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Title Early Expansion Therapy Eliminates Facial Asymmetries In Patients With Functional Unilateral Posterior Cross-Bite (FUPXB)
Clinical Question In young patients who have facial asymmetries with functional unilateral posterior cross-bite, what is the likelihood of eliminating these asymmetries with early expansion therapy?
Clinical Bottom Line There is moderate strength evidence to support the claim that early expansion therapy eliminates facial asymmetries in patients with functional unilateral posterior cross-bite (FUPXB).
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 11709670Pinto/200115 young patients with FUPXBCase Series
Key resultsCompensatory growth during and after early expansion therapy of children with FUPXB appeared to eliminate the positional and skeletal asymmetries observed before treatment.
Evidence Search (("Facial Asymmetry"[Mesh] AND "Malocclusion"[Mesh]) AND "Palatal Expansion Technique"[Mesh]) AND "Temporomandibular Joint"[Mesh]
Comments on
The Evidence
15 orthodontic patients with FUPXB were used for this study in which all the participants followed through. However, there was no control group for this study. Rapid palatal expansion was used on each patient. Morphological and positional symmetry of lower incisor and symphysis were measured relative to midcondylar reference plane (MCP) and midsagittal plane (MSP) before and after treatment. The results show significant changes towards symmetry with a P<.05. This study has strong internal and external validity.
Applicability The study can be applied to orthodontic patients in the mixed dentition state with FUPXB. Practitioners would know to use early expansion therapy to eliminate facial asymmetries in these patients.
Specialty/Discipline (General Dentistry) (Orthodontics)
Keywords Facial Asymmetry, Malocclusion, Crossbite, Palatal Expansion Technique, Temporomandibular Joint
ID# 2150
Date of submission: 09/30/2011spacer
E-mail shaoj@livemail.uthscsa.edu
Author Jeff Shao
Co-author(s) e-mail
Faculty mentor/Co-author Ravikumar Anthony, BDS, MDS, MS, PhD
Faculty mentor/Co-author e-mail ANTHONYR@uthscsa.edu
Basic Science Rationale
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Comments and Evidence-Based Updates on the CAT
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by Angela Yang and Brandon Key (San Antonio, TX) on 12/01/2017
A literature search performed in November 2017 found a systematic review published in 2016 by Tsanidis titled "Functional changes after early treatment of unilateral posterior cross-bite associated with mandibular shift: a systematic review." (PMID#: 26257271) The study concluded that early treatment with maxillary expansion does resolve functional unilateral posterior cross-bite (FUPXB) in young patients in terms of functionality (normalized masticatory cycle and muscle capability). These conclusions support the CAT's earlier assertion that early expansion therapy eliminates facial asymmetries in patients with functional unilateral posterior cross-bite, albeit with one caveat; the original study was actually one of the articles excluded in the new study because it measured facial asymmetry as opposed to functional asymmetry. If anything, this boosts their validity because both studies came to similar conclusions using different metrics

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