Digital workflow for customized TSME manufacturing in interceptive orthodontics: a retrospective clinical study

Interceptive orthodontics plays a key role in the early management of dento-skeletal discrepancies in growing patients, particularly transverse maxillary deficiency. This retrospective clinical study evaluated the dento-skeletal effects of a digitally manufactured, patient-specific Transversal Sagittal Maxillary Expander (TSME). A sample of 45 pediatric patients (mean age 8.5 years) with transverse and sagittal maxillary deficiency was analyzed. All subjects were treated using a customized titanium TSME designed through a multimodal digital workflow combining intraoral scanning, CBCT imaging, and three-dimensional facial acquisition for diagnostic planning and appliance customization. Quantitative treatment outcome assessment was based on standardized lateral cephalometric analysis between pre-treatment (T0) and post-treatment (T1). Statistically significant changes were observed in sagittal and vertical skeletal parameters, including SNA, SNB, ANB, SN–ANS-PNS, SN–GoGn, N–Me, and APDI. The integration of digital technologies and titanium additive manufacturing may support improved appliance customization and workflow standardization. Within the limitations of this retrospective study, digitally manufactured TSME represents a promising approach for patient-specific appliance customization in interceptive orthodontics.