Analysis of condylar differences in functional unilateral posterior crossbite during early treatment--a randomized clinical study.
OBJECTIVE
The analysis of potential discrepancies in condyle position among different occlusal relations (centric relation and maximum intercuspidation) is a key diagnostic component when treating children with unilateral posterior crossbite. Due to strict requirements imposed by ethics committees, and new regulations regarding the use of X-rays, radiological examinations (axial cephalometric radiographs or postero-anterior cephalometric radiographs) are not feasible. Thus the aim of this study was to apply an alternative procedure for the assessment of condylar deviations.


METHODS
: We employed ARCUS digma, a measuring system based on ultrasound technology, to record condylar differences occurring in 65 children (6.9+/-2.0 years of age) with functional unilateral posterior crossbite in late deciduous and early mixed dentition. After randomization, 31 patients underwent early orthodontic treatment (bonded palatal expansion appliance and U-bow activator), whereas 34 patients remained untreated. Examinations were carried out at the beginning (T1) and after 12 months of treatment (T2). A three-dimensional (3D) assessment of deviations between maximum intercuspidation and centric position was carried out. Statistical analysis was performed using the SPSS 12.0 software program.


RESULTS
Initially, the electronic position analysis revealed no significant differences between the control and therapy groups. A mean condylar deviation of > 2 mm was noted at T1 in the sagittal, frontal and transversal planes for crossbite and the noncrossbite sides. This difference was reduced in the therapy group, a finding that proved statistically highly significant (p<0.001). We also observed a highly significant (p<0.001) difference between the control and therapy groups at T2.


CONCLUSIONS
The Münster concept for early treatment of functional unilateral posterior crossbites in late deciduous and early mixed dentition significantly improved the treated patients' occlusion in comparison to a randomized control group, which exhibited no spontaneous self-healing tendencies.
Lippold
Carsten
C
Department for Orthodontics, University Hospital Münster, Münster, Germany. lippold@uni-muenster.de
Hoppe
Gloria
G
Moiseenko
Tatjana
T
Ehmer
Ulrike
U
Danesh
Gholamreza
G
D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000000981:diagnostic imaging* / Q000534:rehabilitation*; D008335:Mandibular Condyle / Q000000981:diagnostic imaging*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010155:Palatal Expansion Technique; D011379:Prognosis; D016896:Treatment Outcome; D014463:Ultrasonography