Evaluation of Skeletal and Dental Expansion in Children and Adults with Mini-Screw Assisted Rapid Palatal Expansion (MARPE): A Systematic Review

Abstract

Aim: The aim of this systematic review was to evaluate the maximum skeletal and dental expansion achieved in children (including adolescents) and adults treated with Mini-implant Assisted Rapid Palatal Expansion (MARPE). Material and methods: A search of the keywords “MARPE” and “transverse maxillary deficiency” was conducted on search engines like PubMed, Google Scholar and Cochrane Library from the year 2010-2022. Inclusion criteria for this systematic review included: all Randomized Controlled and Un-Controlled Trials, all non-randomized controlled and un-controlled trials, prospective and retrospective studies, CBCT studies, articles published from the year 2010-2022, articles published in English language, articles with full text available. Statistical analysis: The following characteristics were evaluated: study design, sample size, sample description, error analysis and statistical analysis. The data from the selected articles were divided into 2 broad groups (children and adults) according to age of the subjects: <18 years and ≥18 years. Risk of bias (whether mentioned or not) was checked and quality assessment of studies were performed. Results: Thirteen studies were reviewed in this article. From the included articles, the following data were extracted independently: author names, year of publication, number of miniscrews used & the type of expander, sample size, mean age of subjects, maximum skeletal expansion achieved, maximum dentoalveolar expansion achieved, and dentoalveolar tipping. The maximum skeletal expansion achieved amongst the included studies was 5.3 ± 1.0 mm [Na Li et al; 2020; mean age = 19.4 ± 3.3 [17]], dentoalveolar was 8.32mm [Sung-Hwan Choi et al; 2016; mean age = 20.9 ± 2.9 [19]] and dental tipping was 8°-10° [Manuel O. Lagrave`re et al; 2010; mean age = 14.4 [11]].  More skeletal expansion was found in adolescents and young adults than in children and skeletally mature adults. Conclusions: MARPE is a reliable treatment modality for the correction of maxillary transverse deficiency in children, adolescents and adults. MARPE resulted in both skeletal and dentoalveolar expansion. More dental tipping is seen in skeletally matured individuals rather than skeletal expansion. MARPE should be used carefully in adults where dental tipping is unfavorable.