Korean J Orthod.  2024 Nov;54(6):422-431. 10.4041/kjod24.142.

Evaluation of condylar dimension and position following rapid maxillary expansion with toothor tooth-bone-borne appliances

• Eglenen MN
• Akan S
• Germec-Cakan D

• KMID: 2561603
• DOI: http://doi.org/10.4041/kjod24.142

Abstract

Objective
To assess and compare changes in the dimension and position of the mandibular condyle after tooth-borne (Hyrax) and tooth-bone-borne (Hybrid Hyrax) expansion.
Methods
Twenty-five patients who underwent expansion with either tooth-borne appliances (8 girls, 5 boys; mean age 14.3 ± 2.3 years) or tooth-bone-borne appliances (6 girls, 6 boys; mean age 13.8 ± 2.2 years) were examined. Condylar and glenoid fossa morphology before (T0) and 3 months after (T1) expansion were evaluated using cone-beam computed tomography. Condylar measurements (anterior, posterior, and superior joint spaces; condylar height, length, and width), along with sagittal and vertical skeletal and maxillary transversal measurements, were analyzed using Dolphin Imaging software. Wilcoxon and Paired t tests were used for T0 and T1 evaluations, and the Mann–Whitney U test for intergroup comparisons.
Results
At both T0 and T1, no statistically significant differences were observed between the groups in terms of condylar dimensions or the position of the condyle within the glenoid fossa. Maxillary transversal measurements increased after expansion in both groups (P < 0.01), with a significantly greater increase in first premolar width in the Hyrax group (P < 0.05). The vertical position of the posterior teeth showed no noteworthy changes (P > 0.05), except for the right second premolar. Temporomandibular joint measurements did not significantly change in either group after treatment (P > 0.05).
Conclusions
Neither tooth-borne nor toothbone-borne expansion caused significant changes in the condylar dimensions and position at the end of treatment.

Keyword

Temporomandibular joint; Expansion; Appliances; Computed tomography

Figure

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  Figure 1 A, Tooth-borne Hyrax expansion appliance. B, Tooth-bone-borne Hybrid Hyrax expansion appliance.

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  Figure 2 Linear measurements taken in the sagittal view. A, Anterior joint space; B, Posterior joint space; C, Superior joint space; D, Condylar height; E, Condylar length; F, Glenoid fossa roof thickness.

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  Figure 3 Linear measurements taken in the coronal view. A, Condylar width; B, Distal joint space; C, Middle joint space; D, Medial joint space.

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  Figure 4 Dental measurements evaluated in the axial and coronal planes; A, Transverse measurements of premolars and molars. B, C, Vertical measurements of premolars and molars.

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