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Effectiveness of Clear Aligner Systems in Mixed Dentition Maxillary Transverse Deficiency

10 de maio de 2026 atualizado por: Celal Irgin, TC Erciyes University

Comparison of the Effectiveness of Different Clear Aligner Systems in Patients With Maxillary Transverse Deficiency During the Mixed Dentition Period: An In-Vivo Randomized Controlled Clinical Trial

he primary aim of this study is to compare the dentoalveolar and skeletal effects of arch expansion using an in-house clear aligner system, produced chairside with an indirect manufacturing technique, and commercially available clear aligner systems (Invisalign) in patients during the mixed dentition period.

Participants will be allocated into five groups: Group A-In-house aligners (5-day activation protocol), Group B-In-house aligners (2-day activation protocol), Group C-Invisalign First aligners, Group D-Invisalign Palatal Expander, and Group E-untreated control group.

Before treatment, demographic data, dental models, intraoral and extraoral photographs, radiographic images, and clinical measurements will be collected. Skeletal measurements, including maxillary and nasal widths, will be evaluated using posteroanterior cephalometric radiographs. Digital models of the maxilla and mandible will be obtained using an intraoral scanner and used for dental measurements before and after treatment.

Secondary outcomes include evaluation of facial soft tissue changes using stereophotogrammetry (3DMD), assessment of white spot lesions using quantitative light-induced fluorescence (QLF), and analysis of patient compliance using the Orthodontic Patient Cooperation Scale. In addition, changes in body mass index (BMI), maxillary-mandibular transverse discrepancies, and appliance wear time will be evaluated.

Visão geral do estudo

Tipo de estudo

Intervencional

Inscrição (Real)

75

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

    • Kayseri
      • Talas, Kayseri, Turquia (Türkiye), 38039
        • Erciyes University Faculty of Dentistry

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Filho

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  • Patients in the early mixed dentition period;
  • Maxillary intermolar width ≤ 31 mm;
  • Presence of at least 5 mm transverse discrepancy between the maxillary and mandibular arches;
  • Normal vertical growth pattern (Sn-GoGn: 32 ± 6°);
  • Eruption of permanent first molars and central incisors;
  • Presence of at least two primary posterior teeth in each quadrant;
  • Posterior teeth with a clinical crown height of at least 4 mm;
  • Patients aged between 7 and 10 years;
  • Absence of any craniofacial anomalies;
  • Good oral hygiene status; Healthy periodontal tissues.

Exclusion Criteria:

  • Patients with the loss of more than one primary tooth
  • Presence of stainless steel crowns on the maxillary permanent first molars, primary first molars, or primary second molars
  • Patients with systemic or syndromic conditions
  • Presence of palatal exostoses or morphological anomalies of the palatal surface
  • Presence of active temporomandibular joint disorders
  • Children with poor compliance
  • History of allergy to any dental material
  • Patients with multiple and/or advanced caries, tooth agenesis, or supernumerary teeth
  • Patients with skeletal asymmetry

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Sem intervenção: Grupo de controle
Experimental: Invisalign Palatal Expander
In patients treated with the Invisalign Palatal Expander (IPE) (Align Technology, Santa Clara, CA), three-dimensional digital models were obtained using an intraoral scanner (iTero Lumina™, Align Technology). Individualized maxillary expansion amounts were prescribed based on clinical objectives. Unlike conventional aligner therapy, the IPE system does not involve full digital treatment simulation; expansion was defined by the planned transverse increase. Following approval, customized IPE appliance sets were manufactured and delivered. Patients were instructed to wear the appliance full-time, including during meals, removing it only for oral hygiene procedures. The activation protocol consisted of appliance changes every 2 days, providing 0.25 mm transverse expansion per stage. After completion of expansion, retention was achieved using Invisalign Palatal Holder appliances fabricated from new digital scans.
Experimental: In-House Aligner (2-Day Protocol)
In-house clear aligners were fabricated using a fully digital workflow. Digital impressions were obtained with an intraoral scanner (3Shape TRIOS), and maxillary models were processed in CAD software for segmentation and attachment planning. Buccal retention attachments were placed on primary canines, primary molars, and permanent first molars. Maxillary models were digitally expanded in 0.2 mm increments per stage, generating sequential STL files. Models were 3D-printed and thermoformed to fabricate aligners, which were then trimmed, polished, and labeled. Patients received five aligners at each visit and were instructed to change them every 2 days. Follow-up visits were scheduled at 10-day intervals. At each visit, treatment progress was assessed, and the next series of aligners was provided.
Experimental: In-House Aligner (5-Day Protocol)
In-house clear aligners were fabricated using a fully digital workflow. Digital impressions were obtained with an intraoral scanner (3Shape TRIOS), and maxillary models were processed in CAD software for segmentation and attachment planning. Buccal retention attachments were placed on primary canines, primary molars, and permanent first molars to enhance retention and support transverse expansion. Models were digitally expanded in 0.2 mm increments per stage and converted into sequential STL files. These models were 3D-printed (Asiga MAX UV) and thermoformed (MINISTAR S) to produce aligners. The appliances were trimmed, polished, and labeled with sequence numbers. Patients received five aligners per visit and were instructed to change them every 5 days. Follow-up visits were scheduled at 25-day intervals, during which treatment progress was evaluated and new aligners were delivered.
Comparador Ativo: Invisalign First Aligner
In patients treated with Invisalign First (Align Technology, Santa Clara, CA), three-dimensional digital models were obtained using an intraoral scanner (3Shape TRIOS). Intraoral, extraoral photographs and radiographs were collected and uploaded to the ClinCheck digital treatment planning platform. Individualized treatment objectives were defined, and expansion was planned without concurrent tooth movement to isolate maxillary transverse effects. After achieving the desired expansion, comprehensive orthodontic treatment was continued. Virtual treatment plans were reviewed and revised when necessary before approval. Attachments were placed on posterior teeth to enhance retention and support expansion. Enamel surfaces were etched, bonded, and light-cured using standard orthodontic protocols. Patients were instructed to wear aligners 20-22 hours daily,and aligners were replaced every 5 days.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Prazo
Maxillary Transverse Dentoalveolar Dimension
Prazo: 20 weeks
20 weeks

Medidas de resultados secundários

Medida de resultado
Prazo
White spot lesion incidence
Prazo: 20 weeks
20 weeks

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

26 de maio de 2025

Conclusão Primária (Estimado)

1 de maio de 2026

Conclusão do estudo (Estimado)

1 de julho de 2026

Datas de inscrição no estudo

Enviado pela primeira vez

3 de maio de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

10 de maio de 2026

Primeira postagem (Real)

14 de maio de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

14 de maio de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

10 de maio de 2026

Última verificação

1 de maio de 2026

Mais Informações

Termos relacionados a este estudo

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

INDECISO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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