Mandibular Dentoalveolar Expansion in Early Mixed Dentition Using the Clara Expander: A Case Series

Objective: Mandibular expansion remains controversial due to concerns about long-term stability and effectiveness. While maxillary expansion protocols are well established, investigations into mandibular expansion remain limited. This study evaluates the efficacy of the Clara Expander appliance for mandibular expansion in early mixed dentition, assessing skeletal and dental changes using cone-beam computed tomography (CBCT). Materials and Methods: This prospective longitudinal study was conducted in Valencia, Spain, with a population of healthy children aged 6-10 years presenting negative osseodental mandibular discrepancies. CBCT scans were performed before and after treatment to evaluate mandibular dimensional changes, with statistical analyses conducted and a significance threshold of p < 0.05. A total of seven subjects were included in this case series, allowing for a descriptive analysis of treatment outcomes within this specific clinical context. Results: CBCT analysis confirmed significant mandibular expansion following the Clara Expander protocol. Post-treatment findings showed statistically significant increases in dental parameters, including Tooth 6 (furcation, MD = -2.25; p = 0.015), Tooth E (furcation, cementoenamel junction, vestibular, lingual, all p < 0.001), Tooth D (all variables significant), and Tooth C (furcation, MD = -4.18; p = 0.002; cementoenamel junction, MD = -3.56; p = 0.015). Conclusions: The Clara Expander appliance effectively promotes skeletal and dental mandibular expansion, with minimal adverse effects. Its user-friendly, non-invasive design enhances patient compliance and outcomes, contributing valuable data to the field of mandibular expansion and informing future research and clinical applications.