Palatal Expansion Research Articles

Association between narrow palate and respiratory function in children: a literature review

Changes in the airways and dentoalveolar system are one of the most challenging aspects of modern practical and theoretical dentistry. Nasal breathing is essential for the normal development of the maxillofacial area. During a child’s growth, the respiratory tract and facial skull development are closely linked. The main stage of dentoalveolar system development occurs during preschool and elementary school years. Nasal breathing disorders are currently widespread in this age group. Dental professionals are frequently the first to detect these disorders. A dental professional can then inform parents on the potential causes and consequences of habitual mouth breathing, justify the need for treatment and prevention of this pathology, and refer a child to an ENT specialist. The review examines the association between narrow palate and respiratory function in children. Domestic and international studies addressing the association between dentoalveolar system pathologies and respiratory patterns and functional parameters were analyzed. The studies present a variety of opinions: some authors confirm the association between narrow palate and mouth breathing, while others refute it. Moreover, changes in respiratory function parameters following rapid palatal expansion have been analyzed, emphasizing the importance of timely orthodontic treatment to improve breathing.

Treatment Stability and Intermolar Width Changes in Patients Undergoing Surgically Aided Rapid Palatal Expansion: A Systematic Review

Introduction: The primary objectives of this systematic review were to critically evaluate clinical research assessing the stability of treatment outcomes following surgically aided rapid palatal expansion (SARPE) and to review published studies on intermolar width measurements taken before and after the treatment.Materials and Methods: A complete search across the electronic databases of the Cochrane Library, Google Scholar, PUBMED, Europe PMC and Science Direct, and a complimentary manual search of all orthodontic journals until 2024 were carried out. Selection criteria were used in the evaluation of the articles.Selection Criteria: Based on the PICOS (population, intervention, comparison, outcome, study design), the inclusion criteria were established. Adult patients with constricted maxillary arches and resulting transverse discrepancies were included in the study, and SARPE was carried out to address this clinical problem. Although many studies have been conducted on this topic, only randomized clinical trials were covered in this review. Excluded from this review were case reports, conference papers, animal experiments, in vitro research, case series, and FEM studies.Data Collection and Analysis: The primary outcome of the systematic review was the assessment of treatment stability and intermolar width changes in patients who underwent surgically aided rapid palatal expansion (SARPE). The selection of studies and data collection were conducted using standard methodological techniques. The assessment of the risk of bias was conducted, and the results were synthesized. Cochrane Risk of Bias was used for evaluating the outcomes obtained in the various studies. They were assessed by the GRADE protocol for Outcome Assessment for listing the parameters studied.Results: No significant difference in stability was noted between the two groups.Conclusion: With adequate literature review and outcome assessment, it can be concluded from this review that weak evidence exists to conclusively prove the stability of SARPE in the inter-molar and inter-first premolar regions. Immediate post-surgical stability is dependent on a variety of factors that have not been standardized in the various RCTs. Further well-designed trials that establish the extent of transverse discrepancies along with defining the obtained results with clarity are required before we obtain sufficiently conclusive outcomes.

Comparative efficacy of microimplant-assisted rapid palatal expansion versus surgically assisted rapid palatal expansion in the treatment of maxillary transverse discrepancy

Background: The maxillary transverse discrepancy is an arch-length reduction that has an unsatisfactory effect on the aesthetics of the face and position while resulting in functional damage. Because of these variations, the goal of this study is to assess the efficacy, stability, and potential adverse effects of Microimplant-Assisted Rapid Palatal Expansion (MARPE) and Surgically Assisted Rapid Palatal Expansion (SARPE) in MTD in adolescents and adults. Methods: An electronic search was conducted in five distinct databases, and the findings contained only peer-reviewed literature from 2018 to 2024. Randomised controlled studies comparing the efficacy of MARPE and SARPE in inducing skeletal and dental alterations, treatment stability, and relapse rates were among the study selection criteria. Data extraction included a review of patient demographics, types of therapies provided, outcomes obtained, and side effects noted. Results: The findings of the study demonstrate that both procedures are appropriate for the treatment of MTD, but MARPE provides advantages in terms of morbidity and patient satisfaction, whilst SARPE may provide faster and more stable outcomes in some circumstances. This study encourages doctors to consider individual patient needs before determining which maxillary transverse discrepancy treatment strategy to use. Conclusion: This study discovered that the MARPE has superior skeletal results and stability than the SARPE, albeit with a higher risk of surgical complications. It is critical to ensure that the unique patient population is carefully selected.

Cephalometric variation of vertical dimension in patients treated with hyrax-type and McNamara-type rapid palatal expander. Study on latero-lateral teleradiography

To analyze changes in the vertical dimension of the lower third of the face studied on teleradiograph in L-L following rapid palatal expansion achieved by four-band Hyrax-type rapid palatal expander (RPE) and by acrylic-bonded McNamara RPE to identify the most appropriate therapeutic choice based on the patient's facial growth pattern. 30 patients were selected, of whom 20 (9 males and 11 females with a mean age of 8.285 ± 1.216) were treated using McNamara RPE (Group D), and 10 (6 males and 4 females with a mean age of 8.562 ± 1.152) were treated with Hyrax RPE (Group B), for an average treatment time T0-T1 of 0.96 ± 0.501 years. According to Tweed and Ricketts, Cephalometric tracings obtained from lateral cephalograms at T0 and T1 were analyzed to study changes in the vertical dimension of the lower third of the face. For this purpose, 6 cephalometric landmarks were considered: convexity (distance of point A to the NPg plane), Ricketts’ total face height (angle between the NBa plane and Xi-Pm plane), lower face height (angle between the ANS and Xi-Pm planes), facial axis (angle between the NaBa plane and PtGn plane), ANB angle, and FMA angle. No statistically significant differences were found between the measurements at T0 and T1 for any of the 6 cephalometric measurements considered, neither within the single groups nor when comparing the two. However, a greater increasing trend was found for some variables between the two groups, such as Ricketts' total facial height, lower facial height, and FMA angle, although not statistically significant. Hyrax and McNamara's RPEs have provided minimal changes in the vertical component during palatal expansion treatment, thus demonstrating their ability to preserve the vertical dimension of the face. Therefore, there are no contraindications for using either appliance for patients with dolichofacial growth patterns.

Miniscrew-Assisted Rapid Palatal Expansion: A Scoping Review of Influencing Factors, Side Effects, and Soft Tissue Alterations

Miniscrew-Assisted Rapid Palatal Expansion: A Scoping Review of Influencing Factors, Side Effects, and Soft Tissue Alterations

Effect of Anchorage Modifications on the Efficacy of Miniscrew-Assisted Rapid Palatal Expansion: A Systematic Review and Meta-Analysis

Effect of Anchorage Modifications on the Efficacy of Miniscrew-Assisted Rapid Palatal Expansion: A Systematic Review and Meta-Analysis

The Success of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in Adult Orthodontics: A Literature Review

This literature review examines the success and effectiveness of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in adult orthodontics. Traditional methods like Surgically Assisted Rapid Palatal Expansion (SARPE) have been commonly used for treating transverse maxillary deficiencies in adults, but they come with significant drawbacks, including higher biological and financial costs. MARPE, which utilizes mini screws to apply controlled forces for palatal expansion, offers a less invasive and more precise alternative. The review analyzes several studies and reports on MARPE's success in expanding skeletal and dental structures, improving respiratory function in obstructive sleep apnea (OSA) patients, and minimizing complications like unwanted tooth movement. Despite some challenges, such as asymmetrical expansion, MARPE has demonstrated a high success rate in adult orthodontics and presents a promising treatment option. Further high-quality, long-term studies are recommended to optimize treatment protocols and evaluate potential risks.

Analysis of literature about methods of maxillary expansion

INTRODUCTION. There is an analysis of the literature data on existing methods of maxillary expansion in this article. AIM. To analyze the published data about constriction of the upper jaw and treatment methods.MATERIALS AND METHODS. As part of this work, a bibliographic search was conducted in the following electronic databases: eLibrary, PubMed, Web of Science and Google Scholar. The following keywords were used in the search: “narrowing of the upper jaw”, “expansion of the upper jaw”, “crowded position of teeth”, “palatal suture”, “devices for rapid palatal expansion”, “hybrid devices”, “orthodontic devices”. A manual method of searching for information was also applied. The analysis included articles mentioning information about the treatment of patients with constriction of the upper jaw.RESULTS. After reviewing and analyzing the articles, according to the criteria described earlier, several publications were identified that meet the inclusion criteria, among which a number were submitted by foreign authors.CONCLUSIONS. In the process of choosing a treatment method for a patient with a narrowing of the upper jaw, it is necessary to pay attention to the stage of maturation of the palatal suture when planning orthodontic treatment, as well as apply modern methods of maxillary expansion in practice, which have a less traumatic effect on the maxillary jaw. Analysis of literature has shown that the usage of hybrid devices based on miniimplants can reduce the negative effects leading to complications, however, in the course of our work, it was determined that for a more detailed consideration of this type of treatment, it is necessary to analyze a larger number of clinical cases and literature.

Mini screw Assisted Rapid Palatal Expansion (MARPE) Application and Impact Evaluation Review

Abstract: A maxillary transverse deficit is one of the most frequent craniofacial issues. Rapid palatal expansion (RPE) has historically been recommended for the treatment of children and early adolescents. However, due to the ossification of facial sutures, this procedure is inappropriate for late teens or adults. The surgical method known as surgically aided rapid palatal expansion (SARPE) was first recommended for this group of individuals; however, the presence of morbidity is related to the surgical process. Micro-implant-assisted rapid palatal expansion (MARPE) has been used to enable maxillary expansion in skeletally mature patients. Through a discussion of its history, indications, treatment effects, stability, and limits in the existing body of research, the purpose of this article is to explore the function that MARPE plays in clinical orthodontics.

Miniscrew-assisted Rapid Palatal Expansion Before Orthognathic Surgery for a Patient With Laterognathia

In this case report, a 19-year-old male patient with maxillary transverse deficiency, concave profile, and facial asymmetry is presented. In the case of transversal insufficiency, nonsurgical maxillary expansion was performed with the miniscrew-assisted rapid palatal expansion (MARPE) appliance to reduce the number of surgeries and provide both dentoalveolar and skeletal expansion. The periodontal soundness and short-term stability of the maxillary expansion were confirmed both clinically and radiologically. Mandibular prognathism was later corrected with orthognathic surgery. MARPE is an effective approach to the treatment of maxillary transverse deficiencies in adult patients.

Cone beam computed tomography changes upon oral appliance therapy for adult patients with obstructive sleep apnea: A non-randomized clinical trial.

Obstructive sleep apnea (OSA) is caused by narrowing or obstruction of the airway lumen at single or multiple levels of the airway, starting from the nasal cavity up to the larynx. Oral appliance therapy for the management of OSA is prescribed as an alternative treatment option for patients with mild to moderate OSA who fail to adhere to Continuous Positive Airway Pressure (CPAP) therapy. Treatment with oral appliances addresses the craniofacial deficiencies that cause OSA by providing means to mandibular advancement and palatal expansion, thus opening the airways and potentially preventing airway collapse during sleep. Imaging the upper airway is employed to investigate the narrowing or the obstruction in the airway. Three-dimensional imaging modalities such as cone beam computed tomography (CBCT) allow for detecting obstructions before commencing treatment and for evaluating changes in the upper airway dimensions after treatment. To evaluate the effect of the biomimetic oral appliance therapy (BOAT) device on the airway measurements taken from a CBCT before and after treatment in correlation with the changes in the AHI. A non-randomized clinical trial. About 17 patients with mild-moderate OSA (9 males, 8 females; age, mean [SD]: 45.76 [10.31]) underwent BOAT therapy. Subjects had 2 months of follow-up visits, including examinations for progress and adjustment of the appliances. The mean apnea-hypopnea index (AHI) with no appliance in the mouth before BOAT and after treatment was recorded. The midpalate screw mechanism of the appliance was advanced once per week. The subjects were asked to wear the appliance for 10 to 12 h/d and night. Pre and Post CBCT were taken. Paired T-test was used to analyze the results. The treatment duration was 15.4 ± 6.3 months. Before treatment, at the diagnosis stage, the mean AHI of the sample (n = 17) was 24.0. After treatment, the mean AHI fell by 5% to 22.8% (P = .019), indicating enhanced upper airway functions. Airway measurements from the CBCT were not statistically significant despite improvement in the polysomnographic parameters. CBCT is a valuable tool for airway assessment and the determination of upper airway anatomic risk factors for OSA.

Orthodontists' Knowledge and Perception of the Prolonged Use of Rapid Palatal Expanders (RPEs) in the Saudi Arabian Population: A Cross-Sectional Study.

Background Orthodontic expansion using a rapid palatal expander (RPE), initiated early in life, is one approach to treating malocclusions. However, prolonged RPE use leads to negative consequences. The study aims to determine the perception and experience of orthodontists related to the prolonged use of RPEand their management. Methods A cross-sectional study was conducted among orthodontists (n = 1,125) in Saudi Arabia using an online survey. The questionnaire consisted of two sections. Section A included personal and demographic details, while Section B contained questions regarding participants' perception, knowledge, and experience related to the prolonged use of RPEand their management protocols among children aged 6 to 14 years. To assess differences in participants' perceptions and work experiences, including their approach toward tele-dentistry, the Chi-Square test was employed. Results The most prevalent reason for patients' prolonged usage of RPE was missing appointments due to multiple reasons, such as negligence, traveling (13.6%), or COVID-19 (9.6%). Among the types, the banded RPE was the most used (68.8%). The most common complications included buccal tipping of posterior teeth (72%), over-expansion (39.2%), and extrusion (25.6%). Conclusions Most orthodontists used a banded type of RPE, and the most common complication was buccal tipping of posterior teeth. There were no significant differences in complications when banded or bonded RPEs were used. The use of tele-dentistry and additional appliances to treat complications was reported by half of the participating orthodontists.

Effect of treatment of transverse maxillary deficiency using rapid palatal expansion on oral health-related quality of life in children: complementary results for a controlled clinical trial.

To evaluate the effect of rapid palatal expansion (RPE) using Haas-type expanders on children's oral health-related quality of life (OHRQOL) and compare said effect with that previously reported for the use of Hyrax-type expanders. Forty participants aged 8-10 years with transverse maxillary deficiency were treated using Haas appliances. OHRQOL was measured using the CPQ8 - 10 before RPE, during RPE (T1), at the end of RPE (T2), and 1 month after appliance removal (T3). Generalized mixed models were fitted to assess the effect of the Haas-type expander compared to previously collected data (a nontreated and a Hyrax-type expander-treated group). RPE with Haas-type appliances had a negative impact on overall OHRQOL at T1 and T2 (P = 0.001), and a positive impact at T3 (P = 0.001). The Haas-type expander had a significantly greater negative impact on OHRQOL than the Hyrax-type appliance during RPE. At T1, overall scores using the Haas-type expander were 1.08 times the scores using the Hyrax-type expander (i.e., 8% increase; 95% CI, 1.01-1.17; P = 0.033). Patients using the Haas appliance had 1.24 times the scores of those using Hyrax-type devices for the oral symptoms domain at T1 (i.e., 24% increase; 95% CI, 1.06-1.46; P = 0.009). Correction of the transverse maxillary deficiency by RPE using the Haas appliance in children 8-10 years improves OHRQOL. The Haas- and Hyrax-type devices temporarily worsen OHRQOL during treatment, however, the negative impact is less with the Hyrax-type expander than with the Haas-type expander, because it causes fewer negative oral symptoms. From a patient-centered perspective, the use of the Hyrax over the Haas appliance may be suggested as it causes less negative oral symptoms during use.

Reconstruction of Pathology Induced Anterior Maxillary Defect: A Case Report

A cyst is defined as a pathologic cavity lined by epithelium. Nasopalatine duct cysts (NPDC) are of non-odontogenic origin arising from epithelial remnants from two embryonic nasopalatine ducts. These cysts may form anywhere along the ducts’ course, which runs from posterior palatal midline to the soft tissue palatine papilla also known as the incisive papilla. NPDC often develop between the 4th and 5th decades of life with men being affected more than women (2:1 ratio). They are typically asymptomatic but present with palatal swelling in the anterior maxillary region. Larger cysts may create a labial expansion in addition to a midpalate expansion which is usually compressible due to resorption of bone beneath the mucosa. Radiography often shows a well demarcated round or pear-shaped radiolucency superimposed on the incisive canal, tooth displacement or divergence of roots may be observed. This pathology is usually greater than 6mm in size which differentiates it from the incisive canal. Differential diagnoses often include a periapical granuloma or radicular cyst from nonvital central incisors, however a palatal radiolucency and expansion represents a NPDC until proven otherwise. Typical treatment includes enucleation and curettage with low recurrence rates.

In-silico evaluation of orthodontic miniscrew-assisted rapid palatal expanders for patients with various stages of skeletal maturation

This study aimed to use a finite element method to assess the stress on the miniscrews, skeletal and dental changes resulting from maxillary expansion using either a tooth-bone-borne (TBB) or a bone-borne (BB) device on patients with various skeletal maturation. Two types of expanders were modeled using SolidWorks. The design of the 2 expanders was similar, with the exception that the BB appliance lacked support for teeth (rods and bands). Both were placed on the palatal bones with the help of 4 miniscrews as bony anchorage. Five skeletal maturation stages were examined using suture maturation classification by Angelieri. A lateral displacement of 0.2 mm was applied to simulate 1 turn of jackscrew per day. The dental and skeletal changes from the treatment were quantified. Stage A sutural maturation exhibited the greatest skeletal movement (0.13 mm/d) with a V-shaped displacement pattern. Stages B and C exhibited a more parallel expansion pattern. Stages D and E exhibited the least amount of skeletal movement with either device. Compared with the BB device, TBB demonstrated greater dental displacement. On average, the BB device exhibited a skeletal-to-dental expansion ratio of 70% from stage A to C compared with 49% with the TBB device. BB device showed more skeletal displacement than TBB, and the latter showed more dental side effects, particularly during stages B and C. The miniscrew-assisted rapid palatal expansion appliance was effective with sutural maturation stages A to C using the classification by Angelieri with a more parallel separation of the midpalatal sutures in stages B and C.

Effects On Palatal Surface Area In Mixed Dentition Patients Treated With Leaf Expander And Rapid Palatal Expander, Compared To Untreated Subjects: A Randomised Clinical Trial.

To evaluate palatal surface effects induced by LE and RPE, alongside spontaneous changes in an untreated group, and to compare differences in canine and molar inclination among the three groups. This randomised clinical trial aimed to compare digital models pre- and post-treatment over 12 months in patients receiving tooth-borne Leaf Expander® (LE) and tooth-borne Hyrax-type maxillary expander (RPE) treatments, alongside untreated patients. Analysis included 24 LE patients (13 males, 11 females, mean age 8.5±1.5), 22 RPE patients (10 males, 12 females, mean age 7.9±1.6), and 17 untreated subjects (7 males, 10 females, mean age 8.1±1.2). Inclusion criteria comprised indications for maxillary expansion treatment, mixed dentition, CVMS ≤ 3, erupted first molars, and good oral hygiene. Digital models were obtained using an intraoral scanner pre- and post-treatment. Palatal surface, segmented into anterior, median, and posterior zones, and canine/molar inclination were measured at T0-T1 using VAM software as the primary and secondary endpoint. Statistical analyses involved paired-sample T-tests for intra-group comparisons and ANOVA tests with Bonferroni correction for inter-group comparisons. No significant difference in palatal surface increment was found between the two experimental groups (LE and RPE); both demonstrated a significant increase in palatal surface. The greatest increment occurred in the median palate zone for both experimental groups. The increment in the untreated control group was not significant. Furthermore, the RPE group showed a greater inclination of permanent molars compared to those treated with LE, indicating that expansion with lighter and continuous forces may lead to fewer dental side effects.

Presurgical Maxillary Segmented Orthodontics Associated With 3-Piece Le Fort 1 Osteotomy for Palatal Expansion.

The aim of this study is to assess maxillary transverse dimension following presurgical maxillary segmented orthodontics associated with 3-piece Le Fort 1 osteotomy in a cohort of "long face syndrome" patients with palatal constriction. Patients with maxillary transverse insufficiency were retrospectively included. They all underwent maxillary segmented orthodontics followed by a 3-piece Le Fort 1 osteotomy with palatal expansion. Palatal width dimensions were collected preoperatively, postoperatively, and at the time of the final follow-up, the stability of the expansion was analyzed. Nineteen patients were included. There was no complication. The mean postoperative expansion was 6 mm (range: 3.1-8.7mm) in the canine region and 4.3mm (range: 0-9.1mm) in the second molar region. The mean relapse was 0.36mm (range: 0-1.4mm) or 6% (range: 0%-16.1%) in the canine region and 0.17mm (range: 0-1.3mm) or 4% (range: 0%-14%) in the second molar region. Presurgical maxillary segmented orthodontics with 3-piece Le Fort 1 osteotomy has shown high stability of the maxillary transverse dimension in a 1-step surgery without dental tipping. It should be considered as an alternative to rapid palatal expansion.

Mechanically induced M2 macrophages are involved in bone remodeling of the midpalatal suture during palatal expansion

BackgroundPalatal expansion is a common way of treating maxillary transverse deficiency. Under mechanical force, the midpalatal suture is expanded, causing local immune responses. This study aimed to determine whether macrophages participate in bone remodeling of the midpalatal suture during palatal expansion and the effects on bone remodeling.MethodsPalatal expansion model and macrophage depletion model were established. Micro-CT, histological staining, and immunohistochemical staining were used to investigate the changes in the number and phenotype of macrophages during palatal expansion as well as the effects on bone remodeling of the midpalatal suture. Additionally, the effect of mechanically induced M2 macrophages on palatal osteoblasts was also elucidated in vitro.ResultsThe number of macrophages increased significantly and polarized toward M2 phenotype with the increase of the expansion time, which was consistent with the trend of bone remodeling. After macrophage depletion, the function of osteoblasts and bone formation at the midpalatal suture were impaired during palatal expansion. In vitro, conditioned medium derived from M2 macrophages facilitated osteogenic differentiation of osteoblasts and decreased the RANKL/OPG ratio.ConclusionsMacrophages through polarizing toward M2 phenotype participated in midpalatal suture bone remodeling during palatal expansion, which may provide a new idea for promoting bone remodeling from the perspective of regulating macrophage polarization.

Tricortical versus bicortical anchorage in a double-screw tandem skeletal expander and a single-screw maxillary anchorage rapid palatal expander: A finite element analysis.

This study aims to employ finite element method (FEM) analysis to compare the differences between bicortical and tricortical anchorage of the posterior miniscrews in a single-screw miniscrew-assisted rapid palatal expansion (MARPE) and a double-screw tandem skeletal expander (TSE) under open and closed suture conditions. A cone beam computed tomography of the human skull of a 21.5-year-old female was utilized as a model for creating a FEM analysis. Simulations involved the insertion of four palatal miniscrews: two anterior ones with bicortical anchorage and two posterior ones (one with bicortical and another with tricortical anchorage), under open and closed suture conditions in a single-screw MARPE and double-screw TSE, resulting in a total of eight different simulation configurations. Evaluation parameters include total deformation (mm), Von Mises stress (MPa), and strain for each miniscrew body. Tricortical anchorage of the posterior miniscrews provides greater anchorage, higher stress, and deformation on the anterior miniscrews in single-screw MARPE. Tricortical anchorage combined with a double-screw TSE promotes a more even distribution of force and stress on miniscrews under open suture conditions, leading to a parallel midpalatal suture opening along its entire length and height. FEM analysis revealed favorable midpalatal suture opening with equal force distribution and less stress when posterior tricortical anchorage in conjunction with double-screw TSE is applied.

Forecasting changes in oral hygiene levels using the API index with different orthodontic appliances

Relevance. The prevalence of various types of orthodontic pathology among the Russian population is quite high. Depending on the region, malocclusion are registered in 30.9% to 76.5% of cases. The high prevalence of orthodontic pathology and the unresolved issues related to both the pathology itself and the presence of concomitant diseases indicate the necessity for personalized methods of prevention and treatment of malocclusion during both the primary and mixed dentitions, which in 70-84% of cases are treated using both removable and fixed orthodontic appliances.Materials and methods. An observational study was conducted to identify factors contributing to the increased intensity of caries among children aged 6 to 11 with orthodontic pathology. The study evaluated the characteristics of hygiene knowledge and skills, as well as the Approximal Plaque Index (API), in children using various orthodontic appliances. To assess hygiene knowledge levels, a survey was administered to two groups of children aged 6-11: those undergoing orthodontic treatment and those who visited the dental clinic for a routine check-up and were diagnosed with orthodontic pathology. The questionnaire included questions about the primary and supplementary tools and practices for daily oral hygiene, the frequency of hygiene activities, and the patients' awareness of the importance of professional oral hygiene.Results. Factors that statistically significantly influence the level of hygiene and the Approximal Plaque Index (API) were identified. A computer program was developed to forecast the dynamics of oral hygiene levels (based on the API index) when using different orthodontic appliances. An algorithm for predicting changes in the API hygiene index was created, considering the use of orthodontic appliances, oral status, adherence to hygiene procedures, presence of harmful habits, and dietary behaviors. Negative factors significantly impacting hygiene levels include bruxism and daily consumption of sweets, while positive factors include adherence to the recommended frequency and duration of tooth brushing (at least twice a day) and the use of a medium-hard toothbrush when permanent teeth are erupting. During orthodontic treatment, additional negative factors impacting hygiene status include gingival bleeding (gingivitis), lack of lip closure, and harmful habits. The study of changes in hygiene levels over one year of treatment with various orthodontic appliances (braces, Haas appliance, SPA) showed that the fixed Haas appliance for treating dental and maxillofacial anomalies is the most favorable orthodontic design for mixed dentition.Conclusion. Factors significantly affecting the level of oral hygiene have been identified. The dynamics of the API hygiene index with various orthodontic appliances have been established. The most favorable appliance for mixed dentition is the HAAS appliance for rapid palatal expansion.