MARPE in post pubertal patients: an overview of literature

Aims of the study: Maxillary transverse discrepancy is a common condition which often requires RME (rapid maxillary expansion) in children while in post pubertal patients and adults it can be dealt with Mini screw-assisted rapid palatal expansion (MARPE) or surgically assisted rapid palatal expansion (SARPE), since sutures are already ossified. The aim of this research was to highlight the existing literature regarding the expansion of the maxilla in young adults in which the results of the level of maxillary sutures interdigitation, leading to more dentoalveolar expansion thus needing MARPE or SARPE in order to obtain skeletal effects of RME are dependent on. Materials and methods: A literature search was conducted on two databases, Medline via PubMed and Embase, to identify articles focusing on the indications, complications and perspectives surrounding MARPE and SARPE in post pubertal patients. Hand search was carried out too, in the most important journals of the sector. This was a literature review focusing on articles published between 2002 and 2022, in English, Spanish or Italian considering the most relevant studies regarding the progression of research in this field. Results and conclusions: MARPE has acquired a lot of interest in the dental community since SARPE has high costs, requires hospitalization, there are risks of post operative infections and suppurative inflammation of the mucosa, more complications and post-surgical morbidity being an invasive surgical procedure. MARPE, still maintaining a high success rate and stability over time is also less invasive, more respectful of the periodontal ligament and has less clinically significant side effects. Moreover, they have two different pattern of expansion (SARPE has a V-shaped pattern while MARPE expansion is more parallel). There are several different MARPE techniques (they differ for the number of mini-implants used, the differences in Mini implants only or hybrid anchorage) and thus the need for a standardized protocol but is a valid alternative to SARPE particularly in young adults and future research might help substantiate its use and limitations.