Effects of Maxillary Expansion on Mastication and Muscle Activity: Case Series
DOI:
https://doi.org/10.15517/pgqccx38Keywords:
Electromyography; Palatal expansion technique; Open bite; Mastication; Children; Case reports.Abstract
This case series evaluated three children with maxillary transverse deficiency and a habitual unilateral mastication preference who were treated with rapid maxillary expansion (RME). Considering the growing recognition of functional alterations in children with transverse deficiencies, RME has been proposed as a therapeutic approach capable of remodeling skeletal structures and influencing muscular dynamics. Electromyographic activity of the bilateral masseter, temporalis, and upper and lower orbicularis oris muscles was recorded during rest, dental clenching, suction, swallowing, and non-habitual mastication at baseline (T0), six months (T1), and eighteen months (T2). By six months, transverse deficiencies were corrected in all patients, with increases in anterior and posterior arch widths and closure of the anterior open bite, and these skeletal and dental changes remained stable throughout the 18-month follow-up. Functionally, an initial increase in orbicularis oris activity and improved muscular symmetry were observed at six months; partial asymmetry reappeared at 18 months, reflecting the persistence of habitual right-sided unilateral mastication. RME produced stable skeletal and dental outcomes and promoted early functional adaptations in these three patients, but when used in isolation, it was insufficient to induce lasting modifications of their established unilateral masticatory patterns, highlighting the need for multidisciplinary management to achieve long-term functional stability.
Downloads
References
Patil G.V., Lakhe P., Niranjane P. Maxillary expansion and its effects on circummaxillary structures: A review. Cureus. 2023; 15 (1): 33755. DOI: https://doi.org/10.7759/cureus.33755
Belluzzo R.H.L., Faltin Junior K., Lascala C.E., Vianna L.B.R. Maxillary constriction: Are there differences between anterior and posterior regions? Dent Press J Orthod. 2012; 17 (4): 1-6. DOI: https://doi.org/10.1590/S2176-94512012000400009
Cerritelli L., Hatzopoulos S., Catalano A., Bianchini C., Cammaroto G., Meccariello G., et al. Rapid Maxillary Expansion (RME): An Otolaryngologic Perspective. J Clin Med. 2022; 11 (17): 5243. DOI: https://doi.org/10.3390/jcm11175243
Zhan Y., Yang M., Bai S., Zhang S., Huang Y., Gong F., et al. Effects of orthodontic treatment on masticatory muscle activity: A meta-analysis. Ann Hum Biol. 2023; 50 (1): 465-471. DOI: https://doi.org/10.1080/03014460.2023.2271840
De Rossi M., De Rossi A., Hallak J.E., Vitti M., Regalo S.C. Electromyographic evaluation in children having rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2009; 136 (3): 355-360. DOI: https://doi.org/10.1016/j.ajodo.2007.08.027
Abate A., Lanteri V, Marcolongo L., Solimei L., Maspero C. Evaluation of masticatory muscles in adult patients with maxillary hypoplasia treated with surgically assisted rapid maxillary expansion (SARME): A retrospective study. J Clin Med. 2023; 12 (2): 607. DOI: https://doi.org/10.3390/jcm12020607
Szyszka-Sommerfeld L., Sycińska-Dziarnowska M., Cernera M., Esposito L., Woźniak K., Spagnuolo G. Electromyographic assessment of muscle activity in children undergoing orthodontic treatment: A systematic review. J Clin Med. 2024; 13 (7): 2051. DOI: https://doi.org/10.3390/jcm13072051
Arat F.E., Arat Z.M., Acar M., Beyazova M., Tompson B. Muscular and condylar response to rapid maxillary expansion. Part 1: Electromyographic study of anterior temporal and superficial masseter muscles. Am J Orthod Dentofacial Orthop. 2008; 133 (6): 815-822. DOI: https://doi.org/10.1016/j.ajodo.2006.07.028
Rakosi T., Jonas I., Graber T.M. Ortodontia e Ortopedia Facial: Diagnóstico. Porto Alegre: Artes Médicas Sul, 1999.
Merletti R., Hermens H. Introduction to the special issue on the SENIAM European Concerted Action. J Electromyogr Kinesiol. 2000; 10 (5): 283-286. DOI: https://doi.org/10.1016/S1050-6411(00)00019-5
Pastana S. da G., Costa S. de M., Chiappetta A.L. de M.L. Análise da mastigação em indivíduos que apresentam mordida cruzada unilateral na faixa-etária de 07 a 12 anos. Rev CEFAC [Internet]. 2007; 9 (3): 351-357. DOI: https://doi.org/10.1590/S1516-18462007000300008
Morais-Almeida M., Wandalsen G.F., Solé D. Growth and mouth breathers. J Pediatr (Rio J) 2019; 95 Suppl 1: 66-71. DOI: https://doi.org/10.1016/j.jped.2018.11.005
Rutili V., Mrakic G., Nieri M., Franceschi D., Pierleoni F., Giuntini V., et al. Dento-skeletal effects produced by rapid versus slow maxillary expansion using fixed jackscrew expanders: a systematic review and meta-analysis. Eur J Orthod. 2021; 43 (3): 301-312. DOI: https://doi.org/10.1093/ejo/cjaa086
Zreaqat M., Hassan R., Alforaidi S, Kassim N.K. Effects of rapid maxillary expansion on upper airway parameters in OSA children with maxillary restriction: A CBCT study. Pediatr Pulmonol. 2024; 59 (10): 2490-2498. DOI: https://doi.org/10.1002/ppul.27050
Garrocho-Rangel A., Rosales-Berber M.Á., Ballesteros-Torres A., Hernández-Rubio Z., Flores-Velázquez J., Yáñez-González E., et al. Rapid maxillary expansion and its consequences on the nasal and oropharyngeal anatomy and breathing function of children and adolescents: An umbrella review. Int J Pediatr Otorhinolaryngol. 2023; 171: 111633. DOI: https://doi.org/10.1016/j.ijporl.2023.111633
Aluru Y., Rng R., Gujar A.N., Kondody R. Correlation of palatal index with pharyngeal airway in various skeletal patterns. Cureus. 2023; 15 (5): e39032. DOI: https://doi.org/10.7759/cureus.39032
Pedreira M.G., Almeida M.H.C., Ferrer K.J.N., Almeida R.C. Avaliação da atresia maxilar associada ao tipo facial. Dent Press J Orthod. 2010; 15 (3): 71-77. DOI: https://doi.org/10.1590/S2176-94512010000300009
Schwarz A.M., Gratzinger M. Removable orthodontic appliances. Philadelphia: WB Saunders, 1966.
Spolaor F., Mason M., De Stefani A., Bruno G., Surace O., Guiotto A., et al. Effects of rapid palatal expansion on chewing biomechanics in children with malocclusion: A surface electromyography study. Sensors (Basel). 2020; 20 (7): 2086. DOI: https://doi.org/10.3390/s20072086
Pignataro Neto G., Bérzin F., Rontani R.M.P. Identificação do lado de preferência mastigatória através de exame eletromiográfico comparado ao visual. Rev Dent Press Ortodon Ortop Facial [Internet]. 2004; 9 (4): 77-85. DOI: https://doi.org/10.1590/S1415-54192004000400008
Di Palma E., Tepedino M., Chimenti C., Tartaglia G.M., Sforza C. Longitudinal effects of rapid maxillary expansion on masticatory muscles activity. J Clin Exp Dent. 2017; 9 (5): e635-e40. DOI: https://doi.org/10.4317/jced.53544
Maspero C., Giannini L., Galbiati G., Kairyte L., Farronato G. Neuromuscular evaluation in young patients with unilateral posterior crossbite before and after rapid maxillary expansion. Stomatologija. 2015; 17 (3): 84-88.
Paschoal M.A.B., Gurgel C.V., Neto N.L., Kobayashi T.Y., da Silva S.M.B., Abdo R.C.C., et al. Perfi de tratamento de urgência de crianças de 0 a 12 anos de idade, atendidas no Serviço de Urgência Odontológica da Faculdade de Odontologia de Bauru da Universidade de São Paulo. Odontol Clín Cient. 2010; 9 (3): 243-247.
Tomita N.E., Bijella V.T., Franco L.J. Relação entre hábitos bucais e má oclusão em pré-escolares. Rev Saúde Pública [Internet]. 2000; 34 (3): 299-293. DOI: https://doi.org/10.1590/S0034-89102000000300014
Trawitzki L.V.V., de Felício C.M., Puppin-Rontani R.M., Matsumoto M.A.N., Vitti M. Mastigação e atividade eletromiográfica em crianças com mordida cruzada posterior. Rev CEFAC 2009; 11, Supl 3, 334-340. DOI: https://doi.org/10.1590/S1516-18462009000700008
Alshammari A., Almotairy N., Kumar A., Grigoriadis A. Effect of malocclusion on jaw motor function and chewing in children: a systematic review. Clin Oral Investig. 2022; 26 (3), 2335-2351. DOI: https://doi.org/10.1007/s00784-021-04356-y
Published
Issue
Section
License
Copyright (c) 2026 Livia Maria Alves Valentim da Silva, Daniela Micheline dos Santos, Victor Perinazzo Sachi, Beatriz Miwa Barros Nakano, Bruna Mike Barros Nakano, Marcelo Coelho Goiato, Wirley Gonçalves Assunção, André Pinheiro de Magalhães Bertoz.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
ODOVTOS - Int. J. Dent. Sc. endorses CC BY-NC-SA
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator. If you remix, adapt, or build upon the material, you must license the modified material under identical terms. CC BY-NC-SA includes the following elements:
BY: credit must be given to the creator.
NC: Only noncommercial uses of the work are permitted.
SA: Adaptations must be shared under the same terms.
Funding data
-
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Grant numbers 001 -
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Grant numbers 141068/2024-8



