Various Clinical Aspects of Orthodontic Clear Aligner Therapy in Maxillary Expansion Procedure in Pediatric Patients during Mixed-dentition Phase: A Comprehensive Review

Abstract The pediatric population has malocclusions with a higher prevalence worldwide. Malocclusion in the mixed-dentition phase has a negative impact on the oral health-related quality of life of pediatric patients and their families. Discrepancy in the transverse dimensions of the maxillary arch may present a range of malocclusion conditions, including cross-bite, functional shift, crowding, impaction, and ectopic eruption of permanent teeth, etc. Usually, orthodontic intervention involves the maxillary expansion to correct the abovementioned malocclusion conditions. In growing children with mixed dentition, various orthodontic intervention modalities using removable or fixed appliances for addressing the maxillary/palatal constriction condition. However, literature highlights various drawbacks or limitations of these traditional appliances. In recent years, the use of clear aligners in pediatric patients in early orthodontic intervention for correcting various malocclusions, including dental crowding, anterior or posterior cross-bite, etc., has been described in the literature. Moreover, clear aligners have been highlighted recently in literature about its use for the purpose of maxillary expansion in the mixed-dentition stage of children. However, to date, there is no comprehensive review article in the existing literature describing the different clinical aspects and factors of the use of clear aligners for maxillary expansion in the mixed-dentition phase of growing patients. Hence, the intention of this review article was to extensively explore the relevant literature in online different databases and to summarize or highlight the clinically important findings and aspects reported by the pertinent published studies.