MSE stands for maxillary skeletal expander. MARPE is micro-implant assisted rapid palatal expander. MSE and MARPE are forms of palatal expansion that happens by putting rapid expansion force directly on the the upper jaw bone. MSE is really good at making the upper jaw wider. And it does so quickly by rapid palatal expansion (RPE). The MSE does not do anything to the lower jaw and it does not get any forward growth. MSE does not correct facial asymmetry. In fact MSE has been accused of making facial asymmetries worse, but that is not true. When a facial asymmetry is present it gets bigger and more noticeable as the upper jaw gets bigger. In other words, it gets more noticeable and appears worse, so in a way facial asymmetry is a bigger problem with MARPE and MSE.
Braces or Invisalign after MSE and MARPE
Once MSE and MARPE treatment is complete, braces will be necessary and something will be done to improve the relationship between the upper and lower jaw. Obviously if the upper jaw grows to be a lot bigger something will need to be done to the lower jaw. One big jaw and one small is a bad match. RPE or rapid palatal expansion causes large spaces to develop between the front teeth. It does not look good for a short period of time you will look like Michael Strahan. The large spaces can be closed by braces or Invisalign.
Homeoblock appliances to improve facial asymmetries
After MSE/MARPE, if there are facial asymmetries present, they can be improved with a Homeoblock or similar appliance. Homeoblock and DNA devices can also achieve some forward growth. The MSE MARPE is a great appliance but people are often surprised at how long the entire process takes and how expensive it gets. 10K dollars for the MSE. 5-10K for braces and maybe 6-12K for a homeoblock appliance. And the fees do not include much needed myofunctional therapy, lip and tongue untie procedures. And you may benefit from physical therapy and chiropractic treatment along the way.
The DNA and Homeoblock Appliances are 3D adult expanders
The DNA appliance places force directly on the teeth. The DNA appliance is called a tooth borne expander whereas MSE is called bone borne. Both forms of expansion are effective but they have pros and cons and grow bone in different ways.
The DNA and Homeblock appliances can get growth in all directions and it works for the upper and lower jaws. The tooth borne adult expanders can also correct facial asymmetries if the doctor knows how to design the appliances to do so. The DNA appliance is capable of changing the upper and lower jaws in all three dimensions of space. The DNA and Homeoblock appliances take 18-24 months to complete. Usually braces and Invisalign are not necessary afterwards.
MSE/MARPE compared to DNA and Homeoblock appliances
MSE and MARPE only make the upper jaw expand wider. MSE and MARPE usually are part of a course of treatment involving other appliances or surgery including braces and possibly lower jaw surgery. The MSE in some cases can get a lot more expansion than the DNA appliance, but the greater capacity comes at a price and a compromise. The price is a lot more expensive. Most treatment courses with MSE cost over 30K. MSE MARPE uses rapid palatal expansion which has been known to cause cranial strains due to the high level of pressure required to force the palatal suture open. The various bones in the head are designed to move. Placing too much stress on the cranial bones can cause them to become stuck and restricted. Cranial strains can make it more difficult to resolve facial asymmetries after MSE MARPE.
Video about MSE/MARPE and DNA/Homeoblock Appliance Therapies
Homeoblock before MSE and MARPE expanders
Starting with the DNA or Homeoblock appliance may be more effective and it is possible that it can get a desired result without any further treatment with MSE or braces. At the very least, it is good to correct the facial asymmetry, improve the bite and get some forward growth. MSE/MARPE does not get any forward growth. It only makes the upper jaw wider. Very often the DNA and Homeoblock appliances can complete a TMJ or Sleep apnea case without the need for surgery.
Criticism of the DNA and Homeoblock appliances
Critics of tooth borne expanders say the DNA and Homeoblock appliances do not work. They say adult jaws do not expand but rather only move the teeth. They claim the DNA will cause recession, gum problems and teeth tipping. All this is not true if the appliances are used properly, designed properly, adjusted slowly. And also any lip and tongue ties need to be addressed. Any necessary breathing and myofunctional therapy needs to be done. As it should be. These are the muscles and dysfunction that is at the root cause to begin with. It is not like making your mouth bigger is going to solve all the problems. It goes back to the original goals of treatment. Airway. Improved sleep. Bite correction. Get rid of TMJ and jaw pain. In order to achieve these goals both structural and functional problems need to be addressed.