# Efficacy of Maximally Expansion with Clear Aligner in the Mixed Dentition: A Systematic Review
## 5 Conclusions  
The therapeutic potential of Invisalign(r) First clear aligners in patients with mixed dentition and transverse maxillary deficiency is highlighted by the results of this systematic review. According to the data gathered, the use of clear aligners significantly improved maxillary dentoalveolar expansion when compared to the pre-treatment state or subjects in the untreated control group (NG). The outcomes were similar to those achieved with the conventional palate expander. More precisely, the review's included research demonstrated several quantifiable and clinically significant dimensions and functional alterations. The first and second molar interdeciduous amplitudes increased in tandem with the transpalatal and dentoalveolar intercanine amplitudes. Along with the amplitude of the first and second inter molars, the molars' transpalatal expansion also demonstrated noticeable improvements. The first intermal's mesial, distal, and transpalatal amplitudes showed positive findings, indicating efficient and carefully managed three-dimensional expansion. Moreover, there was a notable molar derotation, an expansion of the arch depth and perimeter, an improvement in molar inclination without a loss of control, and an increase in intermalor dentoalveolar breadth. These enhancements imply that, despite being based on a low-impact, removable orthodontic technique, Invisalign(r) First treatment can result in multifactorial, successful transverse modifications by precisely and carefully influencing different areas of the dental arch and the alveolar plane. Since Invisalign(r) First clear aligners provide a contemporary, efficient, and well-tolerated alternative for the repair of transverse maxillary deficiency in mixed dentition, they should be regarded as a feasible treatment choice for patients who are growing. This method offers similar clinical outcomes to conventional devices, but it also offers benefits in terms of comfort, appearance, oral cleanliness, and patient compliance. As a result, it is an orthodontic solution that meets the demands of modern clinical practice and families. The comprehensive analysis of the studies reviewed supports the conclusion that Invisalign(r) First represents an effective and promising solution for addressing transverse maxillary deficiency in growing patients. While variability exists among the included studies, the overall evidence indicates that this treatment modality offers favorable outcomes in terms of space management and maxillary expansion. Further high-quality research is encouraged to strengthen these findings and optimize clinical protocols.  
Conceptualization, A.C. and L.L.; methodology, P.A.Z.; software, A.D.; validation, E.I.S., M.C. and S.S.; formal analysis, M.B.; investigation, M.C.; resources, A.C.; data curation, A.C.; writing--original draft preparation, E.I.S.; writing--review and editing, A.D.; visualization, P.A.Z.; supervision, L.L.; project administration, A.C.; funding acquisition, M.B. All authors have read and agreed to the published version of the manuscript. This research received no external funding.  
[PERSON] is a Ph.D. student of the Life Sciences and Biotechnology course at the University of Insubria.