Orthodontist approach to palatal expansion: analysis of indications and clinical choices

The aim of this study is to analyze the clinical conditions that lead orthodontists to use Rapid Maxillary Expansion (RME), by evaluating whether, to date, maxillary contraction remains an essential clinical requirement or if there are other indications. Additionally, it assesses the effects—desirable or not—observed by clinicians following RME treatment. Materials and methods: This research involved developing a questionnaire that collected all possible effects and indications of RME therapy to evaluate, through several questions, how orthodontists currently use RME. The questionnaire was distributed via Google Forms (Google LLC, Mountain View, CA, USA) to national and international orthodontists and dentists. Statistical analysis included descriptive statistics for the initial questions about the characteristics of the respondents and their clinical preferences. Questions regarding the indications for performing RME and the effects or side effects of the technique were analyzed using means and standard deviations. Results: After discarding incomplete responses, the final data from 127 completed questionnaires were processed. Conclusions: There are additional indications beyond the conventional ones (maxillary contraction, unilateral and bilateral posterior crossbite) that clinicians consider when performing RME, indicating an evolution in the clinical use of the technique from its inception to the present. Furthermore, adopting modified techniques—such as skeletal anchorage or digitally designed devices—is becoming more common among orthodontists, sometimes allowing for the resolution of certain limitations or the control of side effects. This suggests that RME is evolving into a technique with potential impacts in orthodontics that extend well beyond its initial application.