Teen and Adult Expansion
Beyond surgery—modern solutions for bite problems
In the past, patients who were done growing or near to it were left with only two options to “fix” skeletal bite problems – jaw surgery or straightening the teeth and “masking it” as best as possible.
Jaw surgery works and accomplishes the end treatment goals very effectively. However, it is intense, and the recovery can take weeks to months. Many patients prefer an alternative option.
Masking a skeletal problem with tooth movements will improve a patient’s smile. But because the teeth are moved or tipped in the jawbones to do this, over time it may have significant consequences to tooth and TMJ health.
The healthy and stable position of the teeth is for them to be upright and centered in the jawbone. To accomplish this, the bones need to also be in the correct positions. Changing the skeleton can now be accomplished without surgery. Read more below!
Miniscrew-Assisted Rapid Palatal Expansion (MARPE)
Miniscrew-assisted rapid palatal expansion (MARPE) is an effective non-surgical and non-extraction treatment approach for expanding the upper jaw, or the maxilla.
Did you know that the roof of your mouth is also the floor of your nose? In fact, a narrow maxilla is associated with nasal obstruction, crowded teeth, and hindered facial development. Interestingly, these characteristics are often noted in airway dysfunction, sleep-disordered breathing (SDB), and obstructive sleep apnea (OSA).
Conventional maxillary expander treatments are common to treat narrow maxilla. However, these are limited to children because the suture holding the maxillary bone together (known as the midpalatal suture) fuses around 12-15 years of age. Dr. Ashley Lee at My Rivertown Dentist offers MARPE as an innovative approach because it extends this timeline by directly connecting the expander to the palatal bone. MARPE can be effective for teens and adults whose suture has already been fused.
MARPE works by using a custom-made expander that is anchored to the maxillary bone using mini-screws. This customization is required for older patients to modify the suture and expand the bone.
The procedure typically lasts 20-30 minutes under local anesthesia. Pain is minimal and can be managed with an over-the-counter painkiller for 1-2 days. After installation, the patient will typically activate the expander every day for 4-6 weeks by turning a screw.
A gap will form between the front teeth when the suture splits. It takes approximately 4-6 months for new bone to form and stabilize the expansion. During that time, orthodontics typically begins to close the gap and stabilize your bite.
Expansion of the upper jaw can be favorable for many patients. Because the roof of the mouth is the floor of the nose, expansion of the bone will not only widen the upper jaw but also the base of the nose. This change is subtle but can greatly increase the breathing volume of the nose.
A wider upper jaw is also able to better accommodate the proper position of the tongue. When the mouth has ample room for the tongue, the tongue is able to sit more up and forward rather than down and back and in the airway.
Expansion can be used to improve breathing and sometimes as a treatment for sleep-disordered breathing (SDB) and obstructive sleep apnea (OSA).
With MARPE, the benefits of maxillary expansion may be provided to a wider age range of patients.
The mini-screws used in MARPE apply forces directly to the mid-palatal suture, whereas conventional expanders use the teeth as anchor units.
MARPE typically avoids undesirable tooth movement and attains greater bone expansion while minimizing dental side effects.
