MARPE expansion has become a widely accepted technique showing promising results in improving upper airway size and dimensions.
Our study (Outcomes Of3D-Guided Midpalatal Piezocorticotomy Combined With MARPE Expansion In Adults , Koval and colleagues, 2025) evaluated the impact of the greater amounts of expansion achieved with3D-guided midpalatal piezocorticitomy-assisted MARPE expansion (8.48 mm)measured between the maxillary crests of the palatient processes of themaxillary bones in axial plane, compared to an average 4.3 mm midpalatal separation in similar studies without 3D-guided midpalatal piezocorticotomy and other appliance designs.
This research suggests that midpalatal disarticulation, evaluated in the axial plane, offers the most accurate representation of maxillary skeletal expansion.This approach contrasts with the previously described method that was used to evaluate the amount of maxillary expansion, who used maxillary first molars as reference points for assessing expansion. The rationale for employing skeletal rather than dental reference landmarks is to minimize inaccuracies associated with molar tipping, which constitutes a significant proportion of the overall transverse change, particularly in cases treated with tooth-bone–borne expansion appliances. Future research should therefore prioritize imaging techniques that capture skeletal landmarks directly, in order to achieve more reliable and clinically meaningful assessments of maxillary expansion.