SynthesisProgress in orthodontics2026
Effectiveness of clear aligners for maxillary expansion in growing patients: a systematic review and meta-analysis.
Synthesis in Progress in orthodontics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
Funding
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Abstract
backgroundMaxillary transverse deficiency is one of the most common issues encountered in orthodontic practice. Ideally, intervention should take place before the midpalatal suture has completely ossified, in order to take advantage of the patient's active growth. In recent years, treatment with clear aligners has emerged as an alternative to fixed appliances, offering a new way to achieve expansion in paediatric patients.
objectivesThis systematic review aimed to analyse the predictability of movements induced by clear aligners in maxillary expansion, and to compare the effectiveness of the Invisalign First® system with conventional expansion appliances. SEARCH
methodsA systematic review was conducted by searching PubMed-Medline, Scopus, Embase, Web of Science and Cochrane databases. ELIGIBILITY CRITERIA: Retrospective and prospective studies, as well as one randomised clinical trial, published between January 2021 and October 2025, which answered the PICO question, were included. DATA EXTRACTION AND SYNTHESIS: The quality of the included studies and the risk of bias were assessed using ROBINS-I (Risk of Bias in Non-randomised Studies) and ROB2 (Risk of Bias 2). For the quantitative analysis, heterogeneity among the included studies was quantified using the I
resultsFollowing a review of 267 publications, 15 studies were ultimately included in the review, and seven in the meta-analysis. Statistically significant differences were reported for the following variables: intermolar distance (6-6) ( - 1.77 mm; -2.57; - 0.97 95%CI; - 4.35 Z-test, p < 0.0001); total palatal volume ( - 460.63 mm
conclusionsClear aligners appear to be capable of producing maxillary expansion, mainly through dentoalveolar changes that are more evident in the anterior region and at the level of deciduous teeth. In patients presenting with more pronounced transverse deficiencies, conventional expanders seem to achieve greater skeletal and posterior transverse changes. However, given that most of the current evidence derives from retrospective studies with moderate risk of bias, these conclusions should be interpreted cautiously and confirmed by well-designed prospective research. REGISTRATION NUMBER: CRD420250608558.
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