Assessment of Dentoskeletal and Airway Changes Using Hyrax and Fan-Type Expanders in Cleft Patients: An In Vivo CBCT Study

Objective To compare dentoskeletal, nasal septal, and upper airway changes following rapid maxillary expansion (RME) using Hyrax and fan-type expanders in growing patients with cleft lip and palate (CLP) using cone-beam computed tomography (CBCT). Design Prospective comparative clinical study. Setting University-based tertiary care dental institution. Patients Twenty patients aged 9 to 15 years with repaired unilateral or bilateral CLP and transverse maxillary deficiency. Interventions Participants were treated with bonded Hyrax ( n = 10) or fan-type expanders ( n = 10) according to maxillary constriction pattern. CBCT scans were obtained before expansion (T0) and after a 3-month retention period (T1). Main Outcome Measures Anteroposterior, vertical, and transverse dentoskeletal parameters, nasal septum deviation, and oropharyngeal airway volume were evaluated. Intragroup comparisons used the Wilcoxon signed-rank test; intergroup comparisons used the Mann-Whitney U test ( P < .05). Results Both appliances achieved significant transverse expansion. The fan-type expander showed greater anterior basal widening, whereas the Hyrax demonstrated greater posterior expansion and nasal cavity width increase. Airway volume increased but was not statistically significant. Conclusions Both expanders effectively correct transverse maxillary deficiency in CLP patients. Appliance selection should be based on constriction pattern. Airway effects appear limited.