Maxillary transverse deficiency is probably one of the most common skeletal problems in the craniofacial region.
When RPE treatment is performed before the pubertal growth spurt, the skeletal expansion predominates over the dentoalveolar changes,but done after we need to use midfacial skeletal expander (MSE) that is a particular type of MARPE supported by palatal micro implants.
The aim of this lecture is to clinically present the differences between maxillary skeletal expander MSE and conventional rapid palatal expansion.
Patients with posterior crossbite, narrow palate, excessive buccal corridor display and transverse maxillary deficiency. In the maxillary arch, there was mild crowding due to the crossbite and lower midline shift at centric occlusion. Right molars and canines displayed a Class I or Class II relationships.
The design of the maxillary skeletal expander: four miniscrews which were placed parallel to the midpalatalsuture. The device had two anterior screws of diameter 1.8mm, length 11, 13mm which could be varied according to the anatomical thickness of the patient’s palate. The rate of expansion was 2 activations per day until a diastema appeared; The duration of maxillary expansion ranged from 25 to 40 days
The effect of MARPE is basically orthopedic, because forces are applied directly to the bone; therefore, there is no need of overcorrection and in conventional expansion, overcorrection is recommended because of the orthodontic effects.
MARPE has proved to be an effective and viable procedure for the correction of transverse maxillary deficiency offering a significant success rate and stability. MARPE is claimed to be more efficacious than conventional RPE at an acceptable choice for a good cost-effective alternative in well definned cases.