MARPE Prices 2026
Calculate your TDB 2026 reference fee for non-surgical mini-screw–supported upper jaw expansion.
The mini-screws placed in the palatal region of a MARPE appliance transfer force directly to the bone. Either 2 or 4 mini-screws are typically used.
Retention treatment is recommended after expansion to stabilise the new position. It improves long-term stability.
Approximate Clinician Fee
TDB 2026 reference · VAT excluded
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This figure reflects the TDB 2026 minimum guideline tariff. For a personalised quote, please get in touch.
Reference fees are based on the TDB 2026 Guideline Tariff (7-44, 7-60, 7-20). Prices shown are exclusive of VAT. MARPE is planned after a clinical examination and digital scan.
MARPE prices are among the current research topics for young adults exploring orthodontic treatment due to upper jaw constriction, crossbite, or airway issues. MARPE (Miniscrew-Assisted Rapid Palatal Expansion) is a modern orthodontic protocol in which mini-screws (temporary anchorage devices) deliver force directly to the palatal bone to expand the upper jaw skeletally. While conventional rapid maxillary expanders have limited effect in patients past growth (16+), MARPE achieves true skeletal expansion of the palatal bone even after adolescence.
Upper jaw constriction is one of the main causes of crossbite, dental crowding, nasal obstruction, mouth breathing, sleep apnea, and aesthetic concerns. A significant portion of orthodontic problems is in fact built on this underlying jaw constriction. The traditional approach for upper jaw expansion in adults was SARPE (surgically assisted rapid palatal expansion). MARPE stands out as a revolutionary approach that delivers similar outcomes without surgery — or with only minimally invasive intervention.
At our clinic Doredent in Avcılar, Istanbul, MARPE treatment is delivered by our orthodontic specialist using CBCT (3D tomography) analysis, digital treatment planning, and specialist orthodontic care. Every patient’s palatal shape, the available areas for mini-screw placement, and treatment goals are planned individually.
MARPE cost varies with the patient’s age and degree of skeletal maturity, the type of appliance used (MSE, Hybrid Hyrax, C-Expander), the number and brand of mini-screws (titanium, with specialised coatings), the scope of any planned additional orthodontic treatment (post-MARPE Invisalign or braces), CBCT imaging needs, and the follow-up schedule.
What Is MARPE?
MARPE (Miniscrew-Assisted Rapid Palatal Expansion) is an orthodontic method that uses mini-screws (TADs — temporary anchorage devices) placed in the palate and connected to the appliance to deliver force directly to the bone in order to expand the upper jaw (maxilla). In classical rapid maxillary expansion (RME) appliances, force is transmitted to the bone via the teeth; in MARPE, the force bypasses the teeth and goes straight to the bone. This difference makes skeletal expansion of the midpalatal suture possible even in post-adolescent patients.
Why MARPE? In children, the midpalatal suture (the bony union line) has not yet closed, so classical rapid maxillary expansion (RME) successfully achieves expansion. After adolescence (15–16+), this suture begins to fuse, and classical appliances only tip the teeth outward (dentoalveolar expansion) without producing skeletal expansion. This means both a higher risk of failure and side effects on the tooth roots. MARPE applies force directly through bone via the mini-screws, initiating mechanical separation even when the suture is fused. For this reason, MARPE is one of the most important innovations in modern orthodontics — making it possible to achieve skeletal expansion in adults without surgery.
When Is MARPE Recommended?
MARPE treatment may be considered for the indications below. A definitive decision is only made after clinical examination and 3D imaging:
Skeletal Upper Jaw Constriction
Main IndicationMARPE is one of the first-line treatments in cases where the crossbite between the upper and lower jaw bones is skeletal in origin. Bringing the upper jaw to the correct dimensions through expansion also significantly reduces crowding issues in the neighbouring teeth.
Bilateral Crossbite
Functional IssueIn cases where there is crossbite in both the right and left posterior regions, skeletal expansion becomes necessary. Untreated crossbite can lead to TMJ problems, facial asymmetry, and chewing difficulties later in life.
Crowding and Space Deficiency
Creating SpaceIn cases of severe crowding in the upper jaw, the expansion achieved with MARPE makes non-extraction treatment possible. The non-extraction approach lets us preserve all teeth.
Airway and Sleep Issues
Functional BenefitUpper jaw expansion also widens the floor of the nasal cavity, improving nasal airflow. MARPE can have a supportive effect in patients with mouth breathing, snoring, and mild-to-moderate sleep apnea. In cases requiring approved sleep apnea treatment, a multidisciplinary plan is set.
The MARPE Treatment Process
MARPE is a multidisciplinary process that requires careful planning and close follow-up. Treatment takes approximately 6–12 months and includes the following steps:
Detailed Clinical and Radiographic Assessment
Before starting treatment, the orthodontist performs a comprehensive clinical examination, photography, and digital intraoral scan. Panoramic and cephalometric radiographs, and especially CBCT (3D tomography), are used to assess the state of the midpalatal suture, bone thickness, and suitable areas for mini-screw placement. CBCT analysis is critical to MARPE success — the degree of suture fusion, bone anatomy, and at-risk anatomic zones are mapped from this scan.
Treatment Planning and Appliance Selection
The MARPE appliance is chosen based on case-specific features: MSE (Maxillary Skeletal Expander), Hybrid Hyrax, or C-Expander are some of the available designs. Each has different screw placement areas, expansion capacities, and indications. Digital treatment planning sets the target expansion amount and timeline. The appliance is usually custom-made in the lab from the patient’s intraoral scan.
Mini-Screw Placement and Appliance Fitting
Under local anaesthesia, 4 mini-screws (TADs) are placed in the palatal region; the MARPE appliance is then fitted onto these screws and the upper molars. The procedure takes 30–45 minutes and is painless. The mini-screws are made of titanium alloy, are biocompatible, and are easily removed at the end of treatment. Mild sensitivity is possible for the first few days but is controlled with pain relief.
Active Expansion Phase
Active expansion begins 5–7 days after fitting. The patient turns the central screw of the appliance once or twice a day (typically morning and evening, recorded in a tracking sheet). Each turn produces approximately 0.25 mm of expansion. Active turning continues for 2–4 weeks until the target amount of expansion is reached. During this period, a gap (diastema) opens between the front teeth — this is the classic sign that the suture has separated, and a marker of treatment success.
Retention Phase
Once expansion is complete, the MARPE appliance is left in place for 4–6 months while new bone formation takes place. During this time, new bone forms in the separated suture area. If the retention phase is skipped, the risk of relapse (loss of expansion) is high. Regular check-ups are scheduled during this period, and panoramic/cephalometric radiographs are used to assess the stability of the treatment.
Removing the Appliance and Mini-Screws
Once the retention phase is complete, the MARPE appliance and mini-screws are removed in the clinic. The procedure is completed quickly under local anaesthesia. Small marks remain on the palate after mini-screw removal, but they heal on their own within a few days. The patient’s palate is now in its newly expanded position.
Transition to Main Orthodontic Treatment
After the jaw is expanded with MARPE, additional orthodontic treatment is needed in most cases to bring the teeth to their ideal positions. At this stage, Invisalign clear aligners or fixed braces are delivered. Treatment concludes with a retainer at the end of the orthodontic phase.
Factors Affecting MARPE Prices
MARPE treatment cost is not fixed — it varies with each patient’s case characteristics and the scope of treatment:
Patient Age and Skeletal Maturity
MARPE success and duration relate directly to the patient’s age. In young adults (18–25), suture fusion is less, and treatment progresses faster. In patients aged 25–35, suture fusion is more extensive, so treatment may take longer and require higher forces and a longer retention phase. In patients over 35, MARPE may not always be suitable; a comparative assessment with SARPE is made.
Appliance Type and Brand
The appliance type (MSE, Hybrid Hyrax, C-Expander, Moss Expander) and brand used in MARPE treatment is one of the biggest factors affecting cost. Premium brands (e.g. MSE Won) are more expensive, but offer advantages in both manufacturing quality and clinical consistency. Because the appliance is custom-made in the lab, the digital design process also feeds into cost.
Number and Quality of Mini-Screws
MARPE appliances typically use 4 mini-screws as standard, but some designs use a different number. The length, diameter, material (titanium alloy), and brand quality of the mini-screws all affect price. High-quality mini-screws stay stable throughout treatment and improve success rates. Cheaper mini-screws carry a higher risk of fracture and loss of stability.
CBCT and Advanced Imaging
CBCT (3D tomography) is essentially mandatory for MARPE treatment planning. The scan is needed to assess the state of the midpalatal suture and the areas available for mini-screw placement. The CBCT fee is added as a separate line item to the cost. Additional CBCT scans may be needed during and at the end of treatment.
Follow-On Orthodontic Treatment
MARPE is rarely a standalone treatment; it is typically followed by Invisalign or braces. The scope and method of orthodontic treatment significantly affect total cost. At Doredent, Invisalign and braces treatments are offered at the same price.
Follow-Up Appointments and Additional Check-Ups
MARPE treatment requires regular check-ups throughout (active expansion + retention). Check-ups every 1–2 weeks are recommended during active expansion and every 1–2 months during retention. These visits assess treatment progress, appliance stability, and patient adherence. Visits may be included in the overall treatment package or priced separately.
Frequently Asked Questions
Mini-screw placement is performed under local anaesthesia, so it’s painless. Mild sensitivity and a pressure feeling in the palate can occur for the first 2–3 days afterwards, easily controlled with prescribed pain relief. During the active expansion phase, a mild pressure sensation can be felt for 10–15 minutes after each turn. These sensations show that treatment is progressing, and severe pain is not expected.
SARPE (surgically assisted rapid palatal expansion) is a surgical procedure; the palatal bone is cut under general anaesthesia to release the suture, then expansion is achieved with the appliance. MARPE is a non-surgical or minimally invasive approach in which force is applied directly to the palatal bone with mini-screws. MARPE is less invasive, less painful, and has a shorter recovery — but it isn’t suitable for every case. MARPE is usually tried first in patients aged 18–35; SARPE is planned in case of failure or in very mature ages. The choice is a joint decision between the orthodontist and the maxillofacial surgeon. For more, see our SARPE prices page.
Total MARPE treatment (active expansion + retention) takes 6–12 months. Active expansion takes 2–4 weeks; retention takes 4–6 months. After this, orthodontic treatment (braces or Invisalign) begins and can take a further 12–18 months. Total treatment may run 2–3 years. Treatment started at younger ages progresses faster.
Yes — during active expansion, a temporary diastema forms between the two upper central incisors. This gap is the marker that the midpalatal suture has separated, and a classic clinical sign of treatment success. It closes during retention and the orthodontic treatment that follows. The diastema during expansion also reduces somewhat on its own over time, but closing it orthodontically is recommended. Patients sometimes have aesthetic concerns during this period, but the development is expected.
No. The mini-screws are removed at the end of treatment, and the small holes they leave in the palate heal on their own within a few days. No permanent marks or tooth root damage are expected. However, in placements not planned by an experienced clinician, there is a risk of damaging tooth roots. CBCT planning and treatment with an experienced orthodontist are critical for this reason.
In properly planned MARPE treatments with a full retention phase, the risk of relapse is low. Skipping retention or removing the appliance early increases the risk. The orthodontic treatment that follows retention and the retainer fitted afterwards consolidate stability. Long-term follow-up after treatment also matters for long-term success.
In older patients (typically over 35–40), the midpalatal suture may be completely fused, and MARPE can fail. Severe palatal bone defects, prior palatal surgery, active gum disease, or general health concerns may also make MARPE unsuitable. In very severe skeletal constriction cases, SARPE may be preferred. Suitability is assessed through clinical examination and CBCT.
For the first 1–2 weeks after the appliance is fitted, mild speech changes — particularly slipping on “s” and “z” sounds — can occur as the tongue adapts. This resolves quickly as the tongue muscles become familiar with the appliance. After expansion is complete, some patients report improvements in speech and breathing because the airway has opened.
MARPE widens the upper jaw and so opens the floor of the nasal cavity and the nasal airways. This may contribute to reducing symptoms in some mild-to-moderate sleep apnea cases. MARPE on its own, however, is not an approved sleep apnea treatment. If you have diagnosed sleep apnea, a joint multidisciplinary plan is set with pulmonology and a sleep centre. MARPE can be a supportive element of treatment in these cases.
MARPE is assessed within the scope of orthodontic treatment. SGK provides partial cover for orthodontic treatment only in congenital anomalies such as cleft lip and palate or in serious orthognathic cases. MARPE treatments for aesthetic or functional purposes are outside SGK coverage. Some private health insurance policies offer orthodontic cover; we recommend checking with your insurance provider about the scope of your cover.
