## 3 Experimental Settings  
Patients in the experimental group were treated with the Eptamed Equilibrator (00 series), an orange elastodontic device of medium hardness (Figure 2), tailored to the individual dental arches, as illustrated in Figure 2. This device, designed in the shape of a mouthguard, covers both the upper and lower arches, extending to the most distal molars. Various sizes of the device are available, allowing for adaptation to the patient's arch dimensions, which are measured by the distance between the palatal cusps of the upper first premolars, or, in their absence, the corresponding deciduous molars. The device operates via bite activation, producing soft elastic forces during muscle contraction.  
The Eptamed Equilibrator is a removable functional appliance that leverages tooth repositioning guides and elasticity to restore balanced oral functions. It repositions the teeth by transmitting corrective forces that encourage proper alignment along the arches. This appliance eliminates the need for traditional fixed braces, offering a flexible, aesthetically pleasing solution that can be removed at any time, primarily for nighttime use. Its design and material properties allow it to rebalance the temporomandibular joint, offering significant aesthetic and postural benefits [8].  
The balancer is worn overnight, utilizing the lingual rest mechanism at the palate's expansion point. This device encourages growth by stimulating tissue development through muscle movement, which contributes to proper chewing function. The biting action of the elastomeric material generates forces that balance tension at the sphenobasilar synchondrosis, following osteopathic principles. Its mechanism operates through varying material elasticity, applying force in a three-dimensional manner to adjust the oral cavity. The device includes upper and lower channels to accommodate and guide the teeth into their correct positions within the arch.  
Additionally, the device incorporates a lingual ramp or internal slide that stimulates tongue placement on the palate. This feature enhances the transverse diameters of the upper arch, promotes nasal breathing, relaxes orofacial and fascial muscles, and harmonizes phonation. Patients were instructed to wear the device overnight and attend monthly follow-up visits for evaluation and adjustment if necessary.  
The control group was treated with Spark clear aligners for both the upper and lower arches. Aligners were changed weekly throughout the treatment period. Patients in this group were instructed to wear the aligners continuously, removing them only during meals.  
Figure 2: Eptamed Equilibrator (00 series), orange, medium hardness.  
Both groups were monitored after 6 months and again after 1 year of treatment. The effectiveness of the dentoalveolar expansion was evaluated by measuring the distance (in mm) between the palatal cusps of the upper first premolars, or, if absent, the corresponding deciduous molars, using a digital caliper. All measurements were conducted by the same operator to maintain consistency.  
All patients adhered to the treatment protocol, and none refused treatment. Some patients required fixed orthodontic therapy for minor final adjustments in alignment after the completion of the treatment.