Hopefully I'm getting this right ... but, it seems that most of the directly bone-born procedures discussed here are aiming to create lateral (transverse?) expansion ... correct?  In other words, you get something like DOME, and it makes your airway wider left-to-right, because it made your overall palate wider left-to-right by splitting it at the suture.

But what about people who may have more of a front-to-back problem (saggital deficiency, maxillary retrusions)?  Those seem like they wouldn't be as useful, correct?  I may be in this camp, unfortunately.  And as an adult, normal procedures that would work on a teenager still growing have no value to me.

MMA surgery is one correction strategy, but obviously ... that's quite intense.

Appliance-based approaches exist like the DNA Appliance, but debate exists here as to whether that is really creating expansion in the palate bone at all ... or is just impacting the alveolar structures (including potentially pushing teeth through the alveolar structure, potentially leading to impaired tooth health/integrity long-term).  FAGGA seems to fit into this category as well, there's debate on whether it's pushing teeth through/out of the alveolar structures.

I would love nothing more than to believe that long-term ... a DNA or FAGGA wouldn't present any potential long-term concerns.  But I'm not sure I'm ready to believe that yet ... hence, investigating bone-born approaches as much as I can.

Bone-based distraction obviously seems like a great way to go, since it's clearly creating skeletal growth with the daily distractions, and that increases the nasal floor as well.  I came across this post on NIH, but it sounds like it ended up being an experimental device ... that was not actually turned into a real product and/or tested on a real human being ... is my assessment correct?    https://www.ncbi.nlm.nih.gov/pubmed/29339002