Short answer: In MARPE treatment, planning is first carried out with three-dimensional imaging, and the expansion appliance is then anchored to the palate with mini-screws. The screw is turned for a few weeks on the schedule set by the orthodontist, with the aim of opening the midline of the palate; afterwards the appliance is left in place for a few months so the bone can mature, and treatment is mostly completed with braces or clear aligners.
Who is MARPE considered for?
- Teenagers and adults whose growth is complete or nearly complete
- People with a crossbite of the back teeth and a narrow upper jaw
- Cases where a conventional expander is expected to be insufficient
For the general framework of palatal expansion options in adults, see our article on palatal expansion in adults.
The MARPE process step by step
- Examination and records: Intraoral examination, digital scan and three-dimensional imaging showing the thickness of the palatal bone
- Making the appliance: Preparing a custom expansion appliance based on the measurements
- Placement: Placing the mini-screws in the palate under local anaesthesia and anchoring the appliance
- Activation: Turning the screw as often as the orthodontist instructs, with regular check-ups
- Waiting period: Keeping the appliance in place for months after expansion is complete
- Orthodontic treatment: A braces or clear aligner phase to align the teeth
How can you tell that expansion has occurred?
When the midline of the palate opens, a gap often appears between the upper front teeth. This is an expected finding and is closed in the later stages of treatment. Whether the opening is sufficient is assessed at check-ups and, if necessary, with imaging.
Possible side effects and things to watch for
- A feeling of pressure at the bridge of the nose and in the teeth after the screw is turned
- Some difficulty speaking and swallowing in the first days
- Food collecting under the appliance; rinsing with plenty of water after every meal is needed
- Loosening of the mini-screws or irritation of the surrounding tissue
- In some people the midline of the palate does not open enough; in that case surgically assisted methods may be discussed
For general information on mini-screws, read our article on orthodontic mini-screws.
Frequently asked questions
How long does MARPE take?
The active turning phase usually lasts a few weeks and the waiting period that follows a few months; orthodontic treatment then continues.
Is MARPE painful?
The screws are placed under local anaesthesia; pressure may be felt during the turning phases, and this feeling is mostly short-lived.
Does MARPE work in every adult?
Success varies with age and bone structure; some people may need surgical assistance.
How can you find out which method suits you?
Whether palatal expansion is needed and which method is suitable are decided by assessing age, the state of the palatal midline, bone structure and three-dimensional imaging together. At our clinic in Oran, Çankaya, Ankara, we discuss the options with you during the first orthodontic examination. For all expansion and other appliance types, take a look at our guide to orthodontic appliances.
