Narrow upper jaw · MARPE
Can a narrow upper jaw be widened without surgery?
For many adults, MARPE may be the answer. Scroll down to see how the appliance works.
An illustrative animation on a real treatment-plan model. Drag to rotate.
A narrow upper jaw leaves too little room for the teeth.
When the upper jaw is too narrow, teeth can crowd and a crossbite can develop.
The appliance is designed for you.
It is planned on a 3D scan. The mini-screw positions are chosen according to bone thickness and the appliance is made for you.
The appliance is fixed to the palate with four mini-screws.
The mini-screws are placed in the palatal bone, so the force goes to the bone rather than the teeth. Placement is done under local anaesthesia.
The screw is turned a small amount each day.
The two halves of the upper jaw separate in a controlled way along the midpalatal suture. This phase depends on your treatment and is usually complete within 1–2 months.
Temporary gaps open between the teeth.
Most often between the front teeth, but gaps can also appear between other teeth. They show that the widening is happening in the bone and are closed later in treatment.
The new bone in the opened line matures.
The appliance stays in place while the new bone matures. Treatment takes about 6 months in total; braces or clear aligners can start after the active phase.
What can point to a narrow upper jaw?
None of these signs is a diagnosis on its own. Each one is a good reason for an examination.
Crossbite
When you bite, some of your upper back teeth sit inside the lower ones instead of outside.
Dark corners of the smile
When you smile, too little of the teeth shows; dark spaces form at both sides of the mouth and the smile looks narrow.
Crowding
There is not enough room and the teeth overlap. The canines in particular may be pushed out of line.
The expansion method depends on how the suture has developed.
The width of the upper jaw depends on the midpalatal suture in the middle of the palate. During growth this suture is flexible connective tissue; from adolescence its two bony edges interlock, and ossification increases with age. The same narrowing is therefore treated differently at different stages of development.
- Children and teenagers
Conventional rapid expansion
An appliance attached to the teeth. Because the suture has not yet ossified, extra anchorage is usually not needed.
- Young adults and adults
MARPE
Once the suture has interlocked and begun to ossify, the appliance is supported by mini-screws placed in the palate. The force goes straight to the bone rather than the teeth and the suture is opened.
How mature the suture is depends more on the person than on age. The right method for you is decided by assessing the suture on your own 3D scan.
MARPE, step by step
Examination and 3D scan
The thickness of the palatal bone and the maturation stage of the midpalatal suture are assessed.
Custom design
The positions of the appliance and the mini-screws are planned on the scan. The appliance is made for you.
Placement
The appliance is fixed to the palate with four mini-screws under local anaesthesia, usually in a single visit.
Active phase: expansion
You turn the screw each day by the set amount, as shown to you. The length depends on your treatment and is usually 1–2 months, with progress checked at visits.
Gaps between the teeth
An expected sign of expansion. Most often between the front teeth, but gaps can also appear between other teeth. They are closed later in treatment.
Passive phase: bone maturation
The appliance stays in place while the new bone in the opened suture matures. The active and passive phases together take about 6 months.
Braces or clear aligners
Once the active phase is complete, treatment with braces or clear aligners can begin.
Frequently Asked Questions
Does it hurt?
Placement is done under local anaesthesia. During the active phase, especially in the first days, you may feel pressure in the palate and at the bridge of the nose. This usually passes quickly.
How long does it take?
MARPE treatment takes about 6 months in total. The active phase (expansion) depends on your treatment and is usually complete within 1–2 months; for the rest of the time the new bone matures in the passive phase. Braces or clear aligners can start after the active phase.
Will it affect speaking and eating?
For the first days your speech may change a little while your tongue gets used to the appliance. This usually settles quickly. The area around the appliance should be cleaned after every meal, and hard or sticky foods are best avoided.
Is it suitable for everyone?
No. If the palatal bone is very thin, the midpalatal suture is heavily ossified, or gum disease is not under control, another approach may be recommended. Suitability is decided by examination and 3D imaging.
Why is a 3D scan needed?
To measure the bone and find where the mini-screws can be placed safely, and to see the maturation stage of the midpalatal suture. A standard X-ray does not show this.
Can other people see the appliance?
No. It sits on the palate, so it does not show when you talk or smile.
Let’s see together whether it suits you.
Fill in the form and we will call you to agree on a day and time for an examination.
This page is for information only. Diagnosis and treatment decisions are made at an examination.