Palatal changes after treatment of functional posterior cross-bite using elastodontic appliances: a 3D imaging study using deviation analysis and surface-to-surface matching technique

Background: The present study aimed to evaluate the changes in palate dimension and morphology after treatment of functional posterior crossbite (FPXB) with elastodontic devices (EAs). Methods: The treatment group (TG) consisted of 25 subjects (mean age 7.3 ± 0.9 years) who received treatment with EA for one year. The control group (CG) comprised 14 untreated subjects (mean age 6.8 ± 0.7 years). Inclusion criteria: intra-oral scan registered before (T0) and after treatment (T1), FPXB with a mandibular shift towards the crossbite site of ≥ 2 mm, class I molar relationship. Exclusion criteria: missing teeth, anterior crossbite, temporomandibular disorders, previous orthodontic treatment, carious lesions, mobility of deciduous posterior teeth, craniofacial deformities. Digital models were analyzed to assess the inter-canine (ICW) and inter-molar widths (IMW) and the corresponding emi-lateral measurements (eICW and eIMW) using the median palatine plane as reference. According to a specific 3D imaging technology, the morphology and symmetry of the palate was investigated by analysing the 3D deviation between the two specular models of the palate. Results: At T0, both groups showed a significantly narrower dimension of eICW and eIMW at the crossbite side compared to the non-crossbite side (p < 0.05). Also, the 3D deviation analysis demonstrates a limited matching percentage of the original/mirrored models in both TG (81.12%) and CG (79.36%), confirming the asymmetry of the palate. The area of mis-matching was located at the alveolar bone level. At T1, subjects in the TG showed a significant increment of ICW and IMW (p < 0.05), a reduction of the differences of eICW and eIMW between both sides (p < 0.05) and an increment of the percentage matching (TG = 92.32%) (p < 0.05), suggesting a significant recovery of the palatal asymmetry. No significant changes were found between T0 and T1 in the CG (p > 0.05). Conclusions: EAs could be successfully used to correct FPXB in mixed dentition and could restore the harmonious development of the palate in children.