Non-Cochrane · intervention · PM42757333
Comparative Evaluation of Transverse Maxillary Arch Changes in Mixed Dentition with Clear Aligners vs Conventional Maxillary Expanders: A Systematic Review and Meta-analysis.
Athawale Sayali, Mohelay Nikita, Batra Puneet, et al. · International journal of clinical pediatric dentistry · 2026 · PubMed · doi:10.5005/jp-journals-10005-3622
Findings
Population Children in mixed dentition with maxillary transverse deficiency
10 findings
| Clear aligner therapy | Conventional maxillary expanders (RME or SME) | Intercanine width | SMD -0.54 [-1.17, 0.09] Very low Downgraded: risk of bias, inconsistency, publication bias 7 studies · 299 participants |
| Clear aligner therapy | Conventional maxillary expanders (RME or SME) | Molar inclination | SMD 1.42 [-0.64, 3.47] Very low Downgraded: risk of bias, inconsistency, publication bias 4 studies · 146 participants |
| Clear aligner therapy | Conventional maxillary expanders (RME or SME) | Intermolar width | SMD -1.01 [-1.59, -0.43] Very low Downgraded: risk of bias, inconsistency, publication bias 7 studies · 299 participants |
| Clear aligner therapy | Rapid maxillary expansion | Intercanine width RME | SMD -0.12 [-0.93, 0.69] GRADE not reported 4 studies · 185 participants |
| Clear aligner therapy | Rapid maxillary expansion | Molar inclination RME | SMD 4.46 [-3.02, 11.94] GRADE not reported 2 studies · 66 participants |
| Clear aligner therapy | Rapid maxillary expansion | Second interdeciduous molar width | SMD -0.59 [-0.94, -0.25] Very low Downgraded: risk of bias, inconsistency, publication bias 3 studies · 146 participants |
| Clear aligner therapy | Rapid maxillary expansion | Intermolar width RME | SMD -1.06 [-1.89, -0.23] GRADE not reported 4 studies · 185 participants |
| Clear aligner therapy | Slow maxillary expansion | Intermolar width SME | SMD -0.95 [-1.95, 0.05] GRADE not reported 3 studies · 114 participants |
| Clear aligner therapy | Slow maxillary expansion | Molar inclination SME | SMD -0.9 [-1.98, 0.18] GRADE not reported 2 studies · 80 participants |
| Clear aligner therapy | Slow maxillary expansion | Intercanine width SME | SMD -1.11 [-1.68, -0.55] GRADE not reported 3 studies · 114 participants |
Included primary studies 9
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Bruni 2024 Efficacy of clear aligners vs rapid palatal expanders on palatal volume and surface area in mixed dentition patients: A randomized… PMID:39066746 | 2024 | 1 other review | not stated | not extracted yet |
| Lombardo 2022 Evaluation of the Upper Arch Morphological Changes after Two Different Protocols of Expansion in Early Mixed Dentition: Rapid Maxillary… PMID:36143360 | 2022 | 1 other review | not stated | not extracted yet |
| Lu 2023 Treatment effects after maxillary expansion using invisalign first system vs. acrylic splint expander in mixed dentition: a prospective… PMID:37635237 | 2023 | 1 other review | not stated | not extracted yet |
| Pamukcu 2024 Evaluation of maxillary dimensional changes in the mixed dentition: clear aligners vs acrylic expanders. PMID:39229950 | 2024 | 1 other review | not stated | not extracted yet |
| Torbaty 2024 Vertical and transverse treatment effects of Invisalign First system compared to Hyrax maxillary expanders with fixed appliances in mixed… PMID:39230021 | 2024 | 1 other review | not stated | not extracted yet |
| Wang 2023 Dimensional changes in the palate associated with Invisalign First System: a pilot study. PMID:37052464 | 2023 | 1 other review | not stated | not extracted yet |
| Lombardo 2023 Maxillary Response Induced by Rapid Palatal Expansion vs. Clear Aligners: A Short-Term Retrospective Evaluation of the Dento-Alveolar… DOI:10.3390/app13158675 | 2023 | this review only | not stated | not extracted yet |
| Zaverdinos 2021 [Changes in the nervous system in kidney diseases]. PMID:202120 | 1977 | this review only | not stated | not extracted yet |
| Zaverdinos et al. 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Effectiveness of clear aligners for maxillary expansion in growing patients: a systematic review and meta-analysis. (2026) | 6 | 0.21 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients in mixed dentition indicated for arch expansion | Children in mixed dentition (n=412; mean age 8.4 ± 1.3 years; 8 studies) |
| Intervention | Maxillary expansion using clear aligners | Invisalign First System clear aligners (n=8 studies) |
| Comparison | Maxillary expansion with rapid or slow expansion protocols | Rapid maxillary expansion (n=5 studies); slow maxillary expansion (n=3 studies); untreated controls also reported in 3 studies |
| Outcomes | Primary: change in intercanine width, intermolar width, arch perimeter, arch width, arch depth; secondary: molar inclination, palatal surface area, palatal volume | Intercanine width (n=7 pooled); intermolar width (n=7 pooled); second interdeciduous molar width (n=3 pooled); molar inclination (n=4 pooled); arch perimeter, arch width, arch depth and palatal volume narrative only |
| Study designs | RCTs, controlled clinical trials, cohort studies and case reports | 1 RCT, 1 prospective cohort, 6 retrospective studies (n=8) |
| Timing | Not specified | Pre-treatment (T0) to post-expansion (T1) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Partial Yes | Partial Yes | yes |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Partial Yes | RCT: Yes · NRSI: No | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | RCT: No · NRSI: No | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |