5.2 What All MARPEs Have in Common
And How They Differ
This is Chapter 5.2 of the JawHacks ebook. See the full Table of Contents here.
MARPE is an umbrella term that covers many individual brands of bone-anchored palatal expanders. To use an analogy, MARPE is like the term “car” and specific expanders like MSE, FME, Partner’s Custom MARPE and the KLS Martin TPD (traditionally associated with EASE) are like Toyota, BMW, Ford, etc.
What They All Have in Common
What all MARPE devices have in common is that they are anchored into the roof of the mouth using temporary anchorage devices (TADs) which are self-tapping screws that fasten the appliance into the basal bone of the maxilla.
They all have a central jackscrew that opens the expander, and hence the palate, in the left/right dimension.
They all aim to widen the roof of the mouth, the nasal cavity and the midface.
They all can be accompanied with a host of surgical assists that range from cortical punctures along the mid-palatal suture (least invasive), to mid-palatal piezo cuts, to full-on SARPE-like assists that include Lefort scoring or cuts and pterygomaxillary suture release. These surgical assists will have their own upcoming dedicated chapter.
They are all not SARPE - SARPE refers to the maximum-level surgical assist paired with a tooth borne expander that pushes on teeth to open the surgically-released palate.
The extreme depth of the SARPE surgical assist allows the teeth to be sufficient levers of expansion in such cases. SARPE is not ideal for a variety of reasons, including 1) difficult recovery, 2) high chance of dentoalveolar tipping rather than actual mid-line skeletal expansion, 3) inability to expand far up the y-axis of the nasal cavity and 4) inability to expand the cheekbones for aesthetic benefit.