Optimization of Orthodontic Treatment for Maxillary Constriction in Children Using Direct 3d Printing of Appliances

Objective. To evaluate the effectiveness and advantages of orthodontic appliances fabricated by direct 3D printing for the treatment of maxillary constriction in children compared to the traditional method. Materials and Methods. The study included 30 children aged 8–10 years with transverse maxillary constriction and unilateral or bilateral posterior crossbite. Patients were randomly divided into two equal groups (n=15 each). In the control group, a conventional fixed palatal expander (Haas/Hyrax type) was used, fabricated in the laboratory with standard orthodontic bands. In the study group, an analogous appliance was designed digitally and manufactured using direct 3D printing from cobalt-chromium alloy. The parameters assessed included appliance fabrication time, number of visits required for placement, need for separator rings, patient comfort (pain VAS and questionnaire), and clinical outcomes of maxillary expansion based on dental models and CBCT data before and after treatment. Results. Both methods successfully eliminated maxillary constriction in all patients. However, the 3D-printed group achieved significantly greater expansion (intermolar width increase of +7.3 mm vs +5.5 mm, p=0.02) and a more pronounced increase in nasal cavity width (though the difference was not statistically significant, p=0.10). The digital workflow eliminated the need for separator rings and appliance adjustment during placement, reducing fabrication time (7 vs 14 days) and the number of visits. Subjective discomfort was significantly lower in the 3D group (pain intensity 3.0±1.2 vs 4.5±1.0 points, p<0.05), which correlated with the absence of the separator stage and superior appliance fit. Conclusions. Direct 3D printing of palatal expanders optimizes the treatment of maxillary constriction in children by shortening treatment timelines, simplifying clinical stages, and improving patient comfort without compromising clinical outcomes. The findings support the promising role of digital technologies (CAD/CAM and 3D printing) in pediatric orthodontics for narrow maxillary arches.