Masseter muscle thickness before and after the correction of unilateral functional posterior crossbite in growing individuals: a prospective controlled clinical trial

Abstract Objectives To evaluate whether unilateral functional posterior crossbite in growing children creates an asymmetry in masseter muscle thickness and whether this asymmetry is normalized after crossbite correction. Materials and methods Two groups of growing individuals were studied prospectively: (i) a treatment group: children with unilateral functional posterior crossbite, undergoing crossbite correction with maxillary expansion; and (ii) a control group: children without transversal malocclusions and orthodontic treatment. The thickness of the masseter muscles was measured bilaterally using ultrasonographic recordings at three time points: pre-treatment (T0); 9 months after (T1); and 30 months after posterior crossbite correction (T2); and at equivalent time points in the control group. Differences within and between the groups were evaluated using paired and unpaired t-tests respectively. Results It was found that the thickness of the masseter muscles in patients with unilateral functional posterior crossbite was significantly thinner on the crossbite side (P = .013) by 0.5 mm. At T1, the masseter muscle of the treated crossbite side was thicker than that of the previous normal side (0.3 mm difference; P = .046) while this difference disappeared at T2 (P > .05). Limitations The lack of the inclusion of an untreated posterior crossbite group, and the heterogeneity in appliances used are the principal limitations of this study. Conclusions The masseter muscles in untreated individuals with unilateral functional posterior crossbite are thinner in the crossbite side than in the contralateral non-crossbite side. This muscular asymmetry however is eliminated some time after successful treatment of this malocclusion, possibly due to the bilateral symmetrization of the activity of the elevator masticatory muscles.