Effects of rapid maxillary expansion on temporomandibular joints:

Abstract

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.

The Impact of Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) on Children’s Health-Related Quality of Life: A Systematic Review and Meta-Analysis

“…The tool consists of 12 to 14 items assessing sources of bias such as patient selection, study power, and confounding ( NHLBI, 2014 ). NHLBI has been widely used in previous literature reviews ( Akpan et al, 2020 ; Gupta et al., 2017 ; Haighton et al, 2019 ; Ismaiel et al, 2021 ; Pires, 2022 ; Torres et al, 2020 ). Inter-rater reliability was conducted for the agreement between raters for each question of the assessment tools.…”

Condylar morphology and position changes after miniscrew-assisted rapid palatal expansion in skeletal Class III malocclusion adult patients with mandibular deviation and unilateral posterior crossbite

“…Previous studies have focused on evaluating the dentoalveolar effects of MARPE, however, the condylar response to this procedure is not well understood, especially in patients with MD. It has been clinically reported that early intervention can promote condylar growth, correct mandibular deviation, achieving symmetrical growth of jaw bones [10][11][12]. However, the adaptive changes of the condyle in adults with Class III malocclusion and horizontal MD after expansion treatment remain to be evaluated.…”

“…It has been found that the growth of the condyle increases in patients with Class II malocclusions after treatment with functional appliances such as the activator, Twin-block and Herbst [10,13,14]. For patients with growth and development, Arat et al [11] and Torres et al [12] observed that rapid maxillary expansion (RME) induced bone modeling in the condyle. Furthermore, based on handwrist radiography, the Herbst appliance has been shown to promote remodeling at the posterosuperior border in patients with minimal or no residual growth [15], and skeletal facial growth potential remained even after the age of 20 [16].…”

Evaluation of the Effect of Surgically Assisted Rapid Maxillary Expansion on Temporomandibular Joint Disc Position With Magnetic Resonance Imaging*

“…A systematic review 4 evaluating conventional rapid maxillary expansion in growing patients showed that there is no change in the position and shape of the articular disc immediately after expansion. However, there is no evidence available on the subject when using, in adults, the rapid expansion of the surgically assisted maxilla.…”