Evidence map›Paper›PMID 41020025›Full record

ArticleCureus2025

Hidden Risks of Miniscrew-Assisted Rapid Palatal Expansion (MARPE): A Retrospective Analysis of Treated Cases With Preventive Strategies.

Rajalakshmi Sj, Nausheer Ahmed, Niharika Eduru, Deeksha Yn, Kesari Ravi, Gowri Sankar Singaraju

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Rajalakshmi SjOrthodontics and Dentofacial Orthopedics, Government Dental College and Research Institute Bangalore, Bengaluru, IND.
Nausheer AhmedOrthodontics and Dentofacial Orthopedics, Government Dental College and Research Institute Bangalore, Bengaluru, IND.
Niharika EduruOrthodontics and Dentofacial Orthopedics, Government Dental College and Research Institute Bangalore, Bengaluru, IND.
Deeksha YnOrthodontics and Dentofacial Orthopedics, Government Dental College and Research Institute Bangalore, Bengaluru, IND.
Kesari RaviOrthodontics and Dentofacial Orthopedics, Government Dental College and Research Institute Bangalore, Bengaluru, IND.
Gowri Sankar SingarajuOrthodontics and Dentofacial Orthopedics, Narayana Dental College, Nellore, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMiniscrew-assisted rapid palatal expansion (MARPE) is an effective non-surgical alternative for managing transverse maxillary deficiency in late adolescents and young adults. While its skeletal effects are well documented, reports of clinical complications remain limited. This retrospective study presents a comprehensive case-based analysis of MARPE-related complications within a cohort, highlighting both management outcomes and preventive strategies. MATERIALS AND

methodsA retrospective review was conducted of 24 consecutive MARPE cases (mean age 17.4 ± 1.3 years; 11 males, 13 females) treated between January and December 2024. Appliance designs included a two-screw hybrid MARPE (n = 16) and a four-screw maxillary skeletal expander (MSE) (n = 8), with miniscrews measuring 1.8-2.0 mm in diameter and 9-11 mm in length. Data were collected on demographics, appliance type, screw size, fabrication method (custom vs. prefabricated), complications, management, and treatment interruptions. In addition to summary statistics, six representative case studies of complications were described in detail.

resultsOf the 24 patients, eight (33.3%) developed true complications, two (8.3%) experienced procedural delays due to screw-locking defects, and 14 (58.3%) had no adverse events. Mechanical complications (n = 6) included screw fracture, appliance arm breakage, and acrylic failure, while biological complications (n = 2) involved tongue irritation and peri-implant mucositis. When the complication and no-complication groups were compared, an independent t-test revealed no significant age difference (17.8 vs. 17.1 years, p = 0.21). Chi-square analysis revealed no significant gender effect, although males experienced more complications (54.5% vs. 30.8%, OR = 2.7, p = 0.064). Fisher's exact test demonstrated that complications were confined to screws ≤10 mm, while none occurred with 11 mm or 2.0 × 10 mm screws (p = 0.03). Activation was interrupted for at least two weeks until the issue was resolved. Six detailed case reports illustrate the causes, management, and clinical precautions for these events.

conclusionsMARPE is an effective and minimally invasive alternative to surgically assisted rapid palatal expansion, but complications occur in nearly one-third of cases. These may arise with any appliance type and are often related to human or technical errors. Early recognition, implementation of preventive strategies, and adherence to standardized protocols are crucial for ensuring safe and predictable outcomes.

Indexed as

appliancebreakagecomplicationsexpansionfracturemarpeminiscrewmucositisorthodonticswallowing

Identifiers

PMID41020025
PMCPMC12467438

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.