ArticleProgress in orthodontics2025
Unwanted creaniofacial fractures in MARPE/MASPE patients: a hidden risk?
Article in Progress in orthodontics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Bone-Screw-Force Interactions in Palatal Orthodontic Mini-Implants: A Scoping Review and Decision Framework for Primary Stability and Biomechanically Driven Site Selection.Journal of functional biomaterials · 2026Review
- Article
- Nasal Fracture During Maxillary Expansion-A Rare Complication?Reports (MDPI) · 2026Article
- Factors influencing complete midpalatal suture separation in adult patients undergoing 3D-guided piezocorticotomy-assisted MARPE: A case-control study.Journal of oral biology and craniofacial researchArticle
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundMiniscrew-assisted palatal expansion techniques such as MARPE (Miniscrew-Assisted Rapid Palatal Expansion) and MASPE (Miniscrew-Assisted Slow Palatal Expansion) represents non-surgical alternatives for the correction of transverse maxillary deficiencies in adults. However, concerns have arisen regarding their potential to cause craniofacial complications due to the high forces applied for midpalatal suture opening in skeletally mature patients. METHODOLOGY: This article aims to present and describe isolated clinical cases of cranialfacial complications observed in adult patients following MARPE and MASPE procedures, and to discuss the potential biomechanical mechanisms behind these events. Eleven clinical cases involving adult patients who underwent skeletal midface expansion with miniscrew-assisted devices are presented. All cases exhibited craniofacial unwanted dislocations identified through CBCT imaging, including zygomatic fractures, parasutural bone fractures, and asymmetrical disjunction of craniofacial sutures. These events were retrospectively documented through clinical follow-up and radiographic analysis.
resultsAmong the eleven cases presented, complications included seven asymmetric fractures of the frontonasal process, two orbital fractures, one zygomatic bone fracture, and one parasagittal fracture of the palatine bone. These complications were primarily observed in patients who underwent MARPE with rapid activation protocols. One minor complication occurred in a MASPE case, where the patient followed the prescribed slow activation schedule.
conclusionNon surgical mid facial expansion is a potential source of unwanted and unpredicted dislocations in the craneofacial complex. According to this report the observed complications do not seem to be age related and are difficult to predict from the CBCT. A close clinical follow up including force monitoring and force limitation should be mandatory when performing MARPE. MASPE and minimally invasive SARPE could be alternatives to minimise the incidence of creaniofacial complications.
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