MARPE in Issaquah, WA

In older teens and adults, your orthodontist may recommend miniscrew-assisted rapid palatal expansion (MARPE) when traditional expansion may not provide enough skeletal support.

How MARPE Supports Palatal Expansion

MARPE stands for miniscrew-assisted rapid palatal expansion. It uses a palatal expander supported by small miniscrews placed in the roof of the mouth.

The miniscrews provide additional anchorage so expansion forces can be directed more toward the upper jaw instead of relying primarily on the teeth. This approach may be recommended for older teens and adults whose upper jaw growth is more mature.

When MARPE May Be Recommended

Your orthodontist may recommend MARPE when the upper jaw needs to be widened and a traditional tooth-supported expander may not provide enough skeletal expansion.

MARPE may help with:

• A narrow upper jaw
• Posterior crossbite
• Crowding related to limited upper jaw width
• Bite concerns caused by upper and lower jaw width mismatch
• Orthodontic cases where tooth-supported expansion may not be enough
• Select airway-related concerns when evaluated by the appropriate provider

Not every patient with a narrow palate needs MARPE. Your orthodontist determines whether it is appropriate and works with our team when miniscrew placement or surgical support is needed.

MARPE vs. Traditional Palatal Expansion

Traditional palatal expanders are often used in younger patients while the upper jaw is still growing. These appliances rely more heavily on the teeth to support expansion.

MARPE adds miniscrew support to help anchor the expander in the palate. This can be useful for older teens and adults, where the goal is to create more skeletal support for expansion instead of placing most of the force on the teeth.

When the suture (the seam down the middle of the palate) will not open with MARPE, which becomes more likely with age, surgically assisted expansion (SARPE) is the next step. We do that here as well, so a patient who turns out not to be a MARPE candidate does not have to start over somewhere else.

How MARPE Works During Orthodontic Treatment

Once the miniscrews and appliance are in place, your orthodontist directs the expansion phase of treatment. You will receive instructions for activating the appliance, and your orthodontist will monitor how the palate and teeth respond over time.

Pressure in the palate, teeth, or nasal area can occur as expansion begins. Some patients also develop a temporary space between the upper front teeth as the palate widens. Your orthodontist will manage tooth positioning as treatment continues.

After the expansion and stabilization phases are complete, the appliance and miniscrews can be removed.

The MARPE Placement Procedure

MARPE miniscrew placement is typically completed as an in-office procedure. Before placement, we review your orthodontic treatment plan and a 3D scan (CBCT), taken in our office if your orthodontist  has not already done one, to evaluate the palate, bone thickness, nearby tooth roots, and the nasal floor. 

The general process includes:

1. Local anesthesia: The placement areas are numbed so you remain comfortable during the procedure. Sedation options are available, including IV sedation in our office for patients who prefer it.
2. Miniscrew placement: The small miniscrews are placed in the planned locations in the palate to support the expander.
3. Orthodontic follow-up: Your orthodontist manages appliance activation and monitors expansion according to your orthodontic plan.
4. Removal: Once the miniscrews are no longer needed, they can be removed during a short visit.

You will receive instructions for keeping the area around the appliance and miniscrews clean during treatment.

Are There Any Risks?

MARPE is well tolerated, but it is not risk-free. A miniscrew can loosen or the gum around it can become inflamed, which is usually managed with cleaning or by replacing the screw. Expansion can be uneven, and in some adults the suture does not open at all, which is when surgically assisted expansion comes in. Pressure across the bridge of the nose, headaches, and some nasal stuffiness during the turning phase are common and settle once the turns stop.

Coordinated Care With Your Orthodontist

MARPE requires close coordination between your orthodontist and oral surgeon. At Adara Surgical Institute, Dr. Hardeep Dhaliwal, a board-certified oral and maxillofacial surgeon in the United States and Canada, works with orthodontists in Issaquah and throughout the Eastside to support patients who need MARPE as part of their orthodontic treatment.

Your orthodontist guides the overall expansion plan, while our surgical team evaluates the palate and uses advanced imaging to plan the miniscrew locations. We coordinate placement with your orthodontist so the appliance has the support needed for the planned expansion.

For patients referred from Issaquah, Bellevue, Redmond, Sammamish, Renton, Kirkland and surrounding communities, our goal is to make this part of orthodontic treatment comfortable, precise, and well coordinated.