame rod, although still less than the facemask. SAVE PEEK showed the least stress across all components, while the facemask recorded the highest stress, particularly at the crossbar and anchorage units. Regarding deformation, SAVE SS exhibited the least deformation, mainly near the anchorage unit, while SAVE PEEK displayed greater deformation, especially at the stents. The facemask experienced the highest deformation, primarily at the crossbar. Overall, SAVE SS demonstrated higher stress and lower deformation, making it a promising alternative to the facemask. Conclusion: The SAVE SS appliance could be used as an alternative to Facemask as it demonstrates higher stress and lower deformation with higher forces in both the maxilla and the appliance, suggestive of its use in maxillary protraction with less deformation in the appliance. Thus, SAVE SS shows strong potential to evolve as a dependable, patient-friendly alternative for early orthopedic correction in cleft patients