Early Treatment with a Slow Maxillary Ni–Ti Leaf Springs Expander

Massimiliano Vella,Cinzia Tripicchio,Luca Esposito,Paolo Cressoni,Eleonora Mainardi

doi:10.3390/app11104541

Massimiliano Vella, Cinzia Tripicchio + Show 3 more

Open Access

https://doi.org/10.3390/app11104541

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Abstract

The aim of this brief report is to analyse the available literature on the clinical outcomes of a particular appliance for slow maxillary expansion that consists of one or more nickel–titanium springs. Materials and methods: The main medical databases (Scopus, Web of Sciences, Pubmed and Google Scholar) were scanned up to January 2020 using “slow maxillary expan*”, “slow palatal expan*”, “leaf expander” and “NiTi Palatal Expander” as keywords. Skeletal changes in the maxilla after expansion with the Leaf Expander (L.E.) or similar appliances were taken into consideration while reviewing relevant manuscripts. The review focuses on the comparison between the L.E. and conventional expanders (i.e., Haas and Hyrax) regarding the increase in both the distance between the palatal cusps of the upper first molars and the distance between the palatal cusps of the upper second deciduous molars, as well as the increment of nasal structures and pain connected to expansion procedures. Results: Bibliographic research retrieved 32 articles that were considered eligible for the present study. The limited number of articles currently available in international medical databases is allegedly partly due to the fact that these expanders are currently produced by only one patent holder company, which affects its diffusion. Conclusion: Despite the reduced number of published articles, due to the recent introduction of the L.E. device, most of the authors have found that the effects of the L.E. device are clinically and radiographically comparable to those achievable with the rapid palatal expander.

Highlights

Accepted: 11 May 2021Transverse maxillary hypoplasia is one of the most frequent problems in interceptive orthodontics and one of the most studied topics in orthodontics
The limited number of articles currently available in international medical databases such as Scopus, Embase and PubMed is allegedly due to the use of two types of nickel–titanium leaf spring expander, the L.E. and L.S.E., which to date are currently produced by only one patent holder company, which affects its diffusion
Considering the slow nickel–titanium spring expander, Lanteri V. [20] demonstrates that the effects after expansion are clinically comparable to those achievable with RME by both digital model overlaps and CBCT before and after expansion

Summary

Introduction

Transverse maxillary hypoplasia is one of the most frequent problems in interceptive orthodontics and one of the most studied topics in orthodontics. This condition is frequently related to as unilateral or bilateral cross-bite and/or antero-superior crowding. Maxillary expansion is considered the gold standard to treat this type of malocclusion. It can be achieved using different types of appliances depending on the clinical defects that have to be treated [6,7,8]. The possibility to achieve palatal expansion decreases with age, so this treatment is to be executed as soon as possible, or until the median palatal suture remains fibrous. There are several orthodontic appliances leading to a maxillary expansion, which differentiate

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