Dental arch changes comparison between expander with differential opening and fan-type expander: a randomized controlled trial

Objectives: To compare posterior crossbite correction frequency and dentoalveolar changes of the expander with differential opening (EDO) and the fan-type expander (FE).

Trial design: Two-arm parallel randomized controlled trial.

Methods: Forty-eight patients from 7 to 11 years of age were allocated into two groups. Twenty-four patients were treated with the EDO and 24 patients were treated with the FE. Block randomization was performed. The study was single blind. Digital dental models were acquired before treatment and 6 months after rapid maxillary expansion. The primary outcomes were crossbite correction rate and maxillary arch width changes. Secondary outcomes were interincisal diastema, arch perimeter, length, size and shape, and mandibular dental arch changes.

Results: The final sample comprised 24 patients (13 female and 11 male; mean initial age of 7.62 years) in the EDO group and 24 patients (14 female and 10 male; mean initial age of 7.83 years) in the FE group. The crossbites were corrected in 100 per cent of subjects from EDO group and in 75 per cent of patients in FE group. EDO showed greater increases in maxillary intermolar region (P < 0.001), while the FE demonstrated greater increases in the intercanine distance (P = 0.008). Increase in mandibular inter-first permanent molar distance was slightly greater in the EDO group (mean difference of 0.8 mm). Changes in arch length and perimeter were similar in both groups. Both expanders changed the maxillary arch shape. The post-treatment arch shape was larger in the anterior region for FE and in the posterior region in the EDO group.

Harms: Discomfort during activation was reported by 54 per cent of the participants. A temporary change in the nasal bridge was reported by one patient from FE group.

Conclusions: Maxillary arch width and shape changes were distinct between the EDO and the FE. Greater transversal increases of the anterior and posterior regions were observed for the FE and the EDO, respectively. A slightly greater mandibular spontaneous expansion was observed for the EDO only at the molar region.

Trial registration: NCT03705871.