The effect of a two miniscrew MARPE on midpalatal suture width in post pubertal patients: A CBCT study

OBJECTIVE: To assess the effectiveness of a two-miniscrew MARPE appliance on midpalatal suture (MPS) width in post-pubertal patients with incomplete sutural ossification. MATERIALS AND METHODS: This prospective, non-controlled interventional study included 14 patients aged 16 to 22 years with transverse maxillary deficiency. Maxillary expanders supported by two paramedian miniscrews were placed in the anterior palate. Cone-beam computed tomography (CBCT) scans were obtained before expansion (T1) and after 3 weeks of active expansion (T2) to evaluate changes in MPS width at the premolar and first molar regions. RESULTS: Post-expansion measurements demonstrated a statistically significant increase in midpalatal sutural width at all evaluated sites—including the first premolar, second premolar, and first molar regions—compared with baseline ( P = 0.001). Greater sutural opening was observed in the premolar regions than in the molar region, indicating a V-shaped expansion pattern. Increased variability in post-expansion measurements was also noted. Patients classified as stage C showed statistically significant increases in sutural width at all sites following expansion ( P = 0.005), whereas stage D patients exhibited minimal, non-significant changes ( P = 0.068). CONCLUSION: The two-miniscrew MARPE appliance produced significant midpalatal sutural expansion in post-pubertal patients with incomplete sutural maturation. Expansion occurred at all evaluated sites and followed a V-shaped pattern, with greater widening in the premolar region than in the molar region. Patients at stage C demonstrated greater and more consistent sutural widening, whereas stage D patients showed limited, and non-significant changes.