Miniscrew-assisted rapid palatal expansion in the treatment of maxillary transverse deficiency: a systematic review

Abstract

Aim: To evaluate the clinical and biomechanical effects of MARPE in the treatment of maxillary transverse deficiency, focusing on skeletal expansion, dentoalveolar changes, periodontal outcomes, airway modifications, and treatment success in adolescent and adult patients.

Methods: The review was conducted in accordance with the PRISMA 2020 guidelines. A systematic electronic search was performed in the PubMed/MEDLINE database for studies published between January 2021 and February 2026. The focused question was structured using the PECO framework. Human clinical studies evaluating MARPE or MSE appliances in patients with maxillary transverse deficiency were considered eligible. Risk of bias was assessed using the RoB 2.0 and ROBINS-I tools.

Results: The electronic search identified 54 records. After screening and full-text evaluation, 11 studies met the eligibility criteria and were included in the qualitative synthesis. Most investigations reported successful opening of the midpalatal suture and significant transverse skeletal expansion after MARPE treatment, even in skeletally mature patients. CBCT analyses showed skeletal expansion values of approximately 4–5 mm, with fewer dentoalveolar side effects compared with conventional rapid palatal expansion. Several studies also reported increases in nasal cavity dimensions and upper airway volume following treatment. Although buccal dental tipping and alveolar remodeling were observed, severe periodontal complications were uncommon. The overall quality of the evidence ranged from low to moderate due to methodological heterogeneity and the limited number of randomized clinical trials.

Conclusion: Within these limitations, MARPE appears to be an effective treatment option for maxillary transverse deficiency in selected adolescent and adult patients, providing clinically significant skeletal expansion while reducing dentoalveolar side effects. However, further high-quality prospective studies and randomized clinical trials are needed to clarify long-term stability, periodontal effects, and the orthopedic predictability of MARPE treatment.