Individualized Design Considerations in Miniscrew-Assisted Rapid Palatal Expansion: A Short Narrative Review

Miniscrew assisted rapid palatal expansion (MARPE) has become an important treatment option for late adolescents and young adults in whom conventional rapid palatal expansion may not produce a predictable skeletal response. By using temporary skeletal anchorage, MARPE aims to achieve greater skeletal expansion while reducing undesirable dentoalveolar effects. However, MARPE represents a broad concept rather than a single appliance design, as differences in palatal anatomy, skeletal maturity, dentition, and treatment objectives require an individualized approach. This narrative review discusses the factors that influence individualized MARPE design and describes how clinical examination, radiographic evaluation, and cone beam computed tomography (CBCT) assessment guide appliance planning. Factors such as palatal morphology, bone availability, soft tissue thickness, miniscrew position, and the severity of the transverse discrepancy play an important role in appliance stability and treatment outcome. The review also highlights the importance of proper miniscrew planning and appliance modification to improve force transmission and skeletal response. Whether achieved through conventional laboratory techniques or digital workflows, individualized MARPE design should be guided by patient specific anatomical and biomechanical considerations to improve the predictability and success of skeletal expansion.