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

Abstract

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.