Positional and dimensional temporomandibular joint changes after correction of posterior crossbite in growing patients:A systematic review

Abstract

The current available data provide insufficient and weak evidence to form a solid and firm conclusion. There is poor, very low-quality evidence regarding the positional and dimensional effects of posterior crossbite correction on the TMJs.

Condylar Changes after Maxillary Expansion in Children with Cleft Lip and Palate—A Three-Dimensional Retrospective Study

“…The most common malocclusions observed are: skeletal class III due to maxillary retrognathia, crowding and anterior and posterior crossbite [ 6 , 15 , 17 ]. The posterior crossbite is also one of the most common malocclusions during deciduous, mixed and permanent dentition [ 18 ]. The presence of this malocclusion, unilateral or bilateral, can trigger dental and functional changes, namely at the level of muscle activity fatigue, contributing to asymmetrical muscle function [ 2 ].…”

“…The presence of this malocclusion, unilateral or bilateral, can trigger dental and functional changes, namely at the level of muscle activity fatigue, contributing to asymmetrical muscle function [ 2 ]. The consequent neuromuscular adaptation, acquired by the position of the mandible, can lead to asymmetrical mandibular growth, facial disharmony and skeletal crossbite in permanent dentition [ 18 ]. Mandibular asymmetry and corresponding condyle adaptation may be an etiological factor in temporomandibular disorder (TMD) since it can affect temporomandibular joint (TMJ) morphology [ 1 , 3 , 18 , 19 ].…”

“…The consequent neuromuscular adaptation, acquired by the position of the mandible, can lead to asymmetrical mandibular growth, facial disharmony and skeletal crossbite in permanent dentition [ 18 ]. Mandibular asymmetry and corresponding condyle adaptation may be an etiological factor in temporomandibular disorder (TMD) since it can affect temporomandibular joint (TMJ) morphology [ 1 , 3 , 18 , 19 ]. This adaptive capacity promotes interpersonal variations that result from the growth of the condyles and the ascending mandibular ramus in several directions [ 3 ].…”

“…However, it is noteworthy that TMD has a multifactorial etiology. In order to avoid these consequences, the transversal maxillary discrepancy must be treated as soon as possible [ 18 , 20 ]. Maxillary expansion is commonly used as part of a sequential treatment for cleft patients since it can correct the transversal constriction caused by previous surgeries, establish the maxillary arch, and expansion appliances can be used to stabilize the upper arch during a secondary bone graft [ 17 , 18 , 21 ].…”

Effects of rapid maxillary expansion on temporomandibular joints:

“…A previous systematic review summarized TMJ alterations after correction of posterior crossbites in growing patients. 7 However, the authors included studies in which patients received other orthodontic procedures associated with RME. In one of them, 8 there was intervention in the maxilla and mandible, including the McNamara expander and U-Bow type I activator.…”