36 patients with unilateral or bilateral cross bite treated with hyrax expanders fabricated through three distinct workflows: fully conventional (physical impression + manual fabrication), hybrid (physical impression + CAD/CAM fabrication), and fully digital (intraoral scanning + CAD/CAM fabrication). To evaluate and compare the clinical fit, workflow efficiency, and patient/clinician satisfaction of palatal expanders fabricated using traditional, hybrid digital, and fully digital workflows.
• Aged between 8 and 13 years with transverse maxillary deficiency ( with unilateral or bilateral crossbite ,with or without anterior cross bite)
Indicated for tooth-borne maxillary expansion
Good oral hygiene and cooperative behavior
No prior orthodontic treatment
• Craniofacial anomalies or syndromes
Requirement for surgically assisted expansion
Poor oral hygiene or high caries index
A total of 36 participants will be selected from outpatient clinic of orthodontics department (Faculty of Dentistry - Mansoura University). Written consent will be obtained from all legal guardians prior to enrollment.
Cohort
Prospective
Not listed
Clinical Fit and accuracy of expander
For the clinical fit of the palatal expander at delivery, a 5-point Likert scale could be used by the clinician as follows: Score Description 1. Very poor fit - Significant rocking or instability; requires remake 2. Poor fit - Major adjustment required (e.g., soldering, bending) 3. Acceptable fit - Minor chairside adjustments needed 4. Good fit - Minimal adjustment required 5. Excellent fit - No adjustment needed, passive and accurate seating
Workflow and Chairside adjustment time
Time measured in minutes from impression to appliance delivery
Expansion Efficacy
Measurement Method: Transverse dental arch width (mm) at canines / premolars / molars (digital calipers on casts/scans) and Arch length.
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