Tricortical versus bicortical anchorage in a double-screw tandem skeletal expander and a single-screw maxillary anchorage rapid palatal expander: A finite element analysis

Objective: This study aims to employ finite element method (FEM) analysis to compare the differences between bicortical and tricortical anchorage of the posterior miniscrews in a single-screw miniscrew-assisted rapid palatal expansion (MARPE) and a double-screw tandem skeletal expander (TSE) under open and closed suture conditions. Methods: A cone beam computed tomography of the human skull of a 21.5-year-old female was utilized as a model for creating a FEM analysis. Simulations involved the insertion of four palatal miniscrews: two anterior ones with bicortical anchorage and two posterior ones (one with bicortical and another with tricortical anchorage), under open and closed suture conditions in a single-screw MARPE and double-screw TSE, resulting in a total of eight different simulation configurations. Evaluation parameters include total deformation (mm), Von Mises stress (MPa), and strain for each miniscrew body. Results: Tricortical anchorage of the posterior miniscrews provides greater anchorage, higher stress, and deformation on the anterior miniscrews in single-screw MARPE. Tricortical anchorage combined with a double-screw TSE promotes a more even distribution of force and stress on miniscrews under open suture conditions, leading to a parallel midpalatal suture opening along its entire length and height. Conclusions: FEM analysis revealed favorable midpalatal suture opening with equal force distribution and less stress when posterior tricortical anchorage in conjunction with double-screw TSE is applied.