Short answer: In adults the midline of the palate has largely fused, so the classic expanders used in children are often not enough. In this case mini-screw-anchored expanders (MARPE) or surgically assisted expansion may be considered. Which method is suitable is determined by age, bone structure and three-dimensional imaging.
Why do adults need a different method?
In children the midline of the palate can be opened with controlled force. With age this suture fuses, and the force is loaded onto the teeth, which can cause them to tip outwards. For use in children, see our article on the palatal expander.
What is MARPE?
MARPE is an expansion appliance anchored on mini-screws placed in the palate. The aim is to transmit the force directly to the bone instead of to the teeth. In young adults it can achieve skeletal expansion; the chance of success varies from person to person.
Surgically assisted expansion
Where the bone is more resistant, small bone cuts made by a maxillofacial surgeon make palatal expansion easier. The expander is then turned in a similar way. For more extensive jaw discrepancies, the option of orthognathic surgery may also be discussed.
Who is it considered for?
- Adults with a crossbite of the back teeth
- People with noticeable dark spaces at the sides when smiling
- People with a narrow upper jaw together with difficulty breathing through the nose (with an ear, nose and throat assessment)
For general information, read our page on orthodontic jaw (palatal) expansion treatment.
Frequently asked questions
Can clear aligners expand the palate in adults?
Clear aligners widen the dental arch to a limited extent; they do not replace skeletal expansion.
Does MARPE hurt?
The screws are placed under local anaesthesia; pressure may be felt during the turning periods.
Will there be a gap after expansion?
A temporary gap may open between the front teeth; it is closed at a later stage of treatment.
Which appliance is right for you?
Which appliance is needed is decided after age, growth stage and the condition of the teeth and jaws have been assessed by examination and X-rays. At our clinic in Oran, Çankaya, Ankara, we discuss the options with you during the first orthodontic examination. To see all types of appliance in one place, take a look at our guide to orthodontic appliances.
