Effect of Rapid Maxillary Expansion on the Pterygoid Process and Spheno-Occipital Synchondrosis in Skulls With Class II and Class III Skeletal Relationships: A Finite Element Analysis Study.

Abstract

<h4>Objetive</h4>To evaluate the effect of the rapid maxillary expansion (RME) on the pterygoid process (PP), spheno-occipital synchondrosis (SOS), and sella turcica (ST) in two patients' skulls with Class II and Class III skeletal relationships and to identify differences in mechanical loading through finite element analysis (FEA).<h4>Materials and methods</h4>Cone-beam computed tomography (CBCT) scans of two patients' skulls were used: (1) a 13-year-old female with a Class II skeletal relationship due to maxillary protrusion and (2) a 14-year-old male with a Class III skeletal relationship due to maxillary hypoplasia. The computer-aided design (CAD) geometry of both skulls was imported into Ansys v14 software to construct the finite element mesh. A transverse force of 100 N was applied to the palatal surfaces of the first upper molar and first premolar to simulate RME. Von Mises stress (VMS) and maximum principal stress (MPS) were assessed at selected nodes representing the anatomical areas of interest.<h4>Results</h4>In VMS, the Class II model showed the highest value at Point 3 (2.077 MPa), similar to the Class III model (1.707 MPa). In MPS, the highest tensile stress in the Class II model occurred at Point 2 (1.396 MPa), while in the Class III model it was at Point 3 (1.813 MPa).<h4>Conclusions</h4>The PP, SOS, and ST in Class II and Class III skeletal patterns are subjected to tensile and compressive loads during RME. The Class III model exhibited higher stress distribution at the skull base compared with the Class II model.<h4>Clinical significance</h4>Understanding how delicate cranial structures respond to heavy orthopedic loads generated during RME may help refine treatment protocols for transverse maxillary deficiency across different malocclusions.