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Eur J Orthod. 2019 Jan 23;41(1):46-53. doi: 10.1093/ejo/cjy019.

Evaluation of masticatory muscle activity in patients with unilateral posterior crossbite before and after rapid maxillary expansion.

Author information

School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy.
University of Toronto, Faculty of Dentistry, Discipline of Orthodontics, University of Toronto Center for The Study of Pain, Toronto, ON, Canada.



The relationship between unilateral posterior crossbite (UPCB) and the possible asymmetric activation of the jaw muscles in children is still under debate. This study aimed at evaluating the jaw muscle activity of children with UPCB before and after rapid maxillary expansion (RME) by means of surface electromyography and a standardized sampling protocol.

Subjects and methods:

Twenty-nine children with UPCB (UPCB-group, mean age 9.6 ± 1.6 years) and 40 UPCB-free controls (Control-group, 10.5 ± 1.1) were recruited. The activity of the left and right anterior temporalis (AT) and superficial masseter muscles (MM) was recorded during maximum voluntary clenching and a chewing task (T0). In the UPCB-group, data were collected, also, after the correction of the UPCB with RME (T1) and 6 months later (T2), without any further treatment. Electromyographic indices comparing the activity of paired muscle were computed via software to estimate the extent of asymmetric AT and MM activity. Paired and unpaired t-test or Wilcoxon-signed rank and Mann-Whitney U test, ANOVA or Friedman test and chi-squared test were used in the statistical analysis.


Both groups presented with asymmetric activity of the muscles, which did not differ between groups (T0, all P > 0.05). The treatment determined a decrease in muscular activity (T1, P = 0.040), and a more asymmetric pattern of muscle activation during chewing (T1, P = 0.040), which returned similar to baseline values at T2 (all P > 0.05).


UPCB does not contribute to an asymmetric activation of AT and MM during functional tasks. The treatment of UPCB by RME did not determine a more symmetric activity of the assessed muscles.


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