British Journal of Orthodontics

ISSN: 0301-228X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/yjor19

Location of the Centre of Resistance for the

Nasomaxillary Complex Studied in a Three-
Dimensional Finite Element Model

Kazuo Tanne D.D.S., D.D.Sc., Susumu Matsubara D.D.S., D.D.Sc. & Mamoru
Sakuda D.D.S., D.D.Sc.

To cite this article: Kazuo Tanne D.D.S., D.D.Sc., Susumu Matsubara D.D.S., D.D.Sc. & Mamoru
Sakuda D.D.S., D.D.Sc. (1995) Location of the Centre of Resistance for the Nasomaxillary
Complex Studied in a Three-Dimensional Finite Element Model, British Journal of Orthodontics,
22:3, 227-232, DOI: 10.1179/bjo.22.3.227

To link to this article: http://dx.doi.org/10.1179/bjo.22.3.227

Published online: 21 Jun 2016.

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 British Jouf1UII of Onhodontics/Vol. 22119951227-232

Location of the Centre of Resistance for the

N asomaxillary Complex Studied in a
Three-Dimensional Finite Element Model
KAZUOTANNE, D.D.S., D.D.SC.
Department of Orthodontics, Hiroshima University School of Dentistry. 1-2-3 Kasumi. Minami-Ku, Hiroshima, Hiroshima 734, Japan

SUSUMU MATSUBARA, D.D.S., D.D.SC.

MAMORU SAKUDA, D.D.S., D.D.SC.
Department of Orthodontics, Osaka University Faculty of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565, Japan
Accepted for publication June 1994

Abstract. The purpose of this study was to investigate the location of the centre of resistance (CRe) for the nasomaxillary
complex by the use of finite element analysis. A three-dimensional finite element model of the craniofacial complex,
consisting of 29I8 nodes and I776 elements, was used for displacement analyses. Anteriorly and inferiorly directed forces
Downloaded by [Tufts University] at 07:40 19 July 2016

of 9·8 N were applied at five different levels, parallel and perpendicular to the functional occlusal plane, respectively. For
each loading condition, horizontal and vertical displacements of eight a_natomic points in the complex and on the maxillary
dentition were analysed. The complex exhibited an almost translatory diSplacement of approximately I·O .,un in the forward
direction when the horizontal force was applied at a point on the horizontal plane, passing through the superior ridge of
the pterygomaxil/ary fissure, whereas the complex experienced clockwise or counter clockwise rotation when the forces
were applied at the remaining levels. Furthermore, the downward forces produced anteriorly upward, or posteriorly upward
rotation. However, the force applied at a point on the vertical plane passing through the posterior wall of the pterygomaxil-
lary fissure, produced almost equal displacements of approximately 6·0 .,un in an inferior direction for all the anatomic
points. It is suggested that CRe of the nasomaxillary complex is located on the posterosuperior ridge of the pterygomaxillary
fissure, registered on the median sagittal plane.
Index words: Centre of Resistance, Finite Element Analysis, Nasomaxillary Complex, Orthopaedic Therapy.

nasomaxillary complex, which might be affected by the

Introduction
Over the years, a number of experimental and analytic
approaches have been conducted to elucidate the nature
of optimal tooth movement (Stoner, 1960~ Storey, 1973~
Caputo et a/., 1974~ Nikolai, 1975; Burstone, 1985;
Reitan, 1985; Tanne et al., 1987). These studies have
indicated that orthodontic tooth movement is influenced
by such variables as the magnitude, direction, and dura-
tion of the forces (Stoner, 1960; Burstone, 1985; Reitan,
1985). In particular, the direction of force has been
pointed out as an important determinant to orthodontic
tooth displacement. These findings are also of great im-
portance for orthopaedic treatment to the nasomaxillary
complex. Differences in the direction of orthopaedic
forces produce completely different displacement patterns
of the complex and stress distribution in the maxillofacial
sutures of the complex (ltoh et al., 1985; Hata et al., 1987;
Tanne et al., 1989; Miyasaka-Hiraga et al., 1994).
Changes of the complex produced by orthopaedic
extraoral forces have been extensively investigated in
cephalometric and experimental studies (Barton, 1972;
Droschl, 1975; Meldrum, 1975; Kambara, 1977; Teuscher,
1978; Jackson eta/., 1979; ltoh et al., 1985; Stockli and
Teuscher, 1985; Kragt et al., 1986; Hata et a/., 1987;
Lagerstrom eta/., 1990; Tanne and Sakuda, 1991). These
studies demonstrated variable orthopaedic changes of the
0301-228X/9S/008000+00$02.00
direction of force. In order to further elucidate sutural
responses to orthopaedic forces, stress distributions in the
sutures in the complex have been investigated in previous
studies (Tanne eta/., 1989~ Miyasaka-Hiraga eta/., 1994).
These preliminary studies revealed different patterns of
stress distributions in loading with the forces applied in
various directions. It has been speculated that these
findings are due to differences in force direction relative
to the centre of resistance (CRe), which is accepted as an
important point of biomechanical 'continuum' (Teuscher,
1978; Burstone and Pryputniewicz, 1980; Burstone,
1985; Stockli and Teuscher, 1985; Kusy and Tulloch, 1986;
Tanne eta/., 1988a). Thus, a better understanding of the
positional relationship between force direction and CRe
of the complex is of clinical relevance.
In attempting to investigate the location of CRe in the
complex, cephalometric analysis has been employed to
approximate the position, based on repositioning of the
nasomaxillary complex (Bench et a/., 1978; Teuscher,
1978; Stockli and Teuscher, 1985). However, exact loca-
tion of the CRe has not been elucidated because of limi-
tations in the precise evaluation of displacements.
With these considerations in mind, finite element
analysis (Zienkiewicz and Cheung, 1967; Smith, 1971) has
recently been applied in biomechanical studies of stresses
and strains, making it practicable to analyse unknown
© !995 British Onhodontic Society
 228 K. Tanne era/. BJO Vol. 22 No.3

TABLE Mechanical properties of different materials in the nodes and 1776 solid elements (Tanne eta/., 1988b).
model The model was restrained at the peripheral regions of
the foramen magnum to avoid sliding movement of the
Material Young's modulus (MPa) Poisson's ratio
model, simulating clinical application of orthopaedic
Tooth 2·0 X )()"' 0·3 extra-oral forces to patients (Fig. 1). Mechanical prop-
Compact bone )·4 X )()"' 0·3 erties of different components in the model were defined
Cancellous bone 7-9 X JlP 0·3 in Table 1. All the materials in this model are assumed to
be isotrophic and to follow elastic behaviour (Carter and
Hayes, 1977; Orr and Carter, 1985).
For loading conditions, anteriorly and inferiorly
displacement in living structures (Tanne et a/., 1989;
directed forces of 9.8 N were applied at five different
McGuinness eta/., 1991; Wilson eta/., 1991). The purpose
levels of H1-H5 and V1-V5, in the parallel and perpen-
of this study was to determine a three-dimensional loca- dicular directions to the functional occlusal plane, respec-
tion of the CRe for the nasomaxillary complex, using finite tively (Fig. 1).
element method (FEM).
Displacements of the complex were analysed by use of
an analysis program (a finite element analysis program
Materials and Methods 'FEM3' provided by Data Processing Centre, Kyoto Uni-
versity, Kyoto, Japan). The horizontal and vertical dis-
A three-dimensional model of the craniofacial complex placements in response to horizontal and vertical loadings
was developed for finite element analysis. The model com- were evaluated for eight points in the complex and on the
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prises 18 cranial and facial sutures, and consists of 2918 upper dentition, as shown in Fig. 1. As a result of displace-

HS (50.0) *
H4 (40.0)

H3 (26.0)
H2 (20.0)
H1 (15.0)
~
z
10mm

X
~y V1 V2
(19.1) (7.8)
V3 V4 VS
(7.7)(18.8) (34 0) **
FIG. I Schematic representation for loading conditions (HI-H5 and VI-V5) and anatomic points where displacements are evaluated.
A = nasion; B = anterior nasal spine; C = central incisor; D = first molar; E = pterygomaxillary fissure (Ptm); F = temporozygomatic suture; G =
frontozygomatic suture; H = frontomaxillary suture. *Distance (mm) measured from the functional occlusal plane in parenthesis. ••Distance (mm) measured
from the Ptm (point E) in parenthesis. Solid triangles indicate restraints of the model under loadings.
 810 August/995 CRe for the Nasomaxillary Complex 229

ment analysis, the force levels which produced the most 4

translatory displacement of the complex in the anterior
and inferior directions were chosen. Finally, the location 3
of the CRe was determined as an intersection of the hori-
zontal and vertical planes.

Results
Figure 2 shows horizontal displacements of the complex
.
evaluated at the eight points (A-H) in loading with the
horizontal forces applied at levels Hl to H5. ...
In loading with the force applied at level H1, the ana-
tomic point A experienced substantial negative (back- ..
-2 d
ward) displacement, whereas the inferior points of C, D,
E, and F exhibited positive (forward) displacements. For
the remaining points, the displacements were negligible. -3 A B c 0 E F G H
These findings indicate a counter-clockwise rotation of the Anatomic points
nasomaxillary complex. The patterns of displacements FIG. 2 Horizontal displacements at the eight anatomic points (A-H) in
produced by the forces applied at levels H2 and H3 were loading with anteriorly directed force of 9·8 N applied at the five levels of
quite similar to those in loading with the force at H1level, HI-H5. (Positive and negati>·e values denote forward and backward
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although no negative (backward) displacements were displacements, respectively.)

observed when the forces were applied at H2 and H3.
Thus, the forces applied at levels H1 to H3 produced
similar displacement patterns of the complex. 0
In loading with the force applied at level H4. all the -1
anatomic points were repositioned forward in an almost -2
translatory manner. The magnitude of displacement ~as -3
approximately 1·0 11m for all the points. The ~orce apphed
-4
at level H5 generated negative (backward) d~splacements e
3 -5
of points C and D. and positive (forward} ~1splace~ents
at the remaining points, indicating a clockw1se rotat1on _of c
G)
-6
E -7
the nasomaxillary complex, which is almo_st the <;>PPOS~te
pattern of displacement to that observed m loadmg w1th ~
Q.
-8
the force applied at level Hl. C/1 -9
i5
Figure 3 shows vertical displacements of the complex -10
evaluated at the eight points (A-H) when_ dow_nward -11
forces were applied at levels V1-V5. In loadmg ~1th the
forces applied at these levels, the ~atterns of d_lsplace-
ments were similar to each other, wh1lst the magmtude of
-12
-13
-14
.. .. ...... -•'
A B c
I

0 E F G
\
'llvs

displacement varied substantially. Th~ anatomic poin~s.
excluding point E. exhibited substantial downward dis-
placements. However. the differences in downward
displacements at the eight points. tended to decrease. in
association with the forces apphed at more postenor
points, from V5 to Vl. Thus. the force applied at the level
of V2 produced inferior displacements of about 6·0 11m in
an almost translatory manner.
From these results, it would seem that the centre of
resistance is located at a point on the posterosuperior
ridge of the pterygomaxillary fissure. determined as an
intersection between the horizontal and vertical planes
passing through the levels H4 and V2. respectively
(Fig. 4).
Discussion
It is generally accepted that orthodontic or orthopaedic
forces should be applied relative to the centre of resistance
(CRe), to achieve desirable movements of the dentition
and nasomaxillary complex. For a tooth or group of teeth.
the location of CRe has been investigated with experimen-
tal and/or analytic approaches (Burstone and Pryput-
H
Anatomic points
F1n. 3 Vertical displacements at the eight anatomic points (A-H) in
loading with inferiorly directed force of 9·8 N applied at the live levels of
VI-V5. (Positi,·e and negative values denote upward and downward
displacements. respectively.)
niewicz. 1980: Kusy and Tulloch, 1986: Vanden Bulcke et
a/., 1987: Tanne eta/., 1988a). These studies reported the
CRe of a single tooth located at approximately 0·30 the
root length measured from the alveolar crest (Burstone
and _Pryputniewicz, 1980: Tanne et a/., 1988a) and an
apical shift of CRe with the incorporation of a greater
number of teeth into an anterior segment (Vanden Bulcke
et a/., 1987). However. it has proved very difficult to
determine the position of CRe in the craniofacial com-
plex. because of its complicated structure and associated
li!""itations in analysing or measuring techniques for
displacements. Therefore. CRe for the nasomaxillary
complex has not been elucidated at all. although some
ceph~lometric studies have explored an approximate
locatmn of the CRe hy means of changes in craniofacial
 230 K. Tanne eta/.
morphology evaluated on lateral cephalograms (Bench et
a/., 1978; Teuscher, 1978; Stockli and Teuscher, 1985).
The present study was conducted to investigate its exact
location by use of finite element analysis. This method was
first applied to structural analysis in the field of engineer-
ing and has been successfully employed in biomechanical
studies in orthodontics (Williams et at., 1986; Tanne et at.,
1989; McGuinness et at., 1991; Wilson et at., 1991;
Miyasaka-Hiraga et a/., 1994). These studies indicated
that the principles of this technique, as documented by
Zienkiewicz and Cheung, (1967) and by Smith, (1971),
might be applied to biological tissues, if the biomechanical
behaviour of these structures is understood.
It is shown in the present study that CRe of the nasa-
maxillary complex is located on the posterosuperior ridge
of the pterygomaxillary fissure, registered on the median
sagittal plane. The location of CRe, as determined by
changes in craniofacial morphology evaluated on lateral
cephalograms in previous studies, was considered to be in
the region of the superior ridge of the pterygomaxillary
Downloaded by [Tufts University] at 07:40 19 July 2016
fissure, or the posterosuperior area of the zygomatico-
maxillary suture (Bench et at., 1978; Teuscher, 1978;
7.8mm
FIG. 4 Schematic representation of the CRe of the nasomaxillary complex and directional angles of force vecton passing through the CRe. and the upper tint
molar. canine. and central incisor.
BJO Vol. 22 No.3
Stockli and Teuscher, 1985). The position of CRe in this
study was slightly more posterior to that found in previous
studies (Teuscher, 1978; Stockli and Teuscher, 1985),
however, it's vertical level was quite similar.
In previous studies (Tanne et at., 1989; Miyasaka-
Hiraga et at., 1994), an anteriorly directed force produced
more optimal patterns of displacements and stress distri-
butions when the force was applied slightly more down-
ward to the functional occlusal plane, than by horizontal
and upward loadings. This may be due to the fact that the
force vector passes more closely to the CRe of the com-
plex. In order to quantify this, directional angles relative
to the occlusal plane can be assessed as follows; if the CRe
is connected to each tooth in the maxillary dentition, the
angles between the lines and the functional occlusal plane
are approximately 52, 36, and 27 degrees for the first
molar, canine, and central incisor, respectively (Fig. 4). It
is known that the nasomaxillary complex displaces an-
teriorly and inferiorly, and that such primary displacement
induces sutural deposits due to, but not because of the
displacement. An orthopaedic force, which can initiate
primary displacement of the complex, might provide a
40.0mm
5z.o· 36.5. 26.5.
 BJO August 1995
useful means of accelerating natural growth. The present
findings described above tend to confirm a previous
finding that a 30 degrees downward maxillary protraction
force applied at the upper canine produced the most opti-
mal pattern of stress distribution in the sutural system
(Miyasaka-Hiraga eta/., 1994).
In future studies, the location of CRe revealed in this
study should be verified in more detail by an integrated
study involving experimental and cephalometric ap-
proaches. The present results are similar to preliminary
findings in previous reports, using different methods.
Conclusions
1. The complex exhibited an almost translatory displace-
ment in an anterior direction, when the horizontal force
was applied at a point on the horizontal plane passing
through the superior ridge of the pterygomaxillary fissure,
whereas the complex experienced substantial rotation
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when the forces were applied at all other levels.
2. All the downward forced produced clockwise or
counter clockwise rotations. However, the force applied
at a point on the vertical plane passing through the pos-
terior wall of the pterygomaxillary fissure produced ~!most
equal displacements of approximately 6·0 ~m m the
inferior direction, for all the anatomic points.
It is suggested that the CRe of the nasomaxillary com-
plex is located on the posterosuperior ridge of the pterygo-
maxillary fissure, registered on the median sagittal plane.
The exact location of the CRe revealed in this study may
provide some insight into the clinical application of or.tho-
paedic maxillary protraction forces in terms of optimal
displacements of the complex.
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