Article Title and Bibliographic Information
Effects of rapid maxillary expansion on temporomandibular joints: A systematic review. Torres D, Lopes J, Magno MB, Cople Maia L, Normando D, Leão PB . Angle Orthod. 2020 Feb 10. https://doi.org/10.2319/080619-517.1 . Epub ahead of print. PMID: 32039632 .
Source of Funding
None. The authors have no actual or potential conflicts of interest.
Type of Study/Design
Electronic search in nine databases was conducted to identify articles through May 2018 reporting the effects of rapid maxillary expansion (RME) on the temporomandibular joint (TMJ) by means of conventional computed tomography (CT), cone beam CT (CBCT), or magnetic resonance imaging (MRI). A hand search was also conducted.
The inclusion criteria consisted of growing patients, with mixed or early permanent dentition and without symptomatology of temporomandibular dysfunction, receiving RME. The types of studies considered were randomized, nonrandomized, prospective, or retrospective clinical trials that measured the TMJ effects by means of tomography (CT, CBCT) or MRI.
A total of 4303 articles were initially identified, with 15 articles selected for full-text review. Of these, only eight articles were included in this systematic review. Studies were assessed independently by two authors, and disagreements were resolved through a consensus meeting or, when appropriate, by consulting a third author.
Key Study Factors
Of the eight studies included, two were randomized controlled trials and six were observational studies without a control group. Sample sizes ranged from 10 to 39 patients of ages ranged 6.8 years to 17 years who underwent RME. The RME activation protocols and time of measurement after the activations varied among the studies.
Main Outcome Measures
The review focused on qualitative measurements of whether any changes were observed in the TMJ after RME. Different aspects of the TMJ (condylar position, disc joint, joint space, and interarticular relationship) were measured in each of the articles that were included in this review. Three articles used MRI; of which, two evaluated the articular disc and the other one evaluated remodeling of the head and the condylar branch. Two articles evaluated the condylar position and articular spaces by means of CT and three by CBCT.