MARPE: widening the upper jaw in adults

MARPE stands for Miniscrew-Assisted Rapid Palatal Expansion: widening the palate with the help of small screws. The expander sits against your palate and is anchored in the bone with those screws. As a result, the force goes mainly to the jaw itself, and not only to the teeth. Part of the widening comes from the bone; in addition, the teeth tilt slightly along with it. MARPE is not jaw surgery.

In children and young teenagers, the upper jaw is still growing. A regular expander can then make the jaw wider. In adults, the upper jaw has often finished growing, and a regular expander no longer works. The upper jaw can then be widened with an operation, in which an oral and maxillofacial surgeon weakens the bone in a few places. MARPE is a way to try it without such an operation.

MARPE is intended for adults and older teenagers with a narrow upper jaw. For example, if the teeth have too little room, or if the upper and lower teeth do not meet properly, as with a crossbite.

It does not work for everyone. In most young adults the widening works well, but the older you are, the smaller that chance. That is why we always start with an examination. Only then will you know whether MARPE is possible for you.

1. First consultation and examination. You register directly with us, without a referral. We look at your teeth, your bite and your palate, and make a 3D scan. We do not use impression material.
2. Placement. The expander is fixed to your palate with small screws.
3. Widening. The expander is widened step by step. You can do this yourself at home, or come to the practice for it. In studies, this phase takes a number of weeks to a few months.
4. Holding in place. After that, the expander stays in place for a while, so that the bone becomes firm in its new position.
5. Straightening the teeth. We straighten your teeth with aligners or with fixed braces. More about Invisalign and fixed braces.
6. Retainer. After the treatment, a removable retainer holds the result: every night for the first year, then 3 to 5 nights a week for life.

At the start of the widening, a feeling of pressure and some pain are normal. In studies, this eased as the widening went on. Speaking and eating take some getting used to at first. Keep the expander and the area around the screws clean.

During the widening, a temporary gap appears between your front teeth. We close it again afterwards with the aligners or the braces.

You may also come across the name DOME zero. This is an approach in which widening with MARPE and straightening with aligners are part of one treatment plan: the upper jaw becomes wider while your teeth move into place. We discuss whether that approach suits you after an examination.

When the upper jaw becomes wider, the floor of the nose becomes wider too. In studies, the nasal cavity was larger directly after the widening. Whether that lasts in the long term, and what you notice of it yourself, has not yet been well researched. MARPE is not a treatment for sleep apnoea. If you snore a lot or suspect sleep apnoea, we refer you to a doctor or a sleep centre. More about airway orthodontics.

You will hear what MARPE costs in your case in your treatment plan, before you start. You can read how our fees work and what applies to your insurance under what braces cost.

You are treated by Drs. Lotte Meereboer, dentist specialising in orthodontics (MSc Orthodontics). She has more than 18 years of experience in orthodontics and treats children, teenagers and adults. About Lotte

The practice is at Teniersstraat 2 hs, near Museumplein in Amsterdam-Zuid, within walking distance of the Concertgebouw. Trams 3, 5, 12 and 16 take you close by.