OBJECTIVEThe purpose of this study was to investigate the biomechanical changes of midface skeleton protraction at its medium position in the craniofacial complex, using the three-dimensional finite element method (FEM).

METHODSA three-dimensional FEM model was developed from the CT scan images by the technologies of three-dimensional reconstruction, image processing and meshing. The protraction forces were applied to the following locations: the first molar, full maxillary arch, and the floor of aperture piriforms. Biomechanical changes from different position protraction were investigated by means of finite element analyses.

RESULTSProtraction forces at the level of the floor of aperture piriforms produced a more forward movement of the upper maxilla in sagittal direction. Vertical and lateral displacements were less than those in loading with teeth or denture. Compressive stress on the radix nasi decreased obviously in midface skeleton protraction at its medium position.

CONCLUSIONSCompared with traditional orthopedic protraction, midface skeleton protraction at its medium position could advance maxilla en bloc, decrease the counterclockwise rotation of the maxilla, and reduce the constriction of the anterior part of the palate.