Patient-specific pre-operative simulation of the surgically assisted rapid maxillary expansion using finite element method and Latin hypercube sampling: workflow and first clinical results

Asymmetric distraction with different expansions of left and right maxillary parts is a serious complication of surgically assisted rapid maxillary expansion. An individual, highly standardized surgical intervention based on three-dimensional finite element analysis (FEA) is a new method to improve the quality of therapy. We describe a fundamental simulation-based workflow for preoperative evaluation of the osteotomies in a pilot study to achieve symmetry. A CT scan of the skull was used for analysis. Many feasible osteotomy configurations were generated and optimized using Latin hypercube sampling method and FEA choosing an individual osteotomy and maxillary movement. We successfully applied this workflow to 14 patients with symmetrical distraction.