Review Article

Miniscrew-assisted rapid palatal expander (MARPE) therapeutic results: A review

Abstract

Background: One of the most common maxillary abnormalities is transverse deficiency, which can be a contributory factor in malocclusions. There are some evidence of successful non-surgical treatment of this type of discrepancy after puberty by using maxillary expansion techniques. The Miniscrew-assisted rapid palatal expander (MARPE) method is a newly introduced method that has attracted the interest of many orthodontists. This study aimed to evaluate the therapeutic results of this technique in a systematic review. Materials and Methods: In this study, various databases including PubMed, Scopus, and ISI (Web of science) were queried with proper keywords, provided by PICO strategy of research, from 1980 to December 2020. Relevant articles were collected with restrictions on the English language. The full text of papers with all inclusion criteria was assessed. The therapeutic outcomes of MARPE were evaluated in the selected studies. Results: A total of 14 studies were included in the systematic review. Totally, 5 case report studies, 8 retrospective studies, and 1 case series study were reviewed. Cone-beam computed tomography was used as an outcome measure in all studies. In all reviewed studies, maxillary expansion occurred with high success rates in patients. Moreover, respiratory characteristics were also assessed in two studies measuring respiratory muscle strength, airflow and nasal and nasopharyngeal airway volume, showing benefits of MARPE. A study also examined three-dimensional soft tissue stereophotogrammetry. Based on these studies, the indication for using this method was a maxillary transverse deficiency as well as upper and lower arches crowding. No serious complications were reported in any of the reviewed studies. However, most studies did not perform long-term follow-ups and the age range of the subjects was mainly between 12 and 24 years. MARPE has been suggested as a treatment modality for correction of maxillary transverse deficiency in young adults but patients under the age of 14 may also benefit from this treatment in special conditions. Conclusion: A general review of the results of studies showed the high efficiency of MARPE technique in correcting maxillary transverse deficiency. Keywords: Maxillary transverse deficiency; Crossbite; Miniscrew; Miniscrew-assisted rapid palatal expander (MARPE).
References:
1. Hasheminasab M, Mortazavi M, Sharifi R, Bolandparva F; Rotation of the maxillomandibular complex in orthognathic surgery: A review. J Craniomax Res 2019; 6(4): 138-142
2. Locker D, Allen F. What do measures of ‘oral health‐related quality of life ‘measure? Community dentistry and oral epidemiology. 2007 Dec;35(6):401-11.
3. Birkeland K, Bøe OE, Wisth PJ. Relationship between occlusion and satisfaction with dental appearance in orthodontically treated and untreated groups. A longitudinal study. The European Journal of Orthodontics. 2000 Oct 1;22(5):509-18.
4. Proffit WF. The evolution of orthodontics to a data-based specialty. American Journal of Orthodontics and Dentofacial Orthopedics. 2000 May; 117(5): 545-7.
5. Andrucioli MC, Matsumoto MA. Transverse maxillary deficiency: treatment alternatives in face of early skeletal maturation. Dental Press Journal of Orthodontics. 2020 Jan;25(1):70-9.
6. McConnell TL, Hoffman DL, Forbes DP, Janzen EK, Weintraub NH. Maxillary canine impaction in patients with transverse maxillary deficiency. ASDC journal of dentistry for children. 1996;63(3):190-5.
7. Sato H, Fueki K, Sueda S, Sato S, Shiozaki T, Kato M, Ohyama T. A new and simple method for evaluating masticatory function using newly developed artificial test food. Journal of oral rehabilitation. 2003 Jan;30(1):68-73.
8. Sermboonsang C, Chantarapanich N, Inglam S, Insee K. Biomechanical study of midpalatine suture and miniscrews affected by maturation of midpalatine suture, monocortical and bicortical miniscrew placement in bone-borne rapid palatal expander: a finite element study. Science, Engineering and Health Studies. 2020 Aug 27:109-22.
9. Persson M, Thilander B. Palatal suture closure in man from 15 to 35 years of age. American journal of orthodontics. 1977 Jul 1;72(1):42-52.
10. Jain, Sumita & Shrivastav, Sunita & Jain, Dr. Nikil. (2015). Maxillary Expansion in Cleft Lip and Palate Cases- A Review. International Journal of Advanced Research. 3. 1455-1461.
11. Kalantar Moetamedi A, Feizbakhsh M, Mortazavi M, Derakhshanfar H, Hasheminasab M. Nasoalveolar molding in cleft lip, a review of literature. J Craniomax Res 2014;1(3-4) 32-36.
12. Lam PH, Sadowsky C, Omerza F. Mandibular asymmetry and condylar position in children with unilateral posterior crossbites. American Journal of Orthodontics and Dentofacial Orthopedics. 1999 May 1;115(5):569-75.
13. Malandris M, Mahoney EK. Aetiology, diagnosis and treatment of posterior cross‐bites in the primary dentition. International journal of pediatric dentistry. 2004 May;14(3):155-66.
14. Allen D, Rebellato J, Sheats R, Ceron AM. Skeletal and dental contributions to posterior crossbites. The Angle Orthodontist. 2003 Sep 1;73(5):515-24.
15. Johal A, Conaghan C. Maxillary morphology in obstructive sleep apnoea: A cephalometric and model study. Angle Orthod 2004; 74(5): 648-56.
16. Agarwal A, Mathur R. Maxillary Expansion. International Journal of Clinical Pediatric Dentistry 2010;3(3):139-146
17. Rungcharassaeng K, Caruso JM, Kan JY, Kim J, Taylor G. Factors affecting buccal bone changes of maxillary posterior teeth after rapid maxillary expansion. American Journal of Orthodontics and Dentofacial Orthopedics. 2007 Oct 1;132(4):428-e1.
18. Northway WM, Meade JB. Surgically assisted rapid maxillary expansion: a comparison of technique, response, and stability. The Angle Orthodontist. 1997 Aug 1;67(4):309-20.
19. Di Luzio C, Bellisario A, Squillace F, Favale M, Caputo M. Miniscrew-Assisted Rapid Palatal Expander (Marpe): An Efficient Alternative Treatment of Axillary Transverse DeficiencySermboonsang C, Chantarapanich N, Inglam S, Insee K. Biomechanical study of midpalatine suture and miniscrews affected by maturation of midpalatine suture, monocortical and bicortical miniscrew placement in bone-borne rapid palatal expander: a finite element study. Science, Engineering and Health Studies. 2020 Aug 27:109-22.
20. Tausche E, Deeb W, Hansen L, Hietschold V, Harzer W, Schneider M. CT analysis of nasal volume changes after surgically-assisted rapid maxillary expansion. Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie. 2009 Jul 1;70(4):306-17.
21. Kravitz ND, Kusnoto B. Risks and complications of orthodontic miniscrews. American Journal of Orthodontics and Dentofacial Orthopedics. 2007 Apr 1;131(4): S43-51.
22. Alhammadi, M. S., Halboub, E., Fayed, M. S., Labib, A., and El-Saaidi, C. (2018). Global distribution of malocclusion traits: A systematic review. Dental Press Journal of Orthodontics, 23(6), e1-e10.
23. Corega, C., Corega, M., Bǎciuţ, M., Vaida, L., Wangerin, K., Bran, S., and Bǎciuţ, G. (2010). Bimaxillary distraction osteogenesis--an effective approach for the transverse jaw discrepancies in adults. Chirurgia (Romania), 105(4), 571-575.
24. Cunha AC, Lee H, Nojima LI, Nojima MD, Lee KJ. Miniscrew-assisted rapid palatal expansion for managing arch perimeter in an adult patient. Dental press journal of orthodontics. 2017 Jun;22(3):97-108.
25. Lee, K.-J., Park, Y.-C., Park, J.-Y., & Hwang, W.-S. (2010). Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. American Journal of Orthodontics and Dentofacial Orthopedics, 137(6), 830–839. doi: 10.1016/j.ajodo.2007.10.065
26. Brunetto DP, Sant’Anna EF, Machado AW, Moon W. Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE). Dental press journal of orthodontics. 2017 Feb;22(1):110-25.
27. Storto CJ, Garcez AS, Suzuki H, Cusmanich KG, Elkenawy I, Moon W, Suzuki SS. Assessment of respiratory muscle strength and airflow before and after microimplant-assisted rapid palatal expansion. The Angle Orthodontist. 2019 Sep 1;89(5):713-20.
28. Lim HM, Park YC, Lee KJ, Kim KH, Choi YJ. Stability of dental, alveolar, and skeletal changes after miniscrew-assisted rapid palatal expansion. The Korean Journal of Orthodontics. 2017 Sep 1;47(5):313-22.
29. Zong C, Tang B, Hua F, He H, Ngan P. Skeletal and dentoalveolar changes in the transverse dimensions using microimplant-assisted rapid palatal expansion (MARPE) appliances. Seminars in Orthodontics 2019;25;46-59.
30. Song J. Retrospective Evaluation of the Changes in the Nasal and Pharyngeal Airway Volume After Miniscrew Assisted Rapid Palatal Expansion (MARPE) Appliance. [Thesis] West Virginia University , 2020, sep, https://doi.org/10.33915/etd.7622

31. Park JJ, Park YC, Lee KJ, Cha JY, Tahk JH, Choi YJ. Skeletal and dent alveolar changes after miniscrew-assisted rapid palatal expansion in young adults: a cone-beam computed tomography study. The Korean Journal of Orthodontics. 2017 Mar 1;47(2):77-86.
32. Gholinia F, Dalili Kajan Z, Irannezhad A. Nonsurgical Miniscrew-Assisted Rapid Palatal Expansion in an Adult Patient. Journal of Dent maxillofacial. 2018 Jun 10;7(2):85-93.
33. Lee SR, Lee JW, Chung DH, Lee SM. Short-term impact of microimplant-assisted rapid palatal expansion on the nasal soft tissues in adults: A three-dimensional stereo photogrammetry study. The Korean Journal of Orthodontics. 2020 Mar 1;50(2):75-85.
34. Rojas V, Macherone C, Zursiedel MI, Valenzuela JG. Rapid maxillary expansion in young adults: comparison of tooth-borne and bone-borne appliances, a cohort study. Journal of Oral Research. 2019 Jun 30;8(3):201-9.
35. Lupini DA, Retrouvey JM, Decesari D, Cozzani M. A Tissue and Boneborne Rapid Palatal Expander. J. Clin. Orthod. 2020; 54:210-20
36. Shin H, Hwang CJ, Lee KJ, Choi YJ, Han SS, Yu HS. Predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion in young adults: A preliminary study. The Korean Journal of Orthodontics. 2019 Nov 1;49(6):360-71.
37. Kolge NE, Patni VJ, Potnis SS, Kate SR, Fernandes FS, et al. (2018) Pursuit for Optimum Skeletal Expansion: Case Reports on Miniscrew Assisted Rapid Palatal Expansion (MARPE). J Orthod Endod 4:9. DOI: 10.21767/2469-2980.10005.
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IssueVol 8, No 1 (Winter 2021) QRcode
SectionReview Article(s)
Published2021-07-07
Keywords
Maxillary transverse deficiency; Crossbite; Miniscrew; Miniscrew-assisted rapid palatal expander (MARPE).

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How to Cite
1.
Mortazavi M, Sharifi R, Hasheminasab M. Miniscrew-assisted rapid palatal expander (MARPE) therapeutic results: A review. J Craniomaxillofac Res. 8(1):1-10.