Effects of rapid maxillary expansion on temporomandibular joints.
OBJECTIVE
To evaluate the impact of rapid maxillary expansion (RME) on the condylar position, disc joint, joint space, and interarticular relationship in growing patients.


MATERIALS AND METHODS
A systematic search was performed in nine databases. The clinical studies selected included those with pre- and post-magnetic resonance, conventional computed tomography or cone beam tomography in growing patients. Risk of bias assessment was performed using the Cochrane Collaboration tool for controlled clinical studies and National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment for Before-After Studies With No Control Group.


RESULTS
Initially, 4303 records were identified. Only eight studies fulfilled the criteria and were included in the qualitative analysis. Of those, two were controlled clinical studies with a risk of uncertain to high bias. The remaining papers had a low to moderate risk of bias. Results showed that RME in children and adolescents promoted the following: remodeling in the head and or condylar branch, changes in condylar position and joint space, maintenance of improved symmetry between the condyles, and no ability to modify the position or shape of the articular disc.


CONCLUSIONS
RME in growing patients is able, in the short term, to modify the condyle-fossa relationship but does not change the position or shape of the articular disc. The intercondylar symmetric relationship is maintained or improved. Although the NHLBI score shows low to moderate risk of bias, the clinical relevance of these review findings is limited by Cochrane and Grades of Recommendation, Assessment, Development and Evaluation scores.
['Torres|Darlyane|D|', 'Lopes|Jéssica|J|', 'Magno|Marcela Baraúna|MB|', 'Cople Maia|Lucianne|L|', 'Normando|David|D|', 'Leão|Patrícia Botelho|PB|']
D000293:Adolescent D002648:Child D054893:Cone-Beam Computed Tomography D006257:Head D006801:Humans D008335:Mandibular Condyle D010155:Palatal Expansion Technique D013704:Temporomandibular Joint D013705:Temporomandibular Joint Disorders
Rapid maxillary expansion Temporomandibular joint Systematic review