Analysis of Condylar Differences in Functional Unilateral Posterior Crossbite during Early Treatment – a Randomized Clinical Study

Lippold, Carsten; Hoppe, Gloria; Moiseenko, Tatjana; Ehmer, U; Danesh, Gholamreza

doi:10.1007/s00056-008-0803-9

Cited by 23 publications

(34 citation statements)

References 30 publications

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“…After correction of the maxillary discrepancy, an orthodontic activator treatment (U-Bow activator Type 1) as described by Karwetzky [12] was applied to achieve midline coordination and to retain the amount of palatal expansion (Figure 2b). Details are given by Lippold et al [7]. …”

Section: Methodsmentioning

confidence: 99%

“…In our own recent study [7], we established that therapeutic improvements in mandibular condyle position could be achieved using orthodontic treatment for functional unilateral posterior cross bite in a sample consisting of 65 children (6.9 ± 2.0 years of age) with late deciduous and early mixed dentition. Of the 65 children used in this randomized clinical trial, 31 underwent early orthodontic treatment and 34 did not.…”

Section: Introductionmentioning

confidence: 99%

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Spine deviations and orthodontic treatment of asymmetric malocclusions in children

Lippold¹,

Moiseenko²,

Drerup

et al. 2012

BMC Musculoskelet Disord

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BackgroundThe aim of this randomized clinical trial was to assess the effect of early orthodontic treatment for unilateral posterior cross bite in the late deciduous and early mixed dentition using orthopedic parameters.MethodsEarly orthodontic treatment was performed by initial maxillary expansion and subsequent activator therapy (Münster treatment concept). The patient sample was initially comprised of 80 patients with unilateral posterior cross bite (mean age 7.3 years, SD 2.1 years). After randomization, 77 children attended the initial examination appointment (therapy = 37, control = 40); 31 children in the therapy group and 35 children in the control group were monitored at the follow-up examination (T2). The mean interval between T1 and T2 was 1.1 years (SD 0.2 years). Rasterstereography was used for back shape analysis at T1 and T2. Using the profile, the kyphotic and lordotic angle, the surface rotation, the lateral deviation, pelvic tilt and pelvic torsion, statistical differences at T1 and T2 between the therapy and control groups were calculated (t-test).Our working hypothesis was, that early orthodontic treatment can induce negative therapeutic changes in body posture through thoracic and lumbar position changes in preadolescents with uniltaral cross bite.ResultsNo clinically relevant differences between the control and the therapy groups at T1 and T2 were found for the parameters of kyphotic and lordotic angle, the surface rotation, lateral deviation, pelvic tilt, and pelvic torsion.ConclusionsOur working hypothesis was tested to be not correct (within the limitations of this study). This randomized clinical trial demonstrates that in a juvenile population with unilateral posterior cross bite the selected early orthodontic treatment protocol does not affect negatively the postural parameters.Trial registrationDRKS00003497 on DRKS

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spine deviations and orthodontic treatment of asymmetric malocclusions in children

Lippold¹,

Moiseenko²,

Drerup

et al. 2012

BMC Musculoskelet Disord

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“…Firstly, it has been suggested that the altered morphological relationship between the upper and lower dentition may result in right-to-left-side differences in the condyle-fossa relationship, and in the height of the condyle and the mandibular ramus resulting in an asymmetric mandibular growth (41)(42)(43)(44)(45)(46). However, early treatment to normalize the occlusion created appropriate conditions to obtain a normal growing pattern both in animal studies and in human studies (44)(45)(46). Secondly, jaw function alteration including asymmetric pattern of jaw muscles EMG activity (47), lower bite forces (48), reduced thickness of the ipsilateral masseter (49) and a reverse sequence chewing pattern (50, 51) have been reported.…”

Section: Does Malocclusion Cause Tmd?mentioning

confidence: 99%

The role of orthodontics in temporomandibular disorders

Michelotti

Iodice

2010

Journal of Oral Rehabilitation

193

167

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Temporomandibular Disorder (TMD) is the main cause of pain of non-dental origin in the oro-facial region including head, face and related structures. The aetiology and the pathophysiology of TMD is poorly understood. It is generally accepted that the aetiology is multifactorial, involving a large number of direct and indirect causal factors. Among such factors, occlusion is frequently cited as one of the major aetiological factors causing TMD. It is well known from epidemiologic studies that TMD-related signs and symptoms, particularly temporomandibular joint (TMJ) sounds, are frequently found in children and adolescents and show increased prevalence among subjects between 15 and 45 years old. Aesthetic awareness, the development of new aesthetic orthodontic techniques and the possibility of improving prosthetic rehabilitation has increased the number of adults seeking orthodontic treatment. The shift in patient age also has increased the likelihood of patients presenting with signs and symptoms of TMD. Because orthodontic treatment lasts around 2 years, orthodontic patients may complain about TMD during or after treatment and orthodontists may be blamed for causing TMD by unsatisfied patients. This hypothesis of causality has led to legal problems for dentists and orthodontists. For these reasons, the interest in the relationship between occlusal factors, orthodontic treatment and TMD has grown and many studies have been conducted. Indeed, claims that orthodontic treatment may cause or cure TMD should be supported by good evidence. Hence, the aim of this article is to critically review evidence for a possible association between malocclusion, orthodontic treatment and TMD.

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“…Of these, one study was eliminated because it was a protocol proposal to be followed in future studies, 15 one for evaluating pre-and post-intervention changes through gypsum models and bite registration, 16 one for assessing condylar change by means of zonograms, 17 and five studies were excluded since they examined patients who underwent slow maxillary expansion. 10,[18][19][20][21] Therefore, seven articles from the systematic search were included for qualitative analysis; [22][23][24][25][26][27][28] as well as one record found by hand search (n ¼ 1); 29 totaling eight articles included in this review ( Table 1). A quantitative analysis was not feasible given the heterogeneity in the methodology of the selected articles.…”

Section: Selection and Characteristics Of The Studiesmentioning

confidence: 99%

Effects of rapid maxillary expansion on temporomandibular joints:

Torres¹,

Lopes²,

Magno³

et al. 2020

The Angle Orthodontist

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Objective To evaluate the impact of rapid maxillary expansion (RME) on the condylar position, disc joint, joint space, and interarticular relationship in growing patients. Materials and Methods A systematic search was performed in nine databases. The clinical studies selected included those with pre- and post-magnetic resonance, conventional computed tomography or cone beam tomography in growing patients. Risk of bias assessment was performed using the Cochrane Collaboration tool for controlled clinical studies and National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment for Before-After Studies With No Control Group. Results Initially, 4303 records were identified. Only eight studies fulfilled the criteria and were included in the qualitative analysis. Of those, two were controlled clinical studies with a risk of uncertain to high bias. The remaining papers had a low to moderate risk of bias. Results showed that RME in children and adolescents promoted the following: remodeling in the head and or condylar branch, changes in condylar position and joint space, maintenance of improved symmetry between the condyles, and no ability to modify the position or shape of the articular disc. Conclusions RME in growing patients is able, in the short term, to modify the condyle-fossa relationship but does not change the position or shape of the articular disc. The intercondylar symmetric relationship is maintained or improved. Although the NHLBI score shows low to moderate risk of bias, the clinical relevance of these review findings is limited by Cochrane and Grades of Recommendation, Assessment, Development and Evaluation scores.

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Analysis of Condylar Differences in Functional Unilateral Posterior Crossbite during Early Treatment – a Randomized Clinical Study

Abstract: The Münster concept for early treatment of functional unilateral posterior crossbites in late deciduous and early mixed dentition significantly improved the treated patients' occlusion in comparison to a randomized control group, which exhibited no spontaneous self-healing tendencies.

Cited by 23 publications

References 30 publications

Spine deviations and orthodontic treatment of asymmetric malocclusions in children

Spine deviations and orthodontic treatment of asymmetric malocclusions in children

The role of orthodontics in temporomandibular disorders

Effects of rapid maxillary expansion on temporomandibular joints:

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