Non-Surgical Maxillary Expansion MARPE

Inadequate nasal breathing, often due to genetic factors or prolonged finger-sucking habits, frequently leads to narrowness in the upper jaw. When upper jaw narrowness is not treated during childhood, it can be closed by shifting it to achieve a proper closure relationship of the lower jaw. However, since the growth of the lower jaw is affected by its movements, shifting the jaw to close it initially, while aimed at addressing a functional issue, can eventually lead to asymmetries in the growth of the lower jaw. Therefore, it is beneficial to treat upper jaw narrowness as soon as it is diagnosed.

Upper jaw narrowness problem can usually be easily corrected until the age of 15 using intraoral removable or fixed appliances, but treatment becomes more challenging in later years. In adults, there are two ways to address skeletal narrowness in the upper jaw. One is to surgically expand the upper jaw, and the other is expansion through screws placed in the palate (MARPE). The decision on which method to use is made by the orthodontic specialist based on clinical and radiological examinations.

The MARPE method is a non-surgical technique that allows for the expansion of the upper jaw. With this method, 2 or 4 screws are painlessly placed in the palate by the orthodontic specialist under local anesthesia. The application of the screws takes approximately 15 minutes. The patient can return to their daily activities after the procedure.

In the MARPE method, an intraoral expansion device is attached to the screws, and the jaw expansion protocol is initiated. To expand the jaw, the screw of the intraoral device should be turned at specific intervals. The turning process is carried out by the patient or a caregiver using a key provided by the doctor, following the doctor’s recommendations. There may be a slight sense of discomfort or tension when the screw is turned.

Once the desired amount of expansion in the upper jaw is achieved, the screw is closed. The intraoral device and screws are kept in the mouth for a while longer. There is no harm in starting wire orthodontic treatment during this period.

The intraoral device and screws are easily removed by the doctor at a time deemed appropriate, again under local anesthesia. Since the healing of the intraoral mucosa is usually very rapid, the gaps left by the removal of the screws are completely closed within a few days.