ASSESSMENT OF MANDIBULAR SYMMETRY IN PATIENTS WITH UNILATERAL CROSSBITE BEFORE AND AFTER RAPID PALATAL EXPANSION

Abstract

Introduction, aim: Rapid Maxillary Expansion (RME) is a treatment method used to expand the maxillary arch and maxillary palatal suture. A less discussed effect of this therapeutic procedure are changes in the mandible and temporomandibular joint (TMJ) region. The aim of this review is to summarize the current published findings of changes in the mandible and TMJ region in patients with unilateral posterior crossbite (UPCB) after treatment with RME. Methods: PubMed/Medline, Scopus, and Embase databases were used for literature search and screening employing the keywords "RME", "unilateral crossbite", "mandible", "TMJ", "dental, dentoalveolar and skeletal changes" and "growing patient". The selected articles were cross-sectional studies, prospective and retrospective clinical trials, randomized controlled trials, and systematic reviews published in English between 1999 and 2023. Results: Forty nine publications met the inclusion criteria, of which 10 were systematic reviews. The largest statistically demonstrable changes in the mandibles of patients with UPCB on the crossbite side were in mandibular length, total height of the ramus mandibulae, condyle height, and condyle position in the fossa glenoidalis using different examination methods. In the analysis of the plaster casts, the majority of the studies agreed with the results of the general tendency of the mandibular expansion in the intermolar distance. Conclusion: Most of the available studies deal with asymmetric skeletal growth. The relationship between unilateral crossbite and skeletal asymmetry is not yet sufficiently described. There is a small number of good quality studies in the literature on the topic of mandibular skeletal changes after RME with statistically and clinically significant results. Further studies with larger sample sizes, well-defined diagnostic criteria, rigorous scientific methodologies and long-term follow-up are needed.

Keywords

• rme
• unilateral posterior crossbite
• mandible
• tmj
• dentoalveolar and skeletal changes
• growing patient