Palatal Expansion, RPE, and MARPE

An Innovative Orthodontic Solution for Better Breathing and Sleep

At Phillips Family Orthodontics, Dr. Joseph Phillips uses cutting-edge orthodontic techniques like palatal expansion to improve more than just smiles. With extensive training under Dr. Stanley Liu and Dr. Audrey Yoon at Stanford Sleep Clinic, Dr. Phillips offers personalized care that enhances dental alignment and improves airway health, breathing, and sleep quality. Whether for growing patients or adults, palatal expansion is a transformative solution that affects the jaw's structure and the ability to breathe easily, particularly for those struggling with conditions like sleep apnea and Upper Airway Resistance Syndrome (UARS).

What Is Palatal Expansion and How Has It Evolved?

Palatal expansion is a time-tested orthodontic technique to widen the upper jaw, creating more space for teeth alignment and improving airflow through the nasal airway. The first palatal expansion device was invented in 1890 and has evolved dramatically since its inception. Older designs are bulky and uncomfortable, often fixed in place for long periods, but modern advancements have transformed this treatment.

Today, we have a variety of custom 3D-printed metal expanders, including Rapid Palatal Expander (RPE), Invisalign Palatal Expanders (IPE), and Miniscrew-Assisted Rapid Palatal Expanders (MARPE). These new appliances are more comfortable, discreet, and highly effective. The RPE and IPE are designed for growing patients as they accelerate the widening of the upper jaw. MARPE is a groundbreaking solution that uses bone anchors to provide enough force to expand the maxilla in adults where natural growth has already ceased. This innovation ensures that patients of all ages can benefit from palatal expansion, whether it’s to correct dental issues or improve breathing and sleep quality.

Palatal Expansion and It's Evolution

Understanding the Anatomy: How Palatal Expansion Affects the Nasal Airway

The nasopharynx, or nasal airway, is a fixed space bounded by the nasal septum, nasal floor, and upper maxilla. As we grow, the upper jaw (or maxilla) fuses at the mid-palatal suture after adolescence, making expanding this area more difficult once growth is complete. This bone fusion makes traditional expanders most effective in younger patients, while adults require more advanced interventions like MARPE to achieve the same results.

The impact of palatal expansion studies consistently shows a change in the nasal cavity. Research by Dr. Audrey Yoon and Dr. Stanley Liu has demonstrated that palatal expansion increases the volume of the nasal airway, improving airflow and reducing nasal resistance. One study published in the American Journal of Orthodontics and Dentofacial Orthopedics (2022) demonstrated that palatal expansion can also decrease the size of tonsils in growing children, improving overall airway function and reducing the likelihood of sleep-related breathing disorders like sleep apnea.

Anatomy of Palatal Expansion

Palatal Expansion for Growing Patients

For children and adolescents under 14, palatal expansion is highly effective in reshaping the upper jaw while the bones are still growing and malleable. We use custom 3D-printed metal appliances that fit comfortably in the mouth and gradually widen the palate.

As a patient, palatal expansion typically feels like mild pressure as the appliance gently widens the upper jaw. This gradual process allows the body time to adjust as the palate expands. Over a few weeks, the patient or guardian turns a key that activates the expander, creating the desired expansion. Most patients report that while there may be some discomfort or tightness, it subsides after an hour, and the long-term benefits—including improved breathing and a well-aligned smile—are well worth the short adjustment period.

Early palatal expansion has significant benefits: it prevents crowding, reduces crossbites, and, as mentioned earlier, can even help reduce the size of the tonsils by creating more space in the nasal airway. This early intervention ensures more effective and less invasive treatment than options needed in adulthood.

Palatal Expansion for Growing Patients

For children and adolescents under 14, palatal expansion is highly effective in reshaping the upper jaw while the bones are still growing and malleable. We use 3D-printed metal appliances that fit comfortably in the mouth and gradually widen the palate.

MARPE for Adults: Palatal Expansion for Non-Growing Patients

Once growth stops and the maxillary suture fuses, traditional palatal expansion is no longer possible without a more advanced appliance. Here, the MARPE (Miniscrew-Assisted Rapid Palatal Expander), also known as MSE (Maxillary Skeletal Expander), comes into play. For patients over the age of 14, including adults, MARPE is a revolutionary tool that makes it possible to expand the upper jaw even after growth has ceased.

MARPE uses bone anchors, also known as TADs or Temporary Anchorage Devices, to apply greater force directly to the maxilla, allowing the expansion of the upper jaw by reopening the fused mid palatal suture. This method has proven effective not only for dental alignment but also for improving airway function. For adults struggling with sleep apnea or UARS, MARPE can offer significant relief by increasing the size of the nasal airway, improving airflow, and reducing breathing difficulties during sleep.

Studies show that adult patients who undergo MARPE treatment report improved sleep quality, better breathing, and enhanced overall health. By addressing the underlying anatomical issues contributing to airway resistance, MARPE offers an innovative solution beyond traditional orthodontics.

Palatal Expansion for Non-Growing Patients

Who Is a Candidate for Palatal Expansion?

For Growing Patients (Under 14):

Palatal expansion is most effective in children and adolescents under 14 years old. Traditional Invisalign Palatal Expander, 3D-printed metal expanders gently widen the upper jaw, creating space for proper tooth alignment and improved nasal breathing.

For Adults and Non-Growing Patients (14 and Older):

MARPE is the best option for adults and teens whose growth has ceased. With its bone anchors, MARPE provides the necessary force to reopen the fused palatal suture, expanding the upper jaw and increasing nasal airflow for enhanced breathing and sleep.

Who Is a Candidate for Expansion?

For Growing Patients (Under 14):

Palatal expansion is most effective in children and adolescents under 14 years old. Traditional Invisalign Palatal Expander, 3D-printed metal expanders gently widen the upper jaw, creating space for proper tooth alignment and improved nasal breathing.

For Adults and Non-Growing Patients (14 and Older):

MARPE is the best option for adults and teens whose growth has ceased. With its bone anchors, MARPE provides the necessary force to reopen the fused palatal suture, expanding the upper jaw and increasing nasal airflow for enhanced breathing and sleep.

Why Choose Phillips Family Orthodontics for Palatal Expansion?

Dr. Joseph Phillips combines advanced techniques, state-of-the-art appliances, and a compassionate approach to deliver personalized orthodontic care. With specialized training in airway-aware orthodontics under Dr. Stanley Liu and Dr. Audrey Yoon, Dr. Phillips has the expertise to treat dental alignment and breathing issues, helping patients of all ages achieve better oral and overall health.

Whether you’re seeking palatal expansion for your child or need more advanced treatment like MARPE, Phillips Family Orthodontics will help create healthy, confident smiles while improving your quality of life.

Why Choose Phillips Family Orthodontics

Start Your Journey to Better Breathing and a Healthier Smile

If you or your child is experiencing breathing issues, sleep problems, or dental crowding, palatal expansion might be the solution you need. Schedule a consultation with Dr. Joseph Phillips at Phillips Family Orthodontics today to learn how our advanced, personalized orthodontic care can improve your health, breathing, and smile.