MARPE: palate expansion for teens and adults

Page updated October 22, 2026.

MARPE, short for miniscrew-assisted rapid palatal expansion, is a palate expander anchored to small screws placed in the roof of the mouth. It's used to widen a narrow upper jaw in older teens and adults, as a less invasive alternative to surgically assisted expansion (BMC Oral Health review). Studies report high success rates, though lower in older patients and especially older men (Jeon et al.). Here is how it works, who it suits, the evidence, the side effects and what to ask about cost.

What MARPE is

A conventional palate expander attaches to the teeth and widens the upper jaw by separating the two halves of the palate along the midline suture (AAO). That works best while a child is growing. In adults the bones are fully formed, so expansion takes longer and moderate to severe cases may need a surgically assisted or implant-supported design (Cleveland Clinic).

MARPE is the implant-supported option. It combines a conventional expander with rigid parts and miniscrews placed in the palate (BMC Oral Health review), so the force goes into the bone rather than only through the teeth. A 2024 review of trials in adolescents found designs with four miniscrews and daily activation had clear advantages over a conventional tooth-borne expander (Cureus review).

Who MARPE is for

MARPE treats a narrow upper jaw (transverse maxillary deficiency) (BMC Oral Health review). The AAO lists crossbite among the most common problems expanders treat (AAO). Its main use is in patients past the age when a regular expander reliably works: the 2023 review covered adolescents and adults over 13.5 years (BMC Oral Health review). Before MARPE, the usual option for these patients was surgically assisted palatal expansion (SARPE) (Jeon et al.).

The AAO notes that if a narrow palate isn't corrected while a child is growing, surgery may be needed in adulthood (AAO), which is why an orthodontic check by age 7 is recommended (AAO).

How well MARPE works

Results vary with age and sex. A 2021 study of 215 patients aged 6 to 60 found the suture separated in 79.53% overall: 94.17% of women and 61.05% of men (Jeon et al.). By age group:

Success rates by age and sex: Jeon et al., 2021. Groups over 30 had too few patients for reliable percentages and aren't shown.

In men, older age was strongly linked to the suture not separating; in women it wasn't, and the amount of expansion fell with age in both sexes (Jeon et al.). The authors suggest treating younger, particularly in men (Jeon et al.). Across 12 studies of teens and adults, the 2023 review found a mean success rate of 93.87% (BMC Oral Health review).

How much it widens, and does it last?

The 2023 review measured an average skeletal gain of about 2.34 mm in the upper jaw's basal bone, with the teeth themselves moving further apart, about 4.79 mm between the first molars (BMC Oral Health review). It also found some skeletal and dental relapse over time (BMC Oral Health review), so a retainer or holding phase matters, as with any expansion.

The authors rate the quality of evidence as very low: most included studies were retrospective, and five had moderate and seven serious risk of bias (BMC Oral Health review). MARPE looks effective, but the long-term numbers are less certain than the headline success rates suggest.

Side effects and risks

The 2023 review says MARPE can cause dental, alveolar and gum side effects (BMC Oral Health review). Measured effects included the first molars tipping outward by about 0.6° to 4.9° and a small loss of bone height at the first molar, up to 0.8 mm (BMC Oral Health review). Studies also monitored gum recession and loosening of the miniscrews (BMC Oral Health review). The 2024 review says robust conclusions about effects on the gums aren't yet possible (Cureus review). If the suture doesn't separate, the Jeon study protocol paused for four weeks and stopped expansion if a second attempt also failed (Jeon et al.); surgically assisted expansion is the usual alternative (Jeon et al.).

How much MARPE costs

We haven't found a reliable published price for MARPE, so we don't give one. It's usually one part of a larger plan that also includes braces or aligners, which typically cost $3,000 to $7,000 for metal braces and $4,000 to $7,000 for aligners before insurance (CareCredit). Ask for an itemized quote that separates:

• The MARPE appliance and miniscrew placement
• Any CBCT scan or imaging
• The braces or aligner phase that follows
• Retainers and visits after expansion
• What happens to the fee if the suture doesn't separate

Insurance with orthodontic benefits pays up to a lifetime maximum; in OrthoFi data for 2021 the average benefit was $1,772 (Align Technology). Compare with surgical options in jaw surgery cost.

Questions to ask your orthodontist

• How likely is the suture to separate at my age?
• How many miniscrews will you use, and who places them?
• How much of the widening do you expect to keep, and how will we hold it?
• What's the plan if MARPE doesn't work?

Many orthodontists offer the first consultation free (AAO); see free orthodontic consultations and braces cost for adults.