Early treatment with a slow maxillary ni–ti leaf springs expander

Massimiliano Vella, Paolo Cressoni, Cinzia Tripicchio, Eleonora Mainardi, Luca Esposito

Research output: Contribution to journalArticlepeer-review


The aim of this brief report is to analyse the available literature on the clinical outcomes of a particular appliance for slow maxillary expansion that consists of one or more nickel–titanium springs. Materials and methods: The main medical databases (Scopus, Web of Sciences, Pubmed and Google Scholar) were scanned up to January 2020 using “slow maxillary expan*”, “slow palatal expan*”, “leaf expander” and “NiTi Palatal Expander” as keywords. Skeletal changes in the maxilla after expansion with the Leaf Expander (L.E.) or similar appliances were taken into consideration while reviewing relevant manuscripts. The review focuses on the comparison between the L.E. and conventional expanders (i.e., Haas and Hyrax) regarding the increase in both the distance between the palatal cusps of the upper first molars and the distance between the palatal cusps of the upper second deciduous molars, as well as the increment of nasal structures and pain connected to expansion procedures. Results: Bibliographic research retrieved 32 articles that were considered eligible for the present study. The limited number of articles currently available in international medical databases is allegedly partly due to the fact that these expanders are currently produced by only one patent holder company, which affects its diffusion. Conclusion: Despite the reduced number of published articles, due to the recent introduction of the L.E. device, most of the authors have found that the effects of the L.E. device are clinically and radiographically comparable to those achievable with the rapid palatal expander.

Original languageEnglish
Article number4541
JournalApplied Sciences (Switzerland)
Issue number10
Publication statusPublished - May 2 2021


  • Cross-bite
  • Digital orthodontics
  • Maxillary expansion
  • Maxillary hypoplasia
  • Slow palatal expansion

ASJC Scopus subject areas

  • Materials Science(all)
  • Instrumentation
  • Engineering(all)
  • Process Chemistry and Technology
  • Computer Science Applications
  • Fluid Flow and Transfer Processes


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