MARPE: Non-Surgical Palatal Expansion for Teens and Adults
In the past, a narrow upper jaw in an adult orthodontic patient meant that a surgical intervention most probably will be required as a preliminary step. That’s because once the suture running down the roof of the mouth is fused solid, it wasn’t possible to widen it without cutting the bone first. That might have changed.
With Miniscrew-assisted rapid palatal expansion, or MARPE, Dr. Michael Stosich can now widen the upper jaw in eligible older teens and adults using small titanium anchors instead of a scalpel. For the right patient, this can be translated to skipping jaw widening surgery altogether.
What is MARPE?
A standard palatal expander works for children because a child’s midpalatal suture, the line where the two halves of the roof of the mouth meet, is yet unfused and soft. Turn the screw of the expander and the suture opens and new bone fills the gap, and the jaw gets wider. In an older patient, that same suture starts to interlock, and eventually it fuses and become solid. A tooth-borne expander used on a fused suture in an adult patient mostly just tips the back teeth outward rather than moving the palate bone, and that kind of movement doesn’t hold up over time. What MARPE’s help with is to get around this limitation in adult patients by anchoring the expander directly into the palatal bone itself with four to six small screws, so that the expansion force directly reaches the suture instead of just the teeth holding the expander.
Who is a candidate for MARPE?
MARPE can be helpful in a few different situations:
- Older teens whose palatal suture is just starting to become mature. The window for a simple tooth-borne expander is closing, but surgery isn’t necessary yet.
- Adults with a narrow, high-arched palate that results in crowding, posterior crossbite, or a smile that looks pinched from the front.
- Adults who were told years ago that surgically-assisted expansion was their only option. That may no longer be true with the MARPE.
- Patients with narrow airway dimensions that contribute to a broader breathing concern, which is exactly how and where MARPE and our airway-focused orthodontics program overlap.
What does the evidence actually show?
Dr. Stosich follows and contributes to the evidence-based approach to orthodontic treatment rather than relying on marketing hypes. Let’s review some of the studies related to MARPE:
MARPE had a high success rate but there is a caveat
A 2023 meta-analysis published in BMC Oral Health, pooled twelve studies of adolescents and adults and found that MARPE’s skeletal expansion success rate has been 93.87%. That’s statistically strong but with a caveat the researchers were transparent about: the overall quality of the underlying evidence was rated low, and a degree of relapse showed up over time in nearly all the reviewed studies.
Age itself may matter less than people assume.
In a 2025 meta-regression in Medicina Oral, Patología Oral y Cirugía Bucal, studying nearly 400 cases, researchers found no significant relationship between a patient’s age and how much expansion they achieved. What mainly predicted the result was rather how mature the suture actually was on imaging rather than the age of the patient.
MARPE is not risk-free, but the risk is minor and mostly appliance related
Researchers writing in Head & Face Medicine followed 32 adult patients, ages 18 to 58, through a carefully controlled expansion protocol and reported an 84.4 percent success rate without surgery. About one in five had some complication along the way, almost always minor and appliance-related, and the odds went up with age.
“MARPE works by borrowing anchorage from bone instead of relying on the teeth to do a job they were never meant to do or even built for,” says Dr. Stosich. “But it’s a real orthopedic procedure. It has to be carefully planned according to each patient’s suture maturity on a CT scan, and can’t be just guessed at from their date of birth.”
How MARPE fits intoairway-focused care
A narrow palate also narrows the floor of the nose, which is part of why Dr. Stosich evaluates palate width as part of his broader airway-focused orthodontics approach rather than as an isolated cosmetic issue. Widening the palate can in turn help open up the nasal breathing passage alongside straightening the patient’s smile.
Dr. Stosich’s approach at Deerpath Orthodontics and Family Dental
Dr. Stosich is a board-certified orthodontist and diplomate of the American Board of Orthodontics who leads the orthodontics team at the University of Chicago, where his work goes way beyond straightening teeth and spans into craniofacial growth, sleep-disordered breathing, and complex skeletal cases. Dr. Stosich follows a conservative, imaging-based approach for MARPE rather than a one-size-fits-all one, and he’ll tell a patient upright when surgically assisted expansion is still the better path for their unique case. Deerpath Orthodontics and Family Dental also offer comprehensive general dentistry services under one roof with Dr. Gerel Emgushova, so your care remains coordinated from diagnosis through retention.
Take the first step today
If you are an adult patient and were told your narrow palate could only be fixed with surgery, now it might be the time for a second opinion. Call our office at 847-579-4979 to schedule your free adult orthodontic consultation and find out if MARPE could help you finally get both: easier breathing and the smile of your dreams.
Sources
Zeng W, Yan S, Yi Y, Chen H, Sun T, Zhang Y, Zhang J. Long-term efficacy and stability of miniscrew-assisted rapid palatal expansion in mid to late adolescents and adults: a systematic review and meta-analysis. BMC Oral Health. 2023;23(1):829. https://pubmed.ncbi.nlm.nih.gov/37924088/
Winsauer H, Walter A, Katsaros C, Ploder O. Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults – a consecutive study using a novel force-controlled polycyclic activation protocol. Head Face Med. 2021;17:50. https://link.springer.com/article/10.1186/s13005-021-00301-2
Lázaro-Abdulkarim A, et al. Is efficacy of miniscrew-assisted rapid palatal expansion in mid to late adolescents and young adults related to craniofacial sutures opening? A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2025;30(2):e271-e281. https://pubmed.ncbi.nlm.nih.gov/39864077/