{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:24:10Z","timestamp":1792041850864,"version":"4.4.0"},"reference-count":31,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,6,5]],"date-time":"2022-06-05T00:00:00Z","timestamp":1654387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomimetics"],"abstract":"<jats:p>Background: The presence of posterior crossbite can trigger aesthetic and functional changes as mandibular asymmetry in individuals, contributing to asymmetrical muscle function. Mandibular asymmetry and respective condyle adaptation may be an etiological factor in temporomandibular disorder. This study aims to evaluate the effects of maxillary expansion on the position and angulation of the condyles as well as the intercondylar distance in children with cleft lip and palate. Methods: Twenty-five individuals with cleft lip and palate who underwent maxillary expansion were selected. Condylar changes were evaluated by cone beam computed tomography using the Pullinger and Hollender formula. To determine the statistically significant differences between the variables, the Student t-test and the Benjamini\u2013Hochberg correction method for multiple comparisons were used. Results: No statistically significant differences between angulation and condylar position before and after maxillary expansion were found. The intercondylar distance tended to increase in growing individuals with cleft lip and palate after maxillary expansion. Conclusions: Intercondylar distance shows a tendency to increase after expansion regardless of the cleft phenotype. No differences were found in angulation and condylar position with the changes in occlusion resulting from maxillary expansion.<\/jats:p>","DOI":"10.3390\/biomimetics7020073","type":"journal-article","created":{"date-parts":[[2022,6,5]],"date-time":"2022-06-05T10:47:11Z","timestamp":1654426031000},"page":"73","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Condylar Changes after Maxillary Expansion in Children with Cleft Lip and Palate\u2014A Three-Dimensional Retrospective Study"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3781-226X","authenticated-orcid":false,"given":"In\u00eas Carolina","family":"Gra\u00e7a","sequence":"first","affiliation":[{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3283-5104","authenticated-orcid":false,"given":"In\u00eas","family":"Francisco","sequence":"additional","affiliation":[{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0015-8604","authenticated-orcid":false,"given":"Francisco","family":"Caramelo","sequence":"additional","affiliation":[{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal"},{"name":"Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-2929","authenticated-orcid":false,"given":"Francisco","family":"Vale","sequence":"additional","affiliation":[{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.ajodo.2013.07.009","article-title":"Condylar and ramal vertical asymmetry in adolescent patients with cleft lip and palate evaluated with cone-beam computed tomography","volume":"144","author":"Celikoglu","year":"2013","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1007\/s00784-015-1651-9","article-title":"Evaluation of the mandibular volume and correlating variables in patients affected by unilateral and bilateral cleft lip and palate: A cone-beam computed tomography study","volume":"20","author":"Celikoglu","year":"2016","journal-title":"Clin. Oral Investig."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1002\/sca.21320","article-title":"Evaluation of temporomandibular fossa and mandibular condyle in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography","volume":"38","author":"Buyuk","year":"2016","journal-title":"Scanning"},{"key":"ref_4","first-page":"11","article-title":"Embryology and epidemiology of cleft lip and palate","volume":"2","author":"Bernheim","year":"2006","journal-title":"B-ENT"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1159\/000337617","article-title":"Roles of BMP signaling pathway in lip and palate development","volume":"16","author":"Parada","year":"2012","journal-title":"Front. Oral Biol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Francisco, I., Francisco, C., Fernandes, M.H., and Vale, F. (2021). Parental Risk Factors and Child Birth Data in a Matched Year and Sex Group Cleft Population: A Case-Control Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094615"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1002\/ajmg.c.31381","article-title":"Genetics of cleft lip and cleft palate","volume":"163C","author":"Leslie","year":"2013","journal-title":"Am. J. Med. Genet. C Semin. Med. Genet."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/bdra.20081","article-title":"Periconceptional multivitamin intake during early pregnancy, genetic variation of acetyl-N-transferase 1 (NAT1), and risk for orofacial clefts","volume":"70","author":"Lammer","year":"2004","journal-title":"Birth Defects Res. A Clin. Mol. Teratol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1597\/06-151.1","article-title":"Folate and clefts of the lip and palate-a U.K.-based case-control study: Part II: Biochemical and genetic analysis","volume":"45","author":"Little","year":"2008","journal-title":"Cleft Palate Craniofac. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1093\/aje\/kwq226","article-title":"Maternal alcohol consumption, alcohol metabolism genes, and the risk of oral clefts: A population-based case-control study in Norway, 1996\u20132001","volume":"172","author":"Boyles","year":"2010","journal-title":"Am. J. Epidemiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s13643-017-0438-2","article-title":"Post-operative outcomes after cleft palate repair in syndromic and non-syndromic children: A systematic review protocol","volume":"6","author":"Zhang","year":"2017","journal-title":"Syst. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1097\/00006534-199705010-00010","article-title":"Fistula formation and repair after palatal closure: An institutional perspective","volume":"99","author":"Emory","year":"1997","journal-title":"Plast Reconstr. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.4103\/jfmpc.jfmpc_472_20","article-title":"Cleft of lip and palate: A review","volume":"9","author":"Vyas","year":"2020","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1016\/j.jcms.2015.04.015","article-title":"A comparative cephalometric study for adult operated cleft palate and unoperated cleft palate patients","volume":"43","author":"Ye","year":"2015","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"59","DOI":"10.4103\/2278-0203.160236","article-title":"Effect of cleft lip palate repair on craniofacial growth","volume":"4","author":"Naqvi","year":"2015","journal-title":"J. Orthod. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1093\/ejo\/cjp140","article-title":"Three-dimensional geometric morphometrics applied to the study of children with cleft lip and\/or palate from the North East of England","volume":"32","author":"Bugaighis","year":"2010","journal-title":"Eur. J. Orthod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1007\/s00784-016-1943-8","article-title":"Slow versus rapid maxillary expansion in bilateral cleft lip and palate: A CBCT randomized clinical trial","volume":"21","author":"Ozawa","year":"2017","journal-title":"Clin. Oral Investig."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"638","DOI":"10.2319\/110217-749.1","article-title":"Positional and dimensional temporomandibular joint changes after correction of posterior crossbite in growing patients: A systematic review","volume":"88","author":"Ellabban","year":"2018","journal-title":"Angle Orthod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1597\/15-280","article-title":"Cone beam computed tomographic evaluation of mandibular asymmetry in patients with cleft lip and palate","volume":"55","author":"Paknahad","year":"2018","journal-title":"Cleft Palate-Craniofac. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s00056-008-0803-9","article-title":"Analysis of condylar differences in functional unilateral posterior crossbite during early treatment--a randomized clinical study","volume":"69","author":"Lippold","year":"2008","journal-title":"J. Orofac. Orthop."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.coms.2020.01.011","article-title":"Orthodontics for Unilateral and Bilateral Cleft Deformities","volume":"32","author":"Parsaei","year":"2020","journal-title":"Oral Maxillofac. Surg. Clin. N. Am."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"American Academy of Oral and Maxillofacial Radiology (2013). Clinical recommendations regarding use of cone beam computed tomography in orthodontics. Position statement by the American Academy of Oral and Maxillofacial Radiology. Oral Surg. Oral Med. Oral Pathol. Oral Radiol., 116, 238\u2013257.","DOI":"10.1016\/j.oooo.2013.06.002"},{"key":"ref_23","first-page":"e891","article-title":"Condylar response to large mandibular advancement combined with maxillary impaction and counterclockwise rotation: A computed tomographic study","volume":"10","author":"Vale","year":"2018","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1177\/0013164403260195","article-title":"A measure of agreement for interval or nominal multivariate observations by different sets of judges","volume":"64","author":"Janson","year":"2004","journal-title":"Educ. Psychol. Meas."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.1016\/j.joms.2013.06.213","article-title":"Short- and long-term changes of condylar position after bilateral sagittal split ramus osteotomy for mandibular advancement in combination with le fort i osteotomy evaluated by cone-beam computed tomography","volume":"71","author":"Chen","year":"2013","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.ajodo.2006.04.041","article-title":"Condylar asymmetry in unilateral posterior crossbite patients","volume":"133","author":"Kilic","year":"2008","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.2319\/112211-725.1","article-title":"Condyle fossa relationship associated with functional posterior crossbite, before and after rapid maxillary expansion","volume":"82","author":"Leonardi","year":"2012","journal-title":"Angle Orthod."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"607","DOI":"10.2319\/101105-360","article-title":"Ultrasonographic thickness of the masseter muscle in growing individuals with unilateral crossbite","volume":"77","author":"Kiliaridis","year":"2007","journal-title":"Angle Orthod."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.5005\/jp-journals-10024-2404","article-title":"Effect of rapid maxillary expansion on condyle-fossa relationship in growing patients","volume":"19","author":"Ghoussoub","year":"2018","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Fastuca, R., Turiaco, H., Assandri, F., Zecca, P.A., Levrini, L., and Caprioglio, A. (2021). Condylar Changes in Children with Posterior Crossbite after Maxillary Expansion: Tridimensional Evaluation. Children, 8.","DOI":"10.3390\/children8010038"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"280","DOI":"10.2319\/0003-3219(2007)077[0280:BAOMEI]2.0.CO;2","article-title":"Biomechanical analysis of maxillary expansion in CLP patients","volume":"77","author":"Holberg","year":"2007","journal-title":"Angle Orthod."}],"container-title":["Biomimetics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2313-7673\/7\/2\/73\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:24:41Z","timestamp":1760138681000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2313-7673\/7\/2\/73"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,5]]},"references-count":31,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["biomimetics7020073"],"URL":"https:\/\/doi.org\/10.3390\/biomimetics7020073","relation":{},"ISSN":["2313-7673"],"issn-type":[{"value":"2313-7673","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,5]]}}}