Effects of Invisalign Palatal Expander vs Rapid Palatal Expander With Facemask in Growing Class III Patients

Effects of the Invisalign® Palatal Expander (IPE) vs. Rapid Palatal Expander With Facemask in Growing Skeletal Class III Patients: A CBCT Randomized Clinical Trial

The goal of this clinical trial is to compare two types of palatal expanders used with a facemask in children who have skeletal Class III and a narrow upper jaw. The study will compare the Invisalign Palatal Expander (IPE) and the Rapid Palatal Expander (RPE). Researchers want to learn how these devices affect jaw bones and tooth position. They also want to learn about children's and parents' experiences during treatment.

The main questions this study aims to answer are:

Do IPE and RPE widen the upper jaw differently?

Do they cause different changes in tooth position?

How do children and parents describe their treatment experience?

Participants will be children aged 8 to 12 years who have skeletal Class III and a narrow upper jaw. Children with craniofacial conditions, previous upper jaw expansion, or medical conditions that prevent orthodontic treatment will not take part. Parents and children must give consent before joining the study.

Participants will:

Be assigned to receive either IPE or RPE

Expand the upper jaw to 7 mm (0.25 mm per day)

After expansion, wear a facemask for at least 12 hours per day for 6 to 8 months

Have cone-beam computed tomography (CBCT) scans taken before expansion, after expansion, and after facemask treatment

Take part in an interview with a parent after expansion

Researchers will use CBCT images to measure changes in jaw bones and tooth position. The main outcomes are changes in jaw bones and tooth position. Secondary outcomes include children's and parents' experiences during treatment.

Inclusion Criteria:

• Patients aged between 8 and 12 years
• Patients in the mixed dentition or early permanent stage have at least three stable teeth per quadrant, good oral hygiene, and healthy periodontal tissues
• Patients with maxilla-mandibular discrepancies; skeletal class III is indicated by an ANB angle < 0 degrees or a Wits appraisal value that is negative, and Maxillary constriction is characterized by posterior crossbite teeth or having a maxillary width below the norm value.

Exclusion Criteria:

• Patients with craniofacial anomalies such as cleft lip and palate
• Patient with a prior history of maxillary expansion.
• Patients who have systemic conditions that contraindicate orthodontic treatment.