Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Advertisement

Scientific Reports
  • View all journals
  • Search
  • My Account Login
  • Content Explore content
  • About the journal
  • Publish with us
  • Sign up for alerts
  • RSS feed
  1. nature
  2. scientific reports
  3. articles
  4. article
The effectiveness of the basal expansion plate in comparison with the traditional expansion plate during the slow maxillary expansion: a randomized clinical trial
Download PDF
Download PDF
  • Article
  • Open access
  • Published: 21 January 2026

The effectiveness of the basal expansion plate in comparison with the traditional expansion plate during the slow maxillary expansion: a randomized clinical trial

  • Suzan Ahmad Ibraheem1 &
  • Mohamed Youssef2 

Scientific Reports , Article number:  (2026) Cite this article

  • 587 Accesses

  • 1 Altmetric

  • Metrics details

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Health care
  • Medical research

Abstract

Although slow maxillary expansion is commonly used, numerous studies have demonstrated that the increase in dental arch width is primarily due to buccal tipping of the lateral teeth, often accompanied by recession of the vestibular alveolar process. This investigation addresses whether buccal shields inserted in a modified expansion plate can improve tooth movement, prevent vertical resorption of the alveolar process, and produce skeletal changes. For this purpose, frontal- and lateral cephalograms, along with cast models of 40 patients (17 males and 23 females; age: 10.28 ± 1.65) were studied. All patients were treated with slow maxillary expansion, and according to the plate used, patients were divided randomly into 2 groups:- 1st group, 20 patients were treated with a modified plate, called the Basal Expanding Plate (BEP), and – 2nd group, 20 patients were treated with a Traditional Expansion Plate (TEP). Measurements included the alveolar process height, inter-alveolar width, distance between the apex of the meso-buccal root of the upper first molar on two sides, and distance between the top of the meso-buccal cusp of the first upper molar bilaterally. were studied. Blinding was applied only for data analysis. The data obtained were subjected to statistical analyses using t-tests to detect significant group differences. The results revealed significant differences in basal width (BEP:2.62 ± 1.32, TEP:-1.87 ± 1.82), tooth root movement whereas it was buccal movement in BEP group (3.70 ± 2.40) and palatal movement in TEP group (-22.2 ± 3.63), and alveolar process dimensions between the two groups after treatment whereas it increased in BEP group in both sides (1.77 ± 1.65, 1.37 ± 1.22) while it decreased in TEP group in both sides too (-0.82 ± 0.81, -1.00 ± 0.84). Also, the difference was significant in S–N: Go-ME angle, whereas it decreased in the BEP group(-0.03 ± 3.02) and increased in the TEP group (0.40 ± 3.36). Based on the results, it can be concluded that the buccal shields of the basal expansion plate can improve the type of tooth movement, the inter-alveolar width and the height of the vestibular alveolar process during the maxillary dental arch expansion.

Trial registration ISRCTN69542858 (27/11/2023)

Similar content being viewed by others

Three-dimensional dentoalveolar changes in open bite treatment in mixed dentition, spurs/posterior build-ups versus spurs alone: 1-year follow-up randomized clinical trial

Article Open access 20 July 2022

Recommendations to minimize tooth root remodeling in patients undergoing maxillary osteotomies

Article Open access 13 June 2024

Do immediately placed implants have better outcomes when placed with a minimal split-thickness envelope flap?

Article 17 December 2021

Data availability

The data used and analyzed during the current research are available from the corresponding author upon request.

Abbreviations

BEP:

Basal expansion plate

TEP:

Traditional expansion plate

References

  1. Adkins, M. D., Nanda, R. S. & Currier, G. F. Arch perimeter changes on rapid palatal expansion. Am. J. Orthod. Dentofac. Orthop. 97(3), 194–199 (1990).

    Google Scholar 

  2. Evangelista, K. et al. Three-dimensional assessment of craniofacial asymmetry in children with transverse maxillary deficiency after rapid maxillary expansion: A prospective study. Orthodontics Craniofacial Research. 23(3), 300–312 (2020).

    Google Scholar 

  3. Karad A. Clinical orthodontics: current concepts, goals and mechanics. 2014.

  4. Sandikçiolu, M. & Hazar, S. Skeletal and dental changes after maxillary expansion in the mixed dentition. Am. J. Orthod. Dentofac. Orthop. 111(3), 321–327 (1997).

    Google Scholar 

  5. Araújo, M.-C., Bocato, J.-R. & de Almeida, M.-R. Tomographic evaluation of dentoskeletal effects of rapid maxillary expansion using Haas and Hyrax palatal expanders in children: A randomized clinical trial. J Clin Exp Dent 12(10), e922 (2020).

    Google Scholar 

  6. Farronato, G. et al. Rapid maxillary expansion in growing patients Hyrax versus transverse sagittal maxillary expander: a cephalometric investigation. The European Journal of Orthodontics. 33(2), 185–189 (2011).

    Google Scholar 

  7. Godoy, F., Godoy-Bezerra, J. & Rosenblatt, A. Treatment of posterior crossbite comparing 2 appliances: a community-based trial. Am. J. Orthod. Dentofac. Orthop. 139(1), e45–e52 (2011).

    Google Scholar 

  8. Rabah N, Al-Ibrahim HM, Hajeer MY, Ajaj MA, Mahmoud G. Assessment of patient-centered outcomes when treating maxillary constriction using a slow removable versus a rapid fixed expansion appliance in the adolescence period: a randomized controlled trial. Cureus. 2022;14(3).

  9. Petrén, S. & Bondemark, L. Correction of unilateral posterior crossbite in the mixed dentition: a randomized controlled trial. Am. J. Orthodon. Dentofacial Orthopedics. 133(6), 790 (2008).

    Google Scholar 

  10. Nagrik, A. P. & Bhad, W. A. A clinical comparison of maxillary expansion: TransForce transverse appliance versus NiTi palatal expander. Journal of the World Federation of Orthodontists. 3(2), e61–e65 (2014).

    Google Scholar 

  11. Ciambotti, C., Ngan, P., Durkee, M., Kohli, K. & Kim, H. A comparison of dental and dentoalveolar changes between rapid palatal expansion and nickel-titanium palatal expansion appliances. Am. J. Orthod. Dentofac. Orthop. 119(1), 11–20 (2001).

    Google Scholar 

  12. Wong, C. A., Sinclair, P. M., Keim, R. G. & Kennedy, D. B. Arch dimension changes from successful slow maxillary expansion of unilateral posterior crossbite. Angle Orthod. 81(4), 616–623 (2011).

    Google Scholar 

  13. Erdinç, A. E., Ugur, T. & Erbay, E. A comparison of different treatment techniques for posterior crossbite in the mixed dentition. Am. J. Orthod. Dentofac. Orthop. 116(3), 287–300 (1999).

    Google Scholar 

  14. Kecik, D., Kocadereli, I. & Saatci, I. Evaluation of the treatment changes of functional posterior crossbite in the mixed dentition. Am. J. Orthod. Dentofac. Orthop. 131(2), 202–215 (2007).

    Google Scholar 

  15. Huynh, T., Kennedy, D. B., Joondeph, D. R. & Bollen, A.-M. Treatment response and stability of slow maxillary expansion using Haas, hyrax, and quad-helix appliances: a retrospective study. Am. J. Orthod. Dentofac. Orthop. 136(3), 331–339 (2009).

    Google Scholar 

  16. Bukhari, A., Kennedy, D., Hannam, A., Aleksejūnienė, J. & Yen, E. Dimensional changes in the palate associated with slow maxillary expansion for early treatment of posterior crossbite. Angle Orthod. 88(4), 390–396 (2018).

    Google Scholar 

  17. Kuhlberg A, Nanda R. Principles of biomechanics. Biomechanics and Esthetic Strategies in Clinical Orthodontics. W. B. Saunders Company, : Philadelphia Elsevier; 2005. p. 1–16.

  18. Greenbaum, K. R. & Zachrisson, B. U. The effect of palatal expansion therapy on the periodontal supporting tissues. Am. J. Orthod. 81(1), 12–21 (1982).

    Google Scholar 

  19. Brunetto M, Andriani JdSP, Ribeiro GLU, Locks A, Correa M, Correa LR. Three-dimensional assessment of buccal alveolar bone after rapid and slow maxillary expansion: a clinical trial study. American Journal of Orthodontics and Dentofacial Orthopedics. 2013;143(5):633–44.

  20. Owen, A. H. III. Morphologic changes in the transverse dimension using the Fränkel appliance. Am. J. Orthod. 83(3), 200–217 (1983).

    Google Scholar 

  21. Fränkel R. Technik und Handhabung der Funktionsregler. (No Title). 1984.

  22. Brieden, C. M., Pangrazio-Kulbersh, V. & Kulbersh, R. Maxillary Skeletal and Dental Change With Fränkel Appliance Therapy: —an implant study. Angle Orthod. 54(3), 226–232 (1984).

    Google Scholar 

  23. Lindauer S. Orthodontic Treatment Planning Biomechanics in Clinical Orthodontics. W.B. Saunders Company: Phila delphia; 1996. p. 26.

  24. Shundo, I., Kobayashi, Y. & Endo, T. Short-term treatment effects of quad-helix on maxillomandibular expansion in patients with maxillary incisor crowding. Odontology 100, 76–86 (2012).

    Google Scholar 

  25. Defraia, E., Marinelli, A., Baroni, G. & Tollaro, I. Dentoskeletal effects of a removable appliance for expansion of the maxillary arch: a postero-anterior cephalometric study. The European Journal of Orthodontics. 30(1), 57–60 (2008).

    Google Scholar 

  26. Kharbanda OP. Orthodontic Diagnosis. Orthodontics: Diagnosis and Management of Malocclusion and Dentofacial Deformities, E-Book: Elsevier Health Sciences; 2009. p. 207–8

  27. Yi, L., Jeon, H. H., Li, C., Boucher, N. & Chung, C.-H. Transverse growth of the maxillo-mandibular complex in untreated children: A longitudinal cone beam computed tomography study. Sensors. 21(19), 6378 (2021).

    Google Scholar 

  28. Lanteri, V. et al. Comparison between RME, SME and Leaf Expander in growing patients: a retrospective. Eur. J. Paediatr. Dent. 19, 199 (2018).

    Google Scholar 

  29. Frank, S. W. & Engel, G. A. The effects of maxillary quad-helix appliance expansion on cephalometric measurements in growing orthodontic patients. Am. J. Orthod. 81(5), 378–389 (1982).

    Google Scholar 

  30. Brin, I. et al. Skeletal and functional effects of treatment for unilateral posterior crossbite. Am. J. Orthod. Dentofac. Orthop. 109(2), 173–179 (1996).

    Google Scholar 

  31. Shoaib, H., Hafez, A. & Fouda, M. Expansion Changes By Removable Quad Helix Appliance On Constricted Maxilla In Growing Patients. Aust. J. Basic Appl. Sci. 11(11), 171–177 (2017).

    Google Scholar 

  32. Akkaya, S., Lorenzon, S. & Üçem, T. T. A comparison of sagittal and vertical effects between bonded rapid and slow maxillary expansion procedures. The European Journal of Orthodontics. 21(2), 175–180 (1999).

    Google Scholar 

  33. Paoloni, V. et al. Comparison of the dento-skeletal effects produced by Leaf expander versus rapid maxillary expander in prepubertal patients: a two-center randomized controlled trial. Eur. J. Orthod. 44(2), 163–169 (2022).

    Google Scholar 

  34. Ladner, P. T. & Muhl, Z. F. Changes concurrent with orthodontic treatment when maxillary expansion is a primary goal. Am. J. Orthod. Dentofac. Orthop. 108(2), 184–193 (1995).

    Google Scholar 

  35. Van de Velde, A., De Boodt, L., Cadenas de Llano-Pérula, M., Laenen, A. & Willems, G. Short term effects of interceptive expansion treatment: a prospective study. Eur. J. Orthod. 43(3), 324–331 (2021).

    Google Scholar 

  36. Fränkel, R. & Fränkel, C. Clinical implication of Roux’s concept in orofacial orthopedics. Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie. 62, 1–21 (2001).

    Google Scholar 

Download references

Acknowledgments

We would like to acknowledge the participation of the patients.

Funding

This study received Damascus University funding.

Author information

Authors and Affiliations

  1. Department of Orthodontics, Damascus University, Damascus, Syria

    Suzan Ahmad Ibraheem

  2. Faculty of Dentistry, Damascus University, Al-Mazzeh St, Damascus, Syria

    Mohamed Youssef

Authors
  1. Suzan Ahmad Ibraheem
    View author publications

    Search author on:PubMed Google Scholar

  2. Mohamed Youssef
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Suzan Ahmad Ibraheem: contributed in collection of data; data analysis/interpretation and writing of the manuscript. Mohamed Youssef: contributed in study design, data analysis and writing of the manuscript

Corresponding author

Correspondence to Suzan Ahmad Ibraheem.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ibraheem, S.A., Youssef, M. The effectiveness of the basal expansion plate in comparison with the traditional expansion plate during the slow maxillary expansion: a randomized clinical trial. Sci Rep (2026). https://doi.org/10.1038/s41598-026-36482-6

Download citation

  • Received: 15 May 2025

  • Accepted: 13 January 2026

  • Published: 21 January 2026

  • DOI: https://doi.org/10.1038/s41598-026-36482-6

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Keywords

  • Maxillary compression
  • Slow maxillary expansion
  • Basal expansion plate
  • Buccal shields
  • Orthodontic tooth movement
  • Alveolar process
Download PDF

Advertisement

Explore content

  • Research articles
  • News & Comment
  • Collections
  • Subjects
  • Follow us on Facebook
  • Follow us on Twitter
  • Sign up for alerts
  • RSS feed

About the journal

  • About Scientific Reports
  • Contact
  • Journal policies
  • Guide to referees
  • Calls for Papers
  • Editor's Choice
  • Journal highlights
  • Open Access Fees and Funding

Publish with us

  • For authors
  • Language editing services
  • Open access funding
  • Submit manuscript

Search

Advanced search

Quick links

  • Explore articles by subject
  • Find a job
  • Guide to authors
  • Editorial policies

Scientific Reports (Sci Rep)

ISSN 2045-2322 (online)

nature.com sitemap

About Nature Portfolio

  • About us
  • Press releases
  • Press office
  • Contact us

Discover content

  • Journals A-Z
  • Articles by subject
  • protocols.io
  • Nature Index

Publishing policies

  • Nature portfolio policies
  • Open access

Author & Researcher services

  • Reprints & permissions
  • Research data
  • Language editing
  • Scientific editing
  • Nature Masterclasses
  • Research Solutions

Libraries & institutions

  • Librarian service & tools
  • Librarian portal
  • Open research
  • Recommend to library

Advertising & partnerships

  • Advertising
  • Partnerships & Services
  • Media kits
  • Branded content

Professional development

  • Nature Awards
  • Nature Careers
  • Nature Conferences

Regional websites

  • Nature Africa
  • Nature China
  • Nature India
  • Nature Japan
  • Nature Middle East
  • Privacy Policy
  • Use of cookies
  • Legal notice
  • Accessibility statement
  • Terms & Conditions
  • Your US state privacy rights
Springer Nature

© 2026 Springer Nature Limited

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing