Three-dimensional evaluation of the temporomandibular joints after unilateral surgically assisted rapid maxillary expansion in adults: A preliminary retrospective study.

Abstract

Unilateral surgically assisted rapid maxillary expansion (U-SARME) is a successful method for correction of true unilateral posterior crossbite (TUPC). This retrospective preliminary study aimed to evaluate the position and morphology of condyles in TUPC cases and the effects of U-SARME on condyle with the help of cone beam computed tomography (CBCT). Fifteen patients (mean age: 18.69 ± 1.59 years) who were diagnosed as TUPC and undergone U-SARME were selected. Preoperative (T0) and after 6-month retention (T1) DICOM data of CBCT images were evaluated with MIMICs version 19.0 software. Condylar morphology (medio-lateral and antero-posterior dimensions) and position (anterior, posterior, medial and lateral joint spaces, frontal/axial axis angles, the ratio of posterior to anterior joint space and the percentage of posterior to anterior joint space) were evaluated. Student's t-test was used for intergroup (crossbite, normal) comparisons. Paired-samples t-test was used for intra-group comparisons (p = .05). There were no positional or dimensional asymmetry of the condyles between crossbite and normal sides initially and after expansion. Regarding T0-T1 changes, while significant increase was determined in medial (0.3 ± 0.29 mm; p = .001) and superior (0.39 ± 0.7 mm; p = .045) joint spaces on crossbite side, posterior (0.79 ± 0.99 mm; p = .008), superior (0.5 ± 0.79 mm; p = .029) and lateral joint spaces (0.31 ± 0.54 mm; p = .042) presented significant increases on normal side. However, no significant changes were found between crossbite and normal sides at T0 and T1. Condyles were symmetrical in true unilateral posterior crossbite cases and the symmetry were not disrupted following U-SARME.