MARPE (Miniscrew-Assisted Rapid Palatal Expander)

Created by Olivia Koehler, Modified on Thu, 29 May at 3:28 PM by Olivia Koehler

This article covers the information, use, and production details of a MARPE produced by NEOLab. MARPE's belong to the Fixed Expansion category.

A MARPE appliance stands for Miniscrew-Assisted Rapid Palatal Expander. It is an orthodontic device used to widen the upper jaw (maxilla) in adolescents and adults, particularly when traditional palatal expansion is not effective due to skeletal maturity.

TABLE OF CONTENTS

General Information
Functional Information
Required To Submit
Billing
- Digital > Fixed > Expander > MARPE
- Digital > 3D Appliance - SLS > Expander (3D) > 3D - MARPE
Production
Share with Doctors

_______________________________________________________________________________________________________________

General Information


4 TAD placements with Leone CAD screw	6 TAD placements with Super Screw

Available In	☐ Physical ☑️ Digital ☑️ 3D
Available On
Alternate Names	The MARPE may also be called a TAD-supported or TAD-borne expander. A subtype of the MARPE, the MSE, is also a commonly-used name. There is a similar-sounding appliance called the SARPE (Surgically-Assisted Rapid Palatal Expander), but this is not something NEOLab manufactures. TADs (temporary anchorage devices) and miniscrews are interchangeable terms.

Functional Information

Recommended for Patients Who:	Are skeletally mature. As TADs are placed into the bone, patients must have skeletal maturity to ensure the anchorage does not move or damage bone structure, and that no more changes to bone structure are expected. Typically, this means the MARPE is reserved for patients above the age of 15 and under the age of 40. Ideal candidates are between the ages of 15 and 25. Feature orthodontic deficiencies, such as a narrow upper jaw, crossbite, crowding, or have an asymmetrical upper jaw. Are looking to avoid surgery. MARPE is considered minimally invasive. May have airway or other breathing issues, including nasal constriction, mouth-breathing issues, or chronic snoring. Have no active periodontal issues.

How it Works:	Mechanism of Action Fundamentally, the MARPE works in the same way as any other traditional expander. The patient turns the expander as recommended by the doctor, often 1-2 times per day. Each activation ratchets the screw forward, creating additional space in the upper arch and palate. Where the MARPE differs is in where the force is applied. Activating a traditional expander creates force on the molars and premolars, which is transmitted indirectly to the palatal suture. In young patients who have an open suture, this creates palatal expansion. Because of the combined use of TADs, the MARPE applies force directly on the palatal suture, dramatically increasing the amount of pressure available to expand mature bone. For most MARPE designs, the TADs will be placed prior to the appliance being manufactured. Any TAD system may be used. The exception is in the MSE, which will place specific MSE TADs after the appliance is cemented.

The MARPE is considered an expander, but differs from our traditional RPE in the following ways:

	Traditional RPE	MARPE
Age Group	Children - adolescents	Adolescents - adults
Anchorage Point	Dental (teeth only, indirect to suture)	Dental and skeletal (TADs, direct to suture)
Ability to Separate Suture	Limited in adults	Effective in adults
Invasiveness	Non-surgical / non-invasive	Minimally invasive

Clinical Protocol

The average clinical protocol for using a MARPE (Miniscrew-Assisted Rapid Palatal Expander) typically spans 4–6 months.

Week 0-2	Doctor plans TAD placement and installs miniscrews. Doctor takes a scan and send to the lab.
Week 3-4	Lab manufactures MARPE around TAD placements. MARPE is returned to the doctor.
Week 5-8 (Month 2)	Doctor cements MARPE and fixes to TADs. Patient turns expansion screw 1-2 times per day, until maximum expansion is reached (depends on screw type and size). Typically, the active expansion phase is finished in roughly 4 weeks, and patients will return to the office weekly for the doctor to verify treatment is going as planned.
Week 9-24 (Months 3-6)	MARPE is left in place without activation for the next 3-6 months, depending on the specific treatment plan. This passive phase allows suture healing and bone regeneration.
Week 25+	MARPE is removed and a patient continues with other orthodontic treatment.

Clinical Cases

Below are a collection of clinical cases related to MARPE usage, published in major dental, orthodontic, and surgical journals:

Ventura V, Botelho J, Machado V, Mascarenhas P, Pereira FD, Mendes JJ, Delgado AS, Pereira PM. Miniscrew-Assisted Rapid Palatal Expansion (MARPE): An Umbrella Review. J Clin Med. 2022 Feb 26;11(5):1287. doi: 10.3390/jcm11051287. PMID: 35268377; PMCID: PMC8911209.
Kapetanović A, Theodorou CI, Bergé SJ, Schols JGJH, Xi T. Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis. Eur J Orthod. 2021 Jun 8;43(3):313-323. doi: 10.1093/ejo/cjab005. PMID: 33882127; PMCID: PMC8186837.
Chun JH, de Castro ACR, Oh S, Kim KH, Choi SH, Nojima LI, Nojima MDCG, Lee KJ. Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT. BMC Oral Health. 2022 Apr 8;22(1):114. doi: 10.1186/s12903-022-02138-w. PMID: 35395801; PMCID: PMC8994336.
Jia H, Zhuang L, Zhang N, Bian Y, Li S. Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage. Angle Orthod. 2021 Jan 1;91(1):36-45. doi: 10.2319/041920-332.1. PMID: 33289835; PMCID: PMC8032284.

Required To Submit

Arch Requirements	Upper scan
Palatal Requirements
Palatal Requirements	Full Palate	3/4 Palate	Horseshoe (1/2 Palate)
Accessory Requirements	☐ Waxbite ☐ Opposing arch or image of occlusion ☐ Articulation ⚠️ If a doctor has indicated that they've already placed TADs, TADs must be present in the scan used to fabricate the appliance.

Billing

The MARPE prescription contains a number of options that may impact billing. Items marked in blue are automapped, and will be present on the prescription by default, according to the options chosen.

Digital > Fixed > Expander > MARPE

Impression

"3D Model w/ Appliance" x 1

Banding

"Doctor will provide clinically fit bands:"	"Seat Doctor Provided Band" x 2
"Lab will indirect band:"	"Indirect Band" x 2
"No buccal tubes." "Add .022 BTs with archwire slot and hook." "Add .018 BTs with archwire slot and hook." "Add .022 BTs with headgear tube archwire slot and hook." "Add .018 BTs with headgear tube archwire slot and hook."	"Buccal Tube" x 2

Expansion Screw

"Forestadent Snaplock - 12mm Lab Standard"	"MARPE Standard" x 1
"MSE"	"MARPE MSE" x 1
"Keles Keyless Expander (KKE)" "Tiger Screw" "Leone CAD Screw" "Super Screw"	"MARPE Premium" x1

TADs

TAD Status	"No, TADS not placed for this case" "Yes, TADs placed for this case"	Included in price, information only
TAD Type	"I will use Vector TADs" "I will use Forestadent TADs" "I will use MSE TADs" "I will use another type of TAD"	Included in price, information only
TAD Position	"Contoured to Palate" "Parallel to Palate" "15 Degree Angulation"	Included in price, information only
TAD Placement	"Palatal to:"	Included in price, information only
Provide TADs	"No, do not provide"	Included in price, information only
Provide TADs	"Yes, provide 11mm TADs" "Yes, provide 13mm TADs"	"MSE TAD" x QTY selected

Addons

"Add Bite Plane"	"Anterior Bite Plane" x 1
"Add Laser Welded Whip Springs"	"Laser welded whip springs (pair)" x 1
"Add Laser Welded Facemask Hooks"	"Reverse pull headgear hooks" x 1

Preview

"I do not need to be contacted about this case"	Included in price, information only
"Contact me about this case with a design preview"	Included in price, information only

Digital > 3D Appliance - SLS > Expander (3D) > 3D - MARPE

Impression

"3D Model w/ Appliance" x 1

Banding

"Standard Band" "C Band" "Rollo Band" "Crown" "Lingual Half Band" "Band Around Bracket"	Included in price, information only
"Buccal Wing, ending on:" "Lingual Wing, ending on:"	Included in price, information only
"No buccal tubes." "Add buccal bumps." "Add .022 BTs with archwire slot and hook." "Add .018 BTs with archwire slot and hook." "Add .022 BTs with headgear tube archwire slot and hook." "Add .018 BTs with headgear tube archwire slot and hook."	"3D Buccal Tubes (No Charge)" x 2

Expansion Screw

"Forestadent Snaplock - 12mm Lab Standard"	"MARPE Standard" x 1
"MSE"	"MARPE MSE" x 1
"Keles Keyless Expander (KKE)" "Tiger Screw" "Leone CAD Screw" "Super Screw"	"MARPE Premium" x1

TADs

TAD Status	"No, TADS not placed for this case" "Yes, TADs placed for this case"	Included in price, information only
TAD Type	"I will use Vector TADs" "I will use Forestadent TADs" "I will use MSE TADs" "I will use another type of TAD"	Included in price, information only
TAD Position	"Contoured to Palate" "Parallel to Palate" "15 Degree Angulation"	Included in price, information only
TAD Placement	"Palatal to:"	Included in price, information only
Provide TADs	"No, do not provide"	Included in price, information only
Provide TADs	"Yes, provide 11mm TADs" "Yes, provide 13mm TADs"	"MSE TAD" x QTY selected

Addons

"Add Bite Plane"	"Anterior Bite Plane" x 1
"Add Laser Welded Whip Springs"	"Laser welded whip springs (pair)" x 1
"Add Laser Welded Facemask Hooks"	"3D Reverse pull headgear hooks" x 1

Preview

"I do not need to be contacted about this case"	Included in price, information only
"Contact me about this case with a design preview"	Included in price, information only

Production

Pan Color

☑️ Violet
☑️ White, if MSE with standard bands
☑️ Orange, if RUSH case

Production Flowchart	For Digital cases:
	For 3D cases:

Standard design

MARPE is a highly-customizable appliance, based primarily on the position of the TADs placed by the doctor. For this reason, there is not a "standard" MARPE design, aside from the MSE.

Examples of common MARPE designs can be found in the photos above, but will usually include:

Bands (whether 3D or standard)
Jackscrew
TAD abutments

The MSE (Maxillary Skeletal Expander) design features the same placement as a standard RPE. For more information about the MSE, please reference this article.

A MARPE product page will be available on the website shortly.