Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in Late Adolescents and Skeletally Mature Adults: A Comprehensive Review of Current Evidence, Clinical Applications, and Treatment Outcomes

Transverse maxillary deficiency represents a common clinical concern in orthodontic practice; however, as skeletal maturation progresses and resistance of the midpalatal suture increases, the predictability of conventional rapid palatal expansion diminishes. With the routine adoption of temporary anchorage devices, miniscrew-assisted rapid palatal expansion (MARPE) has emerged as a conservative option for selected late adolescent and adult patients who would otherwise require surgical interventions. The fundamental rationale underlying this approach is that applying force at a location closer to the maxillary basal bone increases the skeletal component of expansion while limiting dentoalveolar side effects such as molar tipping and extrusion. This review synthesizes current evidence on MARPE, addressing appliance design characteristics, case selection and indications, activation and retention protocols, dentoskeletal and adjunctive treatment effects, stability, and principal limitations of the existing literature. The objective is to support evidence-based clinical decision-making in the management of transverse maxillary deficiency.