The MARPEFACE protocol was specifically developed and is continuously updated and revised by Dr. Svitlana Koval with the mission of developing facial structures and the upper airways. The upper airways represent the portion of the airway system not protected by bone structures, making them susceptible to reactive changes caused by jaw position and neck curvature.
The MARPEFACE protocol consists of several main components that aim to develop all the principal compartments of the upper airway through targeted bone and tooth movements.
The first stage of treatment with the MARPEFACE protocol involves bone development, achieved by increasing the size of the nasal passages and nasopharynx through the use of various modalities of tooth-bone-borne or bone-borne appliances—for example, a custom MARPE or the Facegenic Midfacial Expander (FME).
The second stage of the protocol focuses on subsequent tooth and mandibular movements, with an emphasis on further enhancing lip support, mandibular jawline, neck posture, and related structures.
Below are two projections of facial changes following completion of the first stage of treatment with a custom MARPE appliance activated in accordance with Dr. Koval’s protocol.