Temporomandibular Joint Adaptations Following Miniscrew-Assisted Rapid Palatal Expansion: A Systematic Review and Meta-Analysis

Objectives: Miniscrew-assisted rapid palatal expansion (MARPE) is increasingly used for adult transverse maxillary deficiency. This systematic review and meta-analysis aimed to quantify three-dimensional changes in the temporomandibular joint (TMJ) space and condylar position following MARPE. Methods: A systematic search of PubMed, Scopus, Embase, and Web of Science was conducted through May 2025. Inclusion criteria followed the PICOS framework: human participants (≥12 years) undergoing MARPE with pre- and post-treatment cone-beam computed tomography assessments. Data extraction and risk of bias (ROBINS-I) were performed independently by two reviewers. Pooled standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. Results: Four studies comprising 95 patients were included. Meta-analysis revealed no statistically significant changes in condylar joint spaces: Anterior [SMD = −0.04 (95% CI: −0.35 to 0.26; P = 0.81; I 2 = 0%)], posterior [SMD = 0.31 (95% CI: −0.01 to 0.61; P = 0.06; I 2 = 0%)], and superior [SMD = 0.23 (95% CI: −0.05–0.42; P = 0.12; I 2 = 0%]. Narrative synthesis indicated transient clockwise mandibular rotation that largely relapsed during retention. The certainty of evidence was rated low-to-moderate due to the lack of randomized controlled trials. Conclusions: Current evidence suggests that MARPE does not induce clinically or statistically significant alterations in TMJ morphology or condylar position in the short term. MARPE appears to be a safe orthopedic procedure for the TMJ, although long-term studies with larger cohorts are needed to confirm these adaptive trends.