Abstract

Update on Marpe Approaches with Regard to Age and Clinical Workflow

by Wilmes Benedict

Microimplant-Assisted Rapid Palatal Expansion (MARPE) represents a significant advancement in orthodontic treatment for patients with transverse maxillary deficiency, especially adolescents and young adults. Unlike conventional Rapid Palatal Expansion (RPE), which relies on dental anchorage and often results in undesirable dental tipping and limited skeletal effects, MARPE utilizes temporary anchorage devices (TADs) or mini-implants placed in the palatal bone to achieve direct skeletal expansion. This technique facilitates the separation of the midpalatal suture and stimulates surrounding circummaxillary sutures, allowing for more effective and stable widening of the maxilla. MARPE has demonstrated superior long-term outcomes compared to traditional RPE, including reduced relapse rates and fewer dentoalveolar side effects. Studies show that patients treated with MARPE exhibit significantly lower relapse in maxillary width over a 10-year period, highlighting its durability and effectiveness. Recent innovations such as 3D-printed custom MARPE appliances have further enhanced treatment precision and outcomes, particularly in adult patients where suture interdigitation poses greater resistance. Depending on the age of the patient, different approaches can be chosen (BMX expander, Hybrid Hyrax, Quadexpander). These custom devices allow for individualized implant placement and optimized force distribution, contributing to successful correction of transverse discrepancies.

Learning Objectives

After this lecture, you will be able to know the best insertion sites for TADs in the palate
After this lecture, you will be able to recognize the pros and cons of different expanders
After this lecture, you will be able to choose the appropiate expander for each patient