Alternative Methods of Oral Hygiene Guidance in Rapid Maxillary Expansion: A Randomized Clinical Study

• Grant number: 25/22273-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2025
• End date: November 30, 2026
• Field of knowledge: Health Sciences - Dentistry - Orthodontics
• Principal Investigator: Silvia Amélia Scudeler Vedovello
• Grantee: Juliana Almeida Marques
• Host Institution: Faculdade de Odontologia de Piracicaba (FOP). Universidade Estadual de Campinas (UNICAMP). Piracicaba , SP, Brazil

Abstract

Rapid maxillary expansion (RME) is a well-established orthodontic procedure for the correction of maxillary constriction and posterior crossbite in children during the mixed dentition stage. Although clinically effective, the Hyrax expander may increase biofilm accumulation around metal bands, leading to gingival inflammation and higher plaque levels. Digital educational strategies, such as videos and text messages, have proven beneficial for improving oral hygiene in patients undergoing corrective orthodontic treatment; however, their use during RME has not yet been investigated. This randomized clinical trial aims to evaluate the effect of different electronic oral hygiene instruction methods on periodontal clinical parameters-plaque index and gingival bleeding index-in children treated with the Hyrax expander. Forty-five participants aged 6-11 years will be randomly assigned to three groups: Group 1 - video-based instructions; Group 2 - text message reminders via WhatsApp; and Group 3 - control group without additional interventions. Assessments will be conducted at baseline (T0), 15 days (T1), 3 months (T2), and 9 months (T3) after appliance installation. Statistical analysis will include mixed linear models for repeated measures, with a significance level of 5%. It is expected that electronic educational methods will improve plaque control and reduce gingival inflammation, contributing to more effective clinical protocols and reinforcing the integration of oral health education into interceptive orthodontic practice.