Traditional Versus Customized CAD/CAM Rapid Palatal Expanders in Growing Patients: A Pilot Exploratory Prospective Non-Randomized Clinical Study

Background: Rapid palatal expansion (RPE) is the gold standard for maxillary deficiency in growing patients. Conventional soldered expanders often present challenges in adaptation, chairside procedures and bond stability. This study compares traditional RPEs with customized CAD (Computer Aided Design)/CAM (Computer Aided Manufacturing) expanders regarding clinical efficiency and patient experience. Methods: Thirty growing patients (mean age: 9.2 ± 1.1 years) were allocated to two groups: traditional RPEs (n = 15) and customized CAD/CAM RPEs (n = 15). Outcomes included bond failures, chairside time (from initial try into cementation) and short-term patient-reported discomfort via a 10-point Visual Analogue Scale (VAS) 24 h after appliance placement. Significance was set at p < 0.05. Results: The CAD/CAM group showed significantly fewer bond failures (0.2 ± 0.4 vs. 1.1 ± 0.8; p < 0.05) and shorter chairside time (12.4 ± 2.1 min vs. 24.6 ± 3.8 min; p < 0.001). Patient discomfort was also significantly lower in the CAD/CAM group (VAS: 4.1 ± 1.0 vs. 6.3 ± 1.2; p < 0.05). Conclusions: Within the limitations of this pilot exploratory non-randomized study, customized CAD/CAM RPEs were associated with fewer bond failures, shorter chairside application time, and lower short-term discomfort at 24 h compared with traditional appliances. These preliminary findings should be interpreted with caution and confirmed by larger randomized controlled studies.