Over the past few years, there’s been a noticeable shift in patient inquiries. Once, the focus was on systems like Invisalign and Damon, but now, MARPE (Mini-Implant Assisted Rapid Palatal Expansion) is becoming the new trend. Thanks to direct-to-consumer advertising and increasing online buzz, patients are reaching out to me monthly, specifically requesting MARPE as if it’s the latest miracle solution for all orthodontic and breathing-related issues.
While MARPE can be highly effective in the right cases, it’s essential to clarify that MARPE is not a one-size-fits-all solution. Like any medical treatment, it requires a thorough clinical and radiographic evaluation to ensure it’s the best approach for the patient.
MARPE is a specialized device used for non-surgical palatal expansion, often in adolescent or adult patients with a constricted maxilla. Unlike traditional expanders, which rely on dental anchorage, MARPE uses mini-implants that engage the bone to achieve skeletal expansion when conventional methods are no longer effective due to age or advanced development of the midpalatal suture.
When applied correctly, MARPE can help with problems like crowding, crossbites, and in some cases, improve breathing by expanding the upper jaw. However, the rising demand for MARPE has led to widespread misconceptions that it’s a “gourmet appliance” that can fix everything, which is far from true.
One of the most common misconceptions is that MARPE is a guaranteed solution for all patients, regardless of their specific issues. Many patients come in expecting that MARPE will have a 100% success rate, especially after reading online testimonials. However, MARPE requires a clear clinical need, and success depends heavily on the patient’s age and individual case.
For example, in patients over the age of 20, the midpalatal suture is more resistant to expansion, making MARPE less predictable. In these cases, complications such as pain, bone loss, or failure to achieve the necessary expansion are more likely. That’s why surgical facilitation, often through a corticotomy, is sometimes recommended in adult patients to reduce risks and improve the success of skeletal expansion.
While MARPE can be highly effective, it’s not without its risks, especially in adult patients. Here are some of the potential complications that should be considered:
Another common misconception is that MARPE will solve breathing problems, such as sleep apnea or chronic nasal congestion. While maxillary expansion can sometimes improve airway space, breathing problems are complex and may not always be due to a constricted maxilla.
Issues like nasal obstructions, adenoid hypertrophy, or pharyngeal airway collapse often need specialized treatment from an ENT or sleep specialist. In many cases, MARPE might be only one part of the solution, but not the definitive fix.
The AAO White Paper on orthodontic management of airway disorders emphasizes that while orthodontic treatments, including MARPE, can benefit airway expansion, they are not a guaranteed solution. The AAO advocates for a multidisciplinary approach that involves orthodontists, ENT specialists, and sleep specialists to ensure an accurate diagnosis and effective treatment plan.
In the age of the internet, it’s easy to get swept up in success stories or testimonials about treatments like MARPE. However, just because something sounds good online doesn’t mean it’s the right solution for everyone. As with any medical treatment, it’s important to have a proper clinical evaluation to determine if MARPE is appropriate for your specific case.
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I recommend and prescribe orthodontic treatments to my patients as if they were my own family and I value meaningful relationships based on communication, confidence and trust.
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