Comparison of Efficacy between Tooth Borne and Bone Borne Mini Implant Assisted Rapid Palatal Expansion with Conventional Palatal Expansion – A Systematic Review

Background : Transverse maxillary discrepancies often develop due to altered skeletal growth patterns influenced by prolonged oral habits and impaired orofacial muscle function. Traditional methods like Rapid Maxillary Expansion (RME) and Slow Maxillary Expansion (SME), have been widely used, particularly in younger patients. MARPE is a minimally invasive, micro-implant–supported expansion technique designed to achieve skeletal maxillary widening in adolescents and adults. The objective of this review was to critically appraise and synthesize the evidence comparing mini-screw–assisted rapid palatal expansion (MARPE) with conventional rapid palatal expansion (RPE) in terms of skeletal expansion, dentoalveolar changes, and periodontal effects. Materials and Methods: Electronic and manual searches were performed based on predefined PICO eligibility parameters. Risk of bias was assessed using the ROB-2 tool for randomized controlled trials and the ROBINS-I tool for non-randomized studies. The evidence was then synthesized narratively to evaluate skeletal, dentoalveolar, and periodontal outcomes. Results : Six studies were included, most with low to moderate risk of bias. MARPE showed higher skeletal effectiveness, with midpalatal suture opening rates of 84–100% and consistently greater increases in nasal width compared with conventional RPE. Dentoalveolar changes were smaller with MARPE, with molar inclination ranging from 1.3° lingual to 3.9° buccal, lower than in tooth-borne expanders. Periodontal findings also favored MARPE, with studies reporting less buccal bone and alveolar height loss, indicating improved preservation of supporting structures. Conclusion: The review indicates that MARPE is an effective non-surgical option for maxillary expansion in late adolescents, offering greater skeletal expansion with fewer dentoalveolar and periodontal side effects than conventional expanders. However, the predominance of studies with moderate risk of bias underscores the need for higher-quality research to confirm these findings.