Document Type

Article

Publication Date

7-6-2026

Abstract

OBJECTIVES: Bilateral cleft lip and palate (BCLP) presents a significant clinical challenge characterized by severe premaxillary malalignment, which frequently necessitates intensive orthopedic or surgical intervention. This randomized clinical trial aimed to compare the efficacy of two orthodontic appliances, the modified fan expander and a three‑way palatal expander, in achieving orthopedic anteroposterior repositioning of the premaxilla. MATERIALS AND METHODS: Twenty‑eight patients (8–15 years) were randomized to either a modified fan expander (n = 14) or a three‑way palatal expander (n = 14). Four participants were lost to follow‑up, leaving 24 patients (12/group) for analysis. Cephalometric radiographs were obtained before (T0) and after expansion (T1) and analyzed using Dolphin Imaging software (Version 11.5; Dolphin Imaging and Management Solutions, Chatsworth, CA, USA). Intragroup and intergroup changes were assessed using paired and independent t‑tests. RESULTS: In Group A, a statistically significant increase was observed in premaxillary inclination (17.71° ± 13.85°), maxillary length (6.21 mm ± 3.73), incisor inclination and position. Group B also exhibited significant increases in premaxillary inclination (15.05° ± 8.93°), maxillary length (1.81 mm ± 1.62) and incisor parameters, reflecting a favorable improvement in premaxillary orientation. Intergroup analysis revealed significant differences regarding maxillary length and molar positioning; Group A demonstrated a more pronounced increase in the anteroposterior position of the maxilla, accompanied by induced distal molar movement and tipping. CONCLUSION: Both appliances effectively facilitated the orthopedic repositioning of the premaxilla in BCLP patients. These devices provide concurrent anteroposterior and transverse correction, thereby streamlining the clinical workflow and reducing the therapeutic burden through the utilization of a single multifunctional appliance.

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