Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.03819
Revista de Odontologia da UNESP
Original Article

Rapid maxillary expansion in the treatment of the functional posterior crossbite: joint noise and electromyographic activity analysis

Expansão rápida da maxila no tratamento da mordida cruzada posterior: análise de ruídos articulares e atividade eletromiográfica

Diego Jesus Brandariz PIMENTEL; Laís Valencise MAGRI; Melissa de Oliveira MELCHIOR; Guido Artemio MARAÑÓN-VÁSQUEZ; Mirian Aiko Nakane MATSUMOTO; Marcelo Oliveira MAZZETTO

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Abstract

Abstract: Introduction: The rapid maxillary expansion (RME) reduces the risk of developing structural and functional disorders in the stomatognathic system.

Objective: To examine the effects of the RME as a treatment for the posterior crossbite, related with the electromyographic activity of the masticatory muscles and the TMJ noises in a population of children.

Material and method: 13 girls and 7 boys, regardless of the type of malocclusion, with a mean age of 9 years old (± 3), were treated with RME. The electrovibratography analyzed the TMJ noise, and the electromyography analyzed the masticatory muscles before treatment (T0) and after three months of a short-term follow-up (T1). The comparisons of the affected and unaffected sides by the crossbite were performed using Mann-Whitney’s test, and to compare data before and after treatment the Wilcoxon’s test was used (level of significance: 5%).

Result: No significant differences were found in the parameters of joint noise in comparison to the sides affected and unaffected by the crossbite, in both T0 and T1 (p>0.05); only the side without the crossbite observed decrease in the peak amplitude of the joint noises after treatment. In the static electromyographic analysis, inter-side differences were observed before and after treatment, since the deliberate unilateral chewing showed greater asymmetry activity in T0 for both sides, which has been corrected after treatment, improving the functional chewing.

Conclusion: The proposed treatment did not lead to the occurrence of joint noises and improved the functional pattern of electromyographic activity during chewing at the end of treatment.

Keywords

Crossbite, palatal expansion technique, orthodontics, interceptive, mastication, surface electromyography, joint noise

Resumo

Resumo: Introdução: A expansão rápida da maxila (RME) reduz o risco de desenvolvimento de distúrbios estruturais e funcionais no sistema estomatognático.

Objetivo: Analisar os efeitos desta intervenção como tratamento para a mordida cruzada posterior, relacionados à ocorrência de ruídos nas articulações temporomandibulares e à atividade eletromiográfica dos músculos masseter e temporal anterior.

Material e método: 13 meninas e 7 meninos, independentemente do tipo de maloclusão, com idade média de 9 anos (±3), foram tratadas com RME. Por meio de eletrovibratografia analisou-se ruídos nas articulações temporomandibulares, e de eletromiografia de superfície a atividade dos músculos mastigatórios antes (T0) e após 3 meses do final do tratamento proposto (T1). As comparações entre os lados afetado e não afetado pela mordida cruzada foram realizadas utilizando-se o teste de Mann-Withney. As comparações de antes e após o tratamento foram realizadas pelo teste de Wilcoxon (nível de significância: 5%).

Resultado: Não houve diferença significativa na eletrovibratografia entre os lados afetado e não afetado pela mordida cruzada, tanto em T0 como em T1 (p>0.05); do lado sem mordida cruzada observou-se diminuição do pico de amplitude dos ruídos articulares após a expansão rápida da maxila (p<0.05). Na análise da eletromiografia estática foram observadas diferenças inter-lados antes e após o tratamento, uma vez que a mastigação deliberada unilateral apresentou maior atividade de assimetria em T0 para ambos os lados, o que foi corrigido após o tratamento (p<0.05), melhorando a mastigação funcional padrão.

Conclusão: O tratamento proposto para mordida cruzada posterior funcional não levou à ocorrência de ruídos articulares e melhorou o padrão funcional da atividade eletromiográfica durante a mastigação ao final do tratamento.
 

Palavras-chave

Mordida cruzada posterior, expansão rápida da maxila, ortodontia interceptativa, mastigação, eletromiografia de superfície, ruído articular

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