Muscular and condylar response to rapid maxillary expansion. Part 3: magnetic resonance assessment of condyle-disc relationship

Am J Orthod Dentofacial Orthop. 2008 Jun;133(6):830-6. doi: 10.1016/j.ajodo.2007.03.026.

Abstract

Introduction: The aim of this prospective study was to assess temporomandibular joint (TMJ) condyle-disc positions at the sagittal and coronal planes of magnetic resonance images (MRIs) before and after rapid maxillary expansion (RME).

Methods: The study included 18 subjects (11 girls, 7 boys) with a mean age of 12.54 years with unilateral or bilateral posterior crossbite that included at least 3 posterior teeth. The clinical and radiographic assessments of the TMJ were done before (T1) and 18 weeks after (T2) RME. A Haas-type expansion appliance was used for an average treatment time of 3.5 weeks.

Results: A visual MRI analysis of pretreatment condyle-disc positions showed that 8 TMJs had medial disc displacement, 3 had anteromedial disc displacement, and 2 had lateral disc displacement. The disc positions remained unchanged at T2 except in 1 subject, who developed unilateral anterior disc displacement. Unilateral joint sounds developed in 3 subjects without changes in the disc positions.

Conclusions: Posterior crossbite can be considered a minor risk factor for temporomandibular disorder (TMD). RME is neither a risk factor nor a prevention for TMD. Coronal MRIs contribute complementary information for optimal diagnosis of TMD.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Humans
  • Joint Dislocations / etiology
  • Joint Dislocations / pathology
  • Magnetic Resonance Imaging
  • Male
  • Malocclusion / complications*
  • Malocclusion / therapy
  • Mandibular Condyle / pathology*
  • Mastication / physiology
  • Palatal Expansion Technique*
  • Prospective Studies
  • Temporomandibular Joint / pathology*
  • Temporomandibular Joint Disc / pathology*
  • Temporomandibular Joint Disorders / etiology*
  • Temporomandibular Joint Disorders / pathology