Temporomandibular joint disc position and shape in patients submitted to two protocols of rapid maxillary expansion and face mask therapy: A randomized clinical trial

• Published in: Orthodontics & craniofacial research Vol. 27; no. 4; pp. 615 - 625
• Main Authors: Tagawa, Daniella Torres, Wolosker, Angela Maria Borri, Florez, Bruna Maluza, Dominguez, Gladys Cristina, Yamashita, Helio Kiitiro, Aidar, Luís Antônio de Arruda, Junior, Henrique Carrete
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-08-2024
• Subjects: Angle Class III; Dental occlusion; Magnetic resonance imaging; malocclusion; Maxilla; palatal expansion technique; Patients; Statistical analysis; Temporomandibular joint; palatal expansion technique; magnetic resonance imaging; temporomandibular joint; Angle Class III; malocclusion
• ISSN: 1601-6335; 1601-6343; 1601-6343
• DOI: 10.1111/ocr.12777

Objective
The objective of this prospective study was to assess possible changes in the position and shape of the temporomandibular joint (TMJ) articular disc in patients treated with two protocols of rapid maxillary expansion (RME) and face mask (FM) therapy.
Methods
A sample of 88 patients with Class III or Class III subdivision malocclusions, aged between 6 and 13 years, were consecutively selected and divided into three groups (G): G1‐34 patients were treated with RME, followed by FM therapy; G2‐34 patients were treated using RME according to modified alternate rapid maxillary expansion and constriction (ALT‐RAMEC) protocol, followed by FM therapy. These treated groups were randomly (1:1 allocation ratio) distributed according to the two treatment protocols. G3 – Control Group – 20 untreated patients were followed. Magnetic resonance imaging (MRI) TMJs were obtained before (T1) and after (T2) a treatment period or follow‐up. McNemar test, Fisher's exact test and intra‐ and inter‐observer concordance (K) were performed (p ≤ .05).
Results
There were no statistically significant differences in the baseline cephalometric variables at T1 between the groups. There were statistically significant differences between the groups (p < .001) in relation to the disc shape in T1, since G1 (8 TMJs −11.76%) presented higher occurrences of altered forms in comparison with G2 (no changes). No significant differences were observed in disc position CM and OM (G1 – p > .999; G2 – p = .063; G3 – p = .500) and shape (G1 – p > 0.999; G2 – p = .250; G3 – not calculable), between T1 × T2, in any of the groups studied.
Conclusion
The two treatment protocols did not have adverse effects on the position and shape of the TMJ disc, in a short‐term evaluation.