Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique

Clin Oral Investig. 2021 Apr;25(4):1775-1785. doi: 10.1007/s00784-020-03480-5. Epub 2020 Aug 2.

Abstract

Objectives: The purpose of this study was to evaluate mandibular asymmetry in youngsters with posterior unilateral crossbite (PUXB), through cone-beam computed tomography and reverse engineering technique, before and after rapid maxillary expansion (RME) treatment.

Materials and methods: Forty cone-beam computed tomography (CBCT) images were obtained from all patients at two time points, namely T0 acquired before the placement of a Hyrax expander and T1 after appliance removal. The CBCT scans were segmented and volume rendered into a surface there-dimensional (3D) mesh model. Thereafter, mandibular models were digitally registered by using a "best-fit" algorithm. Surface and volumetric changes, between T0 and T1, were compared by using Student's t tests.

Results: A slight increase of 0.45 cm3 of the total mandibular volume was found at T1 when compared with T0 (p < 0.001). The mandibular hemi-volume on the crossbite side (CB) was slightly smaller than the non-crossbite side both at T0 and T1. However, the mean differences of hemi-volume from the CB (crossbite) and non-CB side between T0 and T1 show a decrease of 0.26 cm3 (p < 0.001). Findings for the surface-to-surface deviation analysis demonstrated a fine percentage of matching at T0 which slightly improved at T1 (p < 0.001).

Conclusions: Youngsters affected by PUXB showed a very slight and not statistically significant volumetric and morphological asymmetry between CB side and non-CB side at T0. However, the change in mean differences of 0.26 cm cannot be considered clinically relevant.

Clinical relevance: Mandibles in young PUXB patients exhibit only a very mild mandibular asymmetry. Although the statistically significant mean change found right after RME removal cannot be considered clinically relevant, a more consistent sample and a longer follow-up could be of interest in explaining the short-term findings.

Keywords: CBCT; Crossbite; Facial asymmetry; Orthodontics; RME.

MeSH terms

  • Cone-Beam Computed Tomography
  • Humans
  • Malocclusion* / diagnostic imaging
  • Malocclusion* / therapy
  • Mandible / diagnostic imaging
  • Maxilla
  • Palatal Expansion Technique
  • Spiral Cone-Beam Computed Tomography*