MARPE is “mini-implant assisted rapid palatal expansion.” The MARPE adult expander uses implants installed into the palatal bone as leverage to increase the width of the palate with rapid palatal expansion. Usually a dental surgeon will install the implants and an orthodontist will design the MARPE device and manage the expansion procedure.
MARPE is a treatment that will increase the width of the upper jaw only. It does not get any forward growth and it does not have any effect on the lower jaw. Rapid palatal expansion (aka RPE) is when an expander device places a large force great enough to split the palate down the middle and open up space between the right and left palate bones. Over time the right and left sides of the palate will fill in with new bone. The net change is a wider palate.
MARPE expansion will result in a large space opening up between the front teeth. The space is called a diastema. Needless to say, MARPE is not a stand-alone treatment. People who undergo MARPE treatment will also need other treatments such as Invisalign for example to close the space between front teeth. Other appliances may be needed to get forward growth or to improve the relationship between the upper and lower jaw or to correct a facial asymmetry.
The Average Orthodontic Treatment Plan with MARPE
Most people do not just have mouths that are not wide enough and problems with only their upper jaw. If they did, MARPE followed by Invisalign would always be the perfect treatment: First MARPE, followed by Invisalign second. Usually people need 3D growth and will need forward growth, improvements to facial asymmetries and advancement of the lower jaw. Often times use of other expanders such as a Homeoblock or even a jaw surgery such as mandibular advancement are necessary. But what appliance is the best one to do first? MARPE in our opinion is a great expander, but usually not the best one to use first. We will address why if you keep reading and watching the videos.
How does MARPE work?
MARPE is a metal expansion mechanism that is fastened to the palatal bone with titanium screws. The MARPE also sits on or around some of the back teeth as well for anchorage. The expansion mechanism has a “jack-screw” that is turned every 1-3 days as prescribed by the dentist. The basic concept is that the device pushes quickly and forcefully to purposely open up a large space between the right and left sides of the palate bone. Hence the term “rapid palatal expansion” or “RPE.” The palate bone is also called the maxilla. The rapid pressure comes with some risk as the pressure can cause other bones in the face to become compressed, stuck and misaligned.
For people who clench and grind and who have tension in the neck, back and headaches, MARPE and the high expansion pressure comes with more risk. Often work with cranial-sacral therapists, chiropractors and physical therapists will become necessary to mitigate some of the side effects of RPE (rapid palatal expansion).
MSE and MARPE skeletal expander video by Dr. Adams
MARPE Expander Costs?
It is important to note that MARPE is not a stand-alone treatment because all that is accomplished during MARPE is getting the upper jaw wider. Nothing has been done to the lower jaw. There is almost always a large space created between the upper two front teeth. And the truth of the matter is MARPE is just one piece to the puzzle in a much more expensive orthodontic treatment course.
The MARPE device itself can cost $8000-$12,000 depending on who is doing it. Other treatments commonly needed with MARPE include:
- Braces $5000-$7500 for teeth straightening and closing spaces
- Invisalign $5500-$8000 for teeth straightening and closing spaces
- Homeoblock device or DNA Appliance to improve facial asymmetry, palatal expansion, improve relationship between upper and lower jaw, forward growth. Expand the lower jaw. $6500- $12,000
- Other jaw surgeries such as maxillary-mandibular advancement or MMA surgery to improve relationship between upper a lower jaw $10,000 – $25,000.
So I guess the real question is how much does it cost to receive all the treatment one needs to meet their treatment goals including the MARPE? Sometimes the answer is not clear when MARPE treatment is initiated because not all cases are straight forward. On the average, a typical MARPE case will also involve at least some teeth alignment with braces or Invisalign. Successful cases also usually involve diagnosis and treatment of lip and tongue ties and sessions with a myofunctional therapist. Especially when the goals of treatment include TMJ, sleep, airway and facial profile complaints.
Alternatives to MARPE adult expanders
Alternatives to MARPE include braces, Invisalign, jaw surgery and Vivos and Homeoblock appliances. How do we improve TMJ, sleep, airway and facial profile complaints. Usually the root cause is undersized and imbalanced jaws/bite and dysfunction of the tongue, chewing and facial muscles. Think of the mouth as an undersized room that needs to be wider, deeper and taller. Let say we need an 12x15ft room with 8 foot ceilings and we only have 8×10 with 6 foot ceilings. The furniture does not fit and all the activities in the room do not work well. So we need a wider, deeper and taller jaw. And jaws that are more balanced. How do we fix it?
Braces and Invisalign
Braces and Invisalign are great treatments but all they do is move the teeth around. Moving teeth around the mouth is not going to work if you need more room. Moving teeth can help but we need a bigger mouth.
MARPE adult palatal expansion
The MARPE will get the upper jaw wider but that is it. It will also open up a huge space between the upper front teeth. Now if we did not need braces before, now we definitely do. MARPE does nothing to the size, shape and position of the lower jaw. And MARPE does not correct any facial asymmetries. MARPE has been accused of causing facial asymmetries, but it usually does not. MARPE will make existing facial asymmetries bigger and more noticeable. MARPE is just one piece to the puzzle and once the MARPE is used other treatments become necessary.
Homeoblock and Vivos removable adult expanders
Homeoblock appliances are capable of 3D facial growth, improving facial symmetry and the relationship between the upper and lower jaw. That is these appliances can create a wider, deeper and taller jaw with more balance. The con of the Homeoblock appliance is that the treatment takes wearing an appliance at night for 12-24 months. The Homeoblock is capable of starting and finishing many cases. It is possible, that no other treatment is necessary other than myofunctional therapy and release of any lip and tongue ties. But certain cases will need Invisalign or braces 6 months after Homeoblock treatment.
Homeoblock and DNA appliances can get a decent amount of expansion for many adults without much teeth movement if done properly. The one thing these appliances can do that the others cannot is correct symmetries. The Homeoblock appliance also can advance the mandible and expand the mandible. The Homeoblock cannot get as much expansion as the MARPE but there are many more advantages to the Homeoblock appliance. The Homeoblock is also much less expensive and more conservative than treatments involving MARPE.
In many cases it is best to start a case that may involve MARPE, with a Vivos appliance or Homeoblock device. In fact the Homeoblock may complete the entire case without the need for any additional treatment (including Invisalign and braces).