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Published in: Journal of Maxillofacial and Oral Surgery 4/2023

22-04-2023 | Digital Volume Tomography | ORIGINAL ARTICLE

Stress Trajectory Variations During Occlusal Loading in Human Skull with a Maxillofacial Defect: A Finite Element Analysis

Authors: Pandurangan Harikrishnan, Varadaraju Magesh

Published in: Journal of Maxillofacial and Oral Surgery | Issue 4/2023

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Abstract

Background and Aim

Biting forces from the teeth are distributed to the facial bones and to the skull through the stress trajectories. The presence of a bony defect in either the maxilla or mandible might lead to variations in the stress distribution. The aim of this study was to evaluate the stress distribution and variations in stress trajectories from biting forces in a human skull with maxillofacial defect using a finite element (FE) model.

Methodology

In this study, a cone beam computed tomography (CBCT) of an adult male patient with a maxillectomy defect consequent to surgical treatment of mucormycosis is evaluated for the stress distribution from the biting forces of the remaining posterior teeth. Finite element model without the mandible was constructed from the patient's CBCT data. Occlusal loading forces of 600 N were applied on each side of the maxillary teeth. Stress trajectories were visualised through the stress distribution pattern.

Results

The results showed deviations in the normal stress distribution during occlusal loading and variations in zygomatic and pterygoid stress trajectories in the maxillofacial and skull regions in our FE model due to the bony defect.

Conclusion

We conclude that a skeletal maxillofacial defect should be reconstructed to resume proper stress distribution during functional forces to maintain a healthy craniofacial skeleton.
Literature
1.
go back to reference Alexandridis C, Caputo AA, Thanos CE (1982) Distribution of stress in the human skull. J Oral Rehabil 12:499–507CrossRef Alexandridis C, Caputo AA, Thanos CE (1982) Distribution of stress in the human skull. J Oral Rehabil 12:499–507CrossRef
2.
go back to reference Harikrishnan P, Balakumaran, (2017) Analysis of stress trajectories in human adult cleft skull. J CraniofacSurg 28(6):1552–1553CrossRef Harikrishnan P, Balakumaran, (2017) Analysis of stress trajectories in human adult cleft skull. J CraniofacSurg 28(6):1552–1553CrossRef
3.
go back to reference Sun HY, Singh N (2011) Mucormycosis: its contemporary face and management strategies. Lancet Infect Dis 11(4):301–311CrossRefPubMed Sun HY, Singh N (2011) Mucormycosis: its contemporary face and management strategies. Lancet Infect Dis 11(4):301–311CrossRefPubMed
4.
go back to reference Jones AC, Bentsen TY, Freedman PD (1993) Mucormycosis of the oral cavity. Oral Surg Oral Med Oral Pathol 75(4):455–460CrossRefPubMed Jones AC, Bentsen TY, Freedman PD (1993) Mucormycosis of the oral cavity. Oral Surg Oral Med Oral Pathol 75(4):455–460CrossRefPubMed
5.
go back to reference Rao V, Arakeri G, Madikeri G, Shah A, Oeppen R, Brennan P (2021) Post-COVID mucormycosis in India: a formidable challenge. Br J Oral Maxillofac Surg 59(9):1095–1098CrossRefPubMedPubMedCentral Rao V, Arakeri G, Madikeri G, Shah A, Oeppen R, Brennan P (2021) Post-COVID mucormycosis in India: a formidable challenge. Br J Oral Maxillofac Surg 59(9):1095–1098CrossRefPubMedPubMedCentral
6.
go back to reference Rapidis AD (2009) Orbito maxillary mucormycosis (zygomycosis) and the surgical approach to treatment: perspectives from a maxillofacial surgeon. Clin Microbiol Infect 15(Suppl 5):98–102CrossRefPubMed Rapidis AD (2009) Orbito maxillary mucormycosis (zygomycosis) and the surgical approach to treatment: perspectives from a maxillofacial surgeon. Clin Microbiol Infect 15(Suppl 5):98–102CrossRefPubMed
7.
go back to reference Gaur V, Patel K, Palka L (2022) An implant-supported prosthetic rehabilitation of a patient with a bilateral subtotal maxillectomy defect secondary to rhino-orbital-cerebral mucormycosis: a clinical report of a graftless approach. J Prosthet Dent 128(1):101–106CrossRefPubMed Gaur V, Patel K, Palka L (2022) An implant-supported prosthetic rehabilitation of a patient with a bilateral subtotal maxillectomy defect secondary to rhino-orbital-cerebral mucormycosis: a clinical report of a graftless approach. J Prosthet Dent 128(1):101–106CrossRefPubMed
8.
go back to reference Kortes J, Dehnad H, Kotte ANT, Fennis WMM, Rosenberg AJWP (2018) A novel digital workflow to manufacture personalized three-dimensional-printed hollow surgical obturators after maxillectomy. Int J Oral Maxillofac surg 47(9):1214–1218CrossRefPubMed Kortes J, Dehnad H, Kotte ANT, Fennis WMM, Rosenberg AJWP (2018) A novel digital workflow to manufacture personalized three-dimensional-printed hollow surgical obturators after maxillectomy. Int J Oral Maxillofac surg 47(9):1214–1218CrossRefPubMed
9.
go back to reference Vega LG, Gielincki W, Fernandes RP (2013) Zygoma implants reconstruction of acquired maxillary bony defects. Oral Maxillofac Surg Clin North Am 25(2):223–239CrossRefPubMed Vega LG, Gielincki W, Fernandes RP (2013) Zygoma implants reconstruction of acquired maxillary bony defects. Oral Maxillofac Surg Clin North Am 25(2):223–239CrossRefPubMed
10.
go back to reference Jose G, Somer N, George Y (2021) Finite element analysis of human skull bone adaptation to mechanical loading. Comput Methods Biomech Biomed Engin 24(7):753–764CrossRef Jose G, Somer N, George Y (2021) Finite element analysis of human skull bone adaptation to mechanical loading. Comput Methods Biomech Biomed Engin 24(7):753–764CrossRef
11.
go back to reference Pierre H, Guillaume D, Patrick G, Thomas S (2018) Comparative finite element analysis of skull mechanical properties following parietal bone graft harvesting in adults. J Craniomaxillofac Surg 46(2):329–337CrossRef Pierre H, Guillaume D, Patrick G, Thomas S (2018) Comparative finite element analysis of skull mechanical properties following parietal bone graft harvesting in adults. J Craniomaxillofac Surg 46(2):329–337CrossRef
12.
go back to reference Janovic A, Saveljic I, Vukicevic A, Nikolic D, Rakocevic Z, Jovicic G, Filipovic N, Djuric M (2015) Occlusal load distribution through the cortical and trabecular bone of the human mid-facial skeleton in natural dentition: a three-dimensional finite element study. Ann Anat 197:16–23CrossRefPubMed Janovic A, Saveljic I, Vukicevic A, Nikolic D, Rakocevic Z, Jovicic G, Filipovic N, Djuric M (2015) Occlusal load distribution through the cortical and trabecular bone of the human mid-facial skeleton in natural dentition: a three-dimensional finite element study. Ann Anat 197:16–23CrossRefPubMed
13.
go back to reference Choi DS, Cha BK, Jang I, Kang KH, Kim SC (2013) Three-dimensional finite element analysis of occlusal stress distribution in the human skull with premolar extraction. Angle Orthod 83(2):204–211CrossRefPubMed Choi DS, Cha BK, Jang I, Kang KH, Kim SC (2013) Three-dimensional finite element analysis of occlusal stress distribution in the human skull with premolar extraction. Angle Orthod 83(2):204–211CrossRefPubMed
14.
15.
go back to reference Gross MD, Arbel G, Hershkovitz I (2001) Three-dimensional finite element analysis of the facial skeleton on simulated occlusal loading. J Oral Rehabil 28(7):684–694CrossRefPubMed Gross MD, Arbel G, Hershkovitz I (2001) Three-dimensional finite element analysis of the facial skeleton on simulated occlusal loading. J Oral Rehabil 28(7):684–694CrossRefPubMed
16.
go back to reference Shinogaya T, Bakke M, Thomsen CE et al (2000) Bite force and occlusal load in healthy young subjects—a methodological study. Eur J Prosthodont Restor Dent 8:11–15PubMed Shinogaya T, Bakke M, Thomsen CE et al (2000) Bite force and occlusal load in healthy young subjects—a methodological study. Eur J Prosthodont Restor Dent 8:11–15PubMed
17.
go back to reference Cattaneo PM, Dalstra M, Melsen B (2003) The transfer of occlusal forces through the maxillary molars: a finite element study. Am J Orthod Dentofacial Orthop 123(4):367–373CrossRefPubMed Cattaneo PM, Dalstra M, Melsen B (2003) The transfer of occlusal forces through the maxillary molars: a finite element study. Am J Orthod Dentofacial Orthop 123(4):367–373CrossRefPubMed
18.
go back to reference Sana S, Kondody RT, Talapaneni AK, Fatima A, Bangi SL (2021) Occlusal stress distribution in the human skull with permanent maxillary first molar extraction: a 3-dimensional finite element study. Am J Orthod Dentofacial Orthop 160(4):552–559CrossRefPubMed Sana S, Kondody RT, Talapaneni AK, Fatima A, Bangi SL (2021) Occlusal stress distribution in the human skull with permanent maxillary first molar extraction: a 3-dimensional finite element study. Am J Orthod Dentofacial Orthop 160(4):552–559CrossRefPubMed
19.
go back to reference Brown JS, Jones DC, Summerwill A, Rogers SN, Howell RA, Cawood JI, Vaughan ED (2002) Vascularized iliac crest with internal oblique muscle for immediate reconstruction after maxillectomy. Br J Oral Maxillofac Surg 40(3):183–190CrossRefPubMed Brown JS, Jones DC, Summerwill A, Rogers SN, Howell RA, Cawood JI, Vaughan ED (2002) Vascularized iliac crest with internal oblique muscle for immediate reconstruction after maxillectomy. Br J Oral Maxillofac Surg 40(3):183–190CrossRefPubMed
20.
go back to reference Andrades P, Militsakh O, Hanasono MM, Rieger J, Rosenthal EL (2011) Current strategies in reconstruction of maxillectomy defects. Arch Otolaryngol Head Neck Surg 137(8):806–812CrossRefPubMedPubMedCentral Andrades P, Militsakh O, Hanasono MM, Rieger J, Rosenthal EL (2011) Current strategies in reconstruction of maxillectomy defects. Arch Otolaryngol Head Neck Surg 137(8):806–812CrossRefPubMedPubMedCentral
Metadata
Title
Stress Trajectory Variations During Occlusal Loading in Human Skull with a Maxillofacial Defect: A Finite Element Analysis
Authors
Pandurangan Harikrishnan
Varadaraju Magesh
Publication date
22-04-2023
Publisher
Springer India
Published in
Journal of Maxillofacial and Oral Surgery / Issue 4/2023
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-023-01924-5

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