Evidences From Systematic Reviews Regarding Miniscrew-Assisted Rapid Palatal Expansion (MARPE) Approach In Orthodontics

Abstract

Background. Miniscrew-assisted rapid palatal expansion (MARPE) has been considered as relatively novel and effective method of orthodontic treatment, but the discussion is still ongoing regarding effectiveness of MARPE for different age population groups, while also in comparison with surgically assisted rapid palatal expansion or conventional rapid maxillary expansions, since evidences available for MARPE is mostly of insufficient quality. Objective. To collect and represent evidences of MARPE treatment outcomes in orthodontics based on the data available within systematic reviews. Materials and Methods. Search was provided via PubMed Central, Web of Science and Scopus databases, while also within Cochrane Library. Only systematic reviews written in English were considered for analysis. Primary outcomes such as success rate (percentage of cases, where required maxillary width was achieved) and maxillary expansion rate in means of midpalatal split, dental intermolar width, skeletal and dentoalveolar expansion, palatal suture opening, palatal width measured in millimeters or percentage were tabulated and analyzed. Secondary outcomes were presented in descriptive manner Results. Overall 12 systematic reviews were enrolled into study group of targeted publications. Among these 12 systematic reviews primary outcomes were extracted from 8 of them, while rest 4 systematic reviews were used for analysis of secondary outcomes. Succes rate of MARPE varied in the range of 82.8-100%, while intermolar width increase after MARPE treatment – in the range of 4.79-6.55 mm. Conclusion. Considering data available within systematic reviews MARPE approach seems to be reliable orthodontic treatment option, which help to gain significant increase for skeletal and dental intermolar width among patients with maxillary transverse deficiency. Such treatment strategy provides better results than conventional rapid maxillary expansion and lesser periodontal negative consequences compare to surgical-assisted rapid palatal expansion, even though quality of data supporting these statements are insufficient and debatable.