MARPE: Mini-screw Assisted Rapid Palatal Expander
Non-Surgical Jaw Expansion for Adults with a Narrow Palate
The MARPE at Textbook Orthodontics is used to correct jaw width, dental crowding, breathing and cross bites.
The MARPE is used on both teens and adults. The inter-maxillary suture fuses around the age of 15 for boys and 13 for girls making the conventional rapid palatal expander no longer effective. After this age, the MARPE can make skeletal changes allowing us to improve airway and often times help patients with sleep apnea.
The MARPE expander is used to widen your arch in order to correct a crossbite or create room for your teeth. To use the expander the key/wrench must be used to turn the screw towards the back of the mouth (throat). This completes one turn.
At Textbook Orthodontics we beleive in slow expansion. Our MARPE turning protocol is as follows: 1 turn per day for 5-7 days then 1 turn every other day after.
It is best to turn the expander at night before you go to sleep. While expanding we need to see a space between your front teeth. This is how we know the expander is opening the suture.
Most of our adult male patients will also recieve a piezo cut on their palate to ensure the suture will split with MARPE treatment.
It is very common to experience some pressure or tingling in the roof of your mouth or on your nose for a short time while using a MARPE.
It is very important to brush your MARPE and its arms thoroughly every time to brush your teeth. I also advise my patients to use alcohol free mouthwash while they are undergoing MARPE treatment. If you see that the gums around your MARPE are getting red and inflamed please use salt water rinse and brush the area more thoroughly this will subside over time.
Most Orthodontists keep the MARPE in for 6 months-1 year after the final turn to allow the sutures to heal and prevent any relapse.
If you are experiencing any pain in between the eyebrows or see any asymmetry in your face please please stop the turns and call your orthodontist immediately.
Custom MARPE Correcting Narrow Jaw And Improving Nasal Airflow
The Diastema (The Space): The noticeable gap between the front teeth during treatment is actually a sign of success! It indicates that the suture of the upper jaw has successfully split, creating the necessary room to expand the palate and optimize the airway. (Don't worry, this space is easily closed during the alignment phase of treatment!)
Patient Transformation & In Their Own Words
Following their MARPE treatment, the patient reported immediate and significant quality-of-life improvements:
Enhanced Airway: Much better overall airflow through the nasal passages.
Restorative Sleep: Waking up feeling truly rested and sleeping deeper.
Effortless Breathing: The ability to breathe way easier throughout the day and night.
"MARPE doesn't just create a beautiful, wide smile—it fundamentally changes how our patients breathe and sleep. When we expand the upper jaw, we widen the floor of the nasal cavity, providing a true health transformation from the inside out."
What is MARPE?
The MARPE appliance is a modern orthodontic device used to widen the upper jaw (maxilla) in patients where conventional methods may not be sufficient. Unlike traditional rapid palatal expanders (RPE), MARPE utilizes miniscrews that anchor to the palate, providing additional stability and direct skeletal expansion. This method is especially beneficial for older teens and adults whose jaw growth has slowed or stopped.
How Does MARPE Work?
MARPE applies gentle, controlled pressure to separate the two halves of the upper jaw, expanding the mid-palatal suture. The miniscrews ensure the force targets the bones rather than just the teeth, promoting effective skeletal changes.
The appliance is custom-made and secured to your upper molars, with miniscrews inserted into the palate by your orthodontist or oral surgeon. Over time, gradual expansion creates more space, improving both function and appearance.
Ventajas de MARPE
Non-Surgical Option for Adults
MARPE provides an effective alternative to surgery for many patients, making jaw expansion possible even after growth has ceased.Improved Airway Function
By expanding the upper jaw, MARPE can increase the airway space, helping patients who experience breathing issues such as sleep apnea.Enhanced Smile and Bite Alignment
MARPE creates room for crowded teeth and improves bite relationships, ensuring a healthier, more balanced smile.Minimally Invasive Procedure
The miniscrews used in MARPE are small and minimally invasive, with a quick recovery time for most patients.Stable Long-Term Results
MARPE’s direct impact on the skeletal structure ensures more predictable and stable outcomes.
Who Can Benefit from MARPE?
MARPE is ideal for patients who:
Have a narrow upper jaw that causes bite issues (crossbite, crowding, or asymmetry).
Are teens or adults for whom traditional expanders are less effective.
Experience breathing or airway problems that may improve with jaw expansion.
Prefer a minimally invasive approach to upper jaw correction.
Qué esperar durante el tratamiento
Consultation and Examination
During your first visit, we’ll evaluate your jaw structure, teeth alignment, and overall oral health. Digital imaging and X-rays may be used to determine if MARPE is right for you.Appliance Placement
The MARPE appliance is custom-fitted and secured in a single visit. Miniscrew placement is quick and straightforward, with local anesthesia to ensure your comfort.Activation Phase
You’ll activate the expander daily using a provided key. This gradual process allows for controlled expansion over several weeks.Retention Phase
After achieving the desired expansion, the MARPE remains in place for a few months to stabilize the results.
Why Choose Textbook Orthodontics for MARPE?
At Textbook Orthodontics, we are committed to providing personalized care with the latest orthodontic technology. Dr. Nathan Nourian and our expert team will guide you through every step of your MARPE treatment, ensuring a comfortable and successful experience.
With our patient-centered approach, we prioritize your goals, comfort, and confidence. We understand that every smile is unique, and we’re here to help you achieve the best possible results. After MARPE completion braces or clear aligners will be necessary to close the space created and adjust the bite.
When MARPE Isn't the Right Answer
MARPE is a powerful tool, but it isn't the right first step for everyone. If your crowding is caused by tooth size rather than a narrow palate, braces or clear aligners alone may be enough — MARPE would expand bone you don't need to move. And if breathing is the primary concern, we screen for other causes first, like enlarged tonsils, adenoids, or a deviated septum, since these often need an ENT's evaluation before — or instead of — palatal expansion. Dr. Nourian will tell you honestly if a lighter treatment will get you the same result.
Coordinated Care for Skeletal Expansion
MARPE is a collaborative treatment. Dr. Nourian designs the appliance, manages the expansion protocol, and places your mini-screws under local anesthesia. If breathing or sleep is part of why you're considering MARPE, we'll also discuss whether an ENT or sleep physician evaluation should happen alongside treatment — MARPE can improve nasal airflow, but it isn't a substitute for a full airway workup.
Traveling for MARPE Treatment? Start with a Virtual Visit.
We treat patients from all over the country who fly to Los Angeles for expert MARPE/MSE expansion. However, we don't want you to book a flight until we know we can help you.
Save time and money by booking a remote assessment with Dr. Nourian first.
What’s Included:
Case Evaluation: Upload your photos and X-rays (if available).
Video Consultation: A 1-on-1 15-30 meeting to discuss your airway issues, palate width, and expansion potential.
Treatment Plan: Learn if you are a candidate for non-surgical expansion before you ever step foot in LA.
Cost: $250 for a virtual consultation, will go towards treatment if you move forward.
Preguntas frecuentes
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A MARPE (Miniscrew-Assisted Rapid Palatal Expander) is an orthodontic device designed to widen the upper jaw using small, temporary screws for added stability. Unlike traditional expanders that rely solely on teeth, MARPE engages the bone directly, making it effective for older teens and adults whose sutures are more mature.
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The MARPE applies gentle, controlled pressure across the upper jaw using a screw mechanism anchored to mini-implants. This pressure stimulates bone growth in the mid-palatal suture, gradually creating more space in the upper arch. Patients typically activate the expander with a small key as directed by the orthodontist.
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A MARPE is typically recommended for patients with a narrow upper jaw, crossbite, or crowding who are too old for traditional expansion alone. It’s ideal for teens and adults who need skeletal (not just dental) expansion. Dr. Nathan Nourian often recommends MARPE when the goal is to avoid surgical options like SARPE (surgically assisted rapid palatal expansion).
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MARPE offers several advantages:
Works effectively in older patients who have finished growing
Widening is more stable and bone-based, not just tooth movement
May prevent the need for jaw surgery
Can improve nasal breathing and facial symmetry
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Most patients experience mild pressure or tightness for a few days after each activation but not significant pain. Over-the-counter pain relievers and soft foods help during the adjustment period. Discomfort typically subsides quickly as the jaw adapts.
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Active expansion usually lasts 2–4 months, depending on the patient’s needs, followed by a retention phase where the appliance stays in place for several months to allow bone stabilization. The total time MARPE remains in the mouth is usually 9-12 months.
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Yes. MARPE is specifically designed for adults and late teens, allowing expansion even after jaw growth is complete. At Textbook Orthodontics in Los Angeles, Dr. Nourian frequently uses MARPE to help adult patients achieve results that were once only possible with surgical methods.
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Yes — in a positive way. By widening the upper jaw, MARPE can create a more balanced facial structure, enhance smile width, and sometimes improve nasal airflow. The changes are subtle but often make the face appear more harmonious.
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You can eat most foods, but it’s best to avoid sticky, hard, or crunchy foods that could loosen the appliance. Softer foods are recommended during the first few days after activation. Dr. Nourian provides patients with a complete list of what to eat and what to avoid.
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Once the desired width is achieved, the MARPE is left in place for a few months to stabilize the bone. After removal, patients often transition into braces or clear aligners to fine-tune tooth alignment. The expansion achieved with MARPE is typically permanent and stable long-term.
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The cost of MARPE in Los Angeles typically ranges between $3,500–$5000, depending on case complexity and whether additional orthodontic treatment (like braces or aligners) follows. Textbook Orthodontics offers flexible payment plans to make treatment affordable for all patients.
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You may notice a small gap forming between your front teeth — this is a normal and positive sign of expansion. Some patients also feel slight pressure in the nose or cheek area. Dr. Nourian monitors progress closely through follow-up visits and 3D scans.
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Yes, widening the upper jaw can also expand the nasal airway, which can improve nasal breathing and, in some cases, reduce snoring or mild sleep apnea symptoms. MARPE can be both a functional and cosmetic improvement.
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Risks are minimal but can include minor gum irritation, screw loosening, or nasal pressure. These are typically temporary and manageable. Dr. Nourian uses 3D imaging and precise planning to ensure safe, predictable results.
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Yes. MARPE is an excellent treatment for posterior crossbites caused by a narrow upper jaw. By expanding the arch, it aligns the bite and improves overall occlusion.
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You can receive expert MARPE treatment at Textbook Orthodontics in Los Angeles, led by Dr. Nathan Nourian, an orthodontist specializing in both child and adult expansion cases. The office combines advanced technology and compassionate care to help patients achieve confident, healthy smiles.
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If your MARPE expander isn’t turning, don’t force it. First, try using two activation wrenches together to give you a little more leverage — sometimes that extra grip helps the key engage properly. If it still doesn’t turn smoothly, stop and contact Textbook Orthodontics in Los Angeles right away. Dr. Nathan Nourian or a team member will check the expander and, if needed, provide a new wrench or adjust the appliance in-office to get it working again.