MARPE expansion is known to produce maxillary skeletal expansion and cause subsequent increase in velopharyngeal, oropharyngeal, and nasal volume.While MARPE designs vary and may include combinations of traditional bands, traditional jackscrews, or milled/3D printed frameworks with other screw designs, there is no agreement on the techniques of MARPE expansion in adult patients.
While the effects of MARPE expansion in adults are well documented, there is a wide variety of techniques and appliance designs used to achieve skeletal maxillary expansion in this population, resulting in variable efficiency and outcomes.
Recent advances in airway-focused orthodontics have shown that nasal base expansion—particularly at the levels of the anterior nasal spine (ANS),posterior nasal spine (PNS), and piriform foramen—can significantly increase airway volumes in the nasal, nasopharyngeal, oropharyngeal, and hypopharyngeal regions.
However, not all MARPE designs consistently achieve separation at both the ANS and PNS.
Adult MARPE expansion—especially in males over 18 years of age—has historically been considered questionable, with alternative techniques often recommended to improve nasal airflow and address nasal breathing as a component of sleep-disordered breathing.
The technique described below has consistently produced midpalatal suture separation at both the ANS and PNS, along with disjunction of the pterygomaxillary sutures. These outcomes result in the forward and downward movement of the maxillary complex. Our findings consistently demonstrate peri-maxillary suture separation following guided midpalatalpiezocorticotomy-assisted MARPE (Microimplant-Assisted Rapid Palatal Expansion)for midfacial expansion. This process involves physiological separation of thefrontomaxillary, nasomaxillary, frontonasal, zygomaticomaxillary, and pterygomaxillary sutures in adult patients.
Our clinical observations and ongoing research suggest that indeal candidates for the Maxillary Skeletal Expansion with custom fabricated MARPE appliances and 3D guided midplaatal piezocorticitomy are:
- Males in their 20s with symptoms of sleep disordered Breathing, increased nasal airflow resistance;
- All males and females 20 y.o and olderwith sufficient bone quality and no systemic diseases;
- Adult females with retruded midfacial complex and orthognathic profiles;
- Male and female patients 20 yo and older with unilateral or bilateral posteiror crossbite;
- Male and female patients 20 yo and older with moderate-to-severe maxillary and/or mandibular crowding;
- Male and female patients with mandibular retrognathia due to retruded maxilalry position;
- Patients diagnosed with mild-moderate-severe Obstructive Sleep Apnea
Source: Koval, S.; Kolesnyk, V.; Chepanova, D. Applications of the Novel Midpalatal Piezocorticotomy Guide for MARPE Midfacial Skeletal Expansion. J. Clin. Med. 2025, 14.