Changes in condylar position with maxillary expansion in growing patients. A systematic review of clinical studies

ABSTRACT Purpose:The aim of the present systematic review was to assess the association between maxillary expansion (ME) and changes in condylar position in growing patients, including patients with functional unilateral posterior crossbite (FUPC), patients with bilateral posterior crossbite (BPC) and patients who have maxillary transverse deficiency (MTD) without posterior crossbite (PC). Materials and methods: Indexed databases were searched up to March 2019, and the following eligibility criteria were imposed: (a) original clinical studies; (b) growing patients; (c) intervention: influence of ME on condylar position; (d) radiographic evaluation of condylar position before and after ME; and (e) statistical analysis. Experimental studies, historic reviews, case reports, cases-series, letters to the Editor, commentaries, studies that did not specify the type of posterior crossbite (PC), studies that included combined ME-facemask intervention, and studies in adult patients were excluded. Quality assessment was performed using the Methodological Index for Non-Randomized Studies (MINORS) guidelines. Results:Eleven clinical studies were selected for data extraction. In 3 studies, significant changes in condylar position were observed bilaterally with ME in patients with FUPC. One study showed significant changes in condylar position with ME only in the non-crossbite sides; and 2 studies found no significant changes in condylar position with ME in patients with FUPC. One study reported significant changes in condylar position in both sides with ME in patients with bilateral PC. In patients without PC, 1 study showed significant changes in condylar position bilaterally with ME; and 2 studies reported no significant changes in condylar position. The mean MINORS score was 13.8 2.89 (out of 24). Conclusion:The association between ME and changes in condylar position in growing patients remains debatable.