Miniscrew-assisted rapid palatal expansion (MARPE) is used primarily in:

 # Miniscrew-assisted rapid palatal expansion (MARPE) is used primarily in: 
a) young children 
b) the mixed dentition 
c) older adolescents and adults 
d) adults who cannot tolerate other devices

The correct answer is C. Older adolescents and adults.

In late adolescents and adults, more force is required to open the midpalatal suture due to its increased interdigitation. Treatment with a conventional RPE (Rapid Palatal Expansion) could lead to unwanted dental side effects. Therefore, from the age of 16 onwards, surgically-assisted RPE (SARPE) is commonly applied to overcome these limitations by surgically releasing the interdigitated suture prior to maxillary expansion with an RPE (Rapid Palatal Expansion) device, such as a hyrax or a Trans-Palatal Distractor (TPD). However, the inherent risks of a surgical operation, together with the cost, the hospitalization, and attendant morbidity may pose a constraint for patients to undergo this procedure.

The ensuing quest for a non-surgical treatment for maxillary transverse deficiency in patients who would normally apply for a SARPE stimulated the development of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) by Lee et al. in South Korea and by Moon et al. in the USA. MARPE is either a tooth-bone-borne or a solely bone-borne RPE device with a rigid element that connects to mini-screws inserted into the palate, delivering the expansion force directly to the basal bone of the maxilla. It was designed to maximize skeletal effects and to minimize dentoalveolar effects of expansion, based on the findings of previous histological studies revealing that the mid-palatal suture does not fully ossify in humans even at an elderly age, possibly due to the constant mechanical stress that it undergoes. MARPE has received widespread attention in recent years and several researchers have studied the efficacy of MARPE. However, to our knowledge, a systematic review on this topic has not yet been published.

Reference: Kapetanović A, Theodorou CI, Bergé SJ, Schols JGJH, Xi T. Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis. Eur J Orthod. 2021;43(3):313-323. doi:10.1093/ejo/cjab005

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