What Is MARPE?

MARPE stands for mini-implant-assisted rapid palatal expansion. This innovative procedure began gaining traction in the mid-2000s, and today, MARPE is a common treatment for maxillary transverse deficiency, especially effective for patients in their late teens and into early adulthood.

What Is MARPE and What Does It Do?

Mini-implant-assisted rapid palatal expansion, or MARPE, is a nonsurgical orthodontic technique that treats maxillary transverse deficiency, which can cause numerous physical complications and an undesirable appearance. The procedure expands the maxilla (upper jaw) to align properly with the mandible (lower jaw).

MARPE is particularly beneficial for adolescents and young adults whose palatal sutures have begun fusing but still have some flexibility. This technique can result in significant skeletal expansion in these patients. The MARPE expander directly targets the upper jaw bone, making it a less invasive alternative to surgical methods with reduced risks and recovery time.

What Is Maxillary Transverse Deficiency?

Maxillary transverse deficiency is when the upper jaw is abnormally narrow compared to the lower jaw. MTD, also referred to as a narrow palate, often results in crossbite or dental crowding. These issues can interfere with functionality and lead to:

• Difficulty biting and chewing food
• Problems articulating speech
• Trouble breathing through the nose
• Higher risk of tooth decay and gum disease
• Temporomandibular joint (TMJ) strain

The causes of MTD vary, but genetics plays a big role. Developmental factors like prolonged thumb-sucking or pacifier use during childhood can also interfere with palate growth.

How Does MARPE Work?

The rapid palatal expander consists of a central expansion screw connected to mini-implants in the palate. These implants anchor the device to the maxillary bone, effectively distributing the expansion forces to the skeletal structure rather than the teeth. This method reduces dental tipping and increases the widening of the upper jaw.

After an assessment and imaging, your orthodontist designs a MARPE device fitted to your anatomy. Your orthodontist, or sometimes an oral surgeon, places four mini-implants in the upper jaw bone and attaches the MARPE expander. Then, you activate (turn) the expansion screw daily to gradually increase the width of your palate over several weeks.

Is MARPE Risky?

MARPE is a generally safe, effective, and accepted orthodontic procedure. However, there are some risks and undesirable effects:

• Asymmetrical Expansion: Improper placement or activation can lead to uneven widening.
• Pain and Discomfort: The activation phase can cause discomfort or pain in some patients.
• Infection or Bone Loss: Improper placement or mini-implant failure can lead to infection or loss of bone in severe cases.
• Dental and Periodontal Side Effects: MARPE orthodontics can cause issues such as dental tipping or changes in tooth stability.
• Soft Tissue Alterations: The procedure can lead to changes in facial appearance.

What Is MARPE vs. SARPE?

Surgically assisted rapid palatal expansion, or SARPE, is another orthodontic procedure that treats MTD by expanding the upper jaw. However, SARPE involves maxillofacial surgery to produce expansion results that orthodontics alone cannot achieve.

During SARPE, your oral surgeon makes precise cuts in the maxillary bone to make it more pliable. They then place a rapid palatal expander somewhat similar to the one used in MARPE. After the procedure, your orthodontist starts the activation phase and teaches you how to adjust the expander yourself.

A few other distinctions between SARPE and MARPE include:

• Age and Skeletal Maturity:
  • SARPE is for skeletally mature patients with fused palatal sutures.
  • MARPE is for adolescents and young adults with some suture flexibility.
• Invasiveness:
  • SARPE requires surgery and anesthesia.
  • MARPE is less invasive and performed in an orthodontic setting.
• Recovery and Discomfort:
  • SARPE carries the potential for post-surgical discomfort and swelling and has a longer recovery period.
  • MARPE has a lower risk of discomfort and faster recovery time.
• Complications:
  • SARPE risks include infection, bleeding, and anesthesia complications
  • MARPE risks are usually less severe and limited to mini-implant failure or palatal tissue irritation.

What Is MARPE vs. MSE?

The maxillary skeletal expander, or MSE, is a specialized type of MARPE expander developed to address severe maxillary constriction. The placement procedures are similar, but there are notable differences in other categories, such as:

• Design:
  • MARPE uses a hybrid expander attached to the teeth and anchored in the front or middle of the palate.
  • MSE devices attach directly to the anchors placed in the more robust posterior section of the palate and have fewer dental side effects.
• Activation:
  • MARPE activation protocol involves turning the expansion screw a quarter turn (about 0.25 mm) once or twice daily.
  • MSE devices can support faster expansion with two to four activations that move the palate 0.5 mm to 1.0 mm per day.
• Effectiveness:
  • MARPE orthodontics improves airways by expanding nasal passages and creates space for crowded teeth and better alignment.
  • MSE is minimally invasive, but can achieve results close to SARPE and substantially increase nasal volume and airway function.

Are You a Potential MARPE Candidate?

If you have MTD and are between 16 and 25 years old, you are likely a prime candidate for the MARPE procedure. However, there are a few considerations.

Treatment success often hinges on your periodontal tissue health. Conditions like active periodontal disease or significant bone loss can affect the stability and integration of the mini-implants used in MARPE.

Your overall health status matters as well. Certain systemic health conditions, such as osteoporosis, rheumatoid arthritis, or chronic kidney disease, affect bone biology and can influence the outcomes.

Will I Need Additional Orthodontic Treatments After MARPE?

While the rapid palate expander effectively widens your upper jaw, it does not directly address the positioning of individual teeth. Therefore, orthodontists often use additional treatments, such as braces or Invisalign, to reposition your teeth properly.

How Much Does MARPE Cost?

MARPE is usually part of your comprehensive orthodontic plan, and the average costs break down as such:

• MARPE Device and Placement: $8,000 to $12,000
• Braces or Invisalign: $5,000 to $8,000
• Additional Expenses: Diagnostic evaluations and imaging, follow-up visits, potential corrective surgeries, post-treatment retainers

Schedule a MARPE Consultation With Dr. Peterson

In the past, you would need surgery to correct your MTD. The widespread adoption of MARPE means that it is no longer necessary in many cases. Are you a good candidate for MARPE? Contact us today to schedule a complimentary consultation with Dr. Peterson in our San Tan Valley office.