Is efficacy of miniscrew-assisted rapid palatal expansion in mid to late adolescents and young adults related to craniofacial sutures opening? A systematic review and meta-analysis

Transverse maxillary deficiency is a relatively common type of malocclusion, that if left untreated will probably affect the permanent dentition. Recent investigations have proposed the use of bone-supported miniscrews around the midpalatal suture to expand the palate in late adolescents. The aim of this systematic review was to assess the efficacy of the Miniscrew Assisted Rapid Palatal Expansion (MARPE) technique in young adult patients, by quantifying skeletal expansion in relation to the age of the patient, as well as the impact upon other craniofacial sutures, and to describe the possible dental side effects. An electronic and manual search was conducted, in which 17 were included in the study. The estimated mean palatal opening width and nasal cavity width was 2.99 ± 0.33 mm and 2.24 ± 0.17 mm, respectively. A significant association was observed between midpalatal and pterygoid suture opening (p=0.010). No association was found between age and the MARPE technique (p=0.701). The results of this study show that the MARPE technique produces significant opening width in young adults at both at midpalatal suture and nasal cavity level, and apparently only significantly widens the pterygoid suture. Greater dental side effects are directly associated to a reduced midpalatal suture opening width.