Miniscrew Assisted Rapid Palatal Expander (MARPE)
MARPE is an appliance that increases the width of the upper jaw. MARPE causes the upper
jaw to widen by applying the force directly to the bone using four miniscrews rather than applying the
force to teeth. This helps to open space in the nose more effectively than expanders that push only
on the teeth.
How To Prepare:
When you come in for the procedure, we will utilize local anesthesia to place the four miniscrews.
● Before you come in, have a good meal and take 800 mg of Ibuprofen for adults or 400-600 mg
for teens.
● It is normal to feel a little tenderness around the mid palatal suture for a few days after
placement.
● After the procedure, you can continue to take Ibuprofen for 1-3 days until the discomfort
subsides.
● We recommend a warm saltwater rinse 2-3 times a day.
Activate your expander __ times a day, for a total of __ days. Then turn __ for _ _ days.
Send us photos of the expansion and we will instruct next steps.
Send photos on Day 7. Thank you!
Food List for MARPE
The first week After the first week
Avoid: Peanut butter or Nutella textured foods, Avoid: Ice, peanut brittle, hard crust pizza, corn on
breads, meats and cheeses in addition to the cob, ribs, dried meats, chips, hard tacos,
popcorn, pretzels, hard rolls and bagels, whole raw
or hard fruits and vegetables
Foods to eat: Foods to eat:
● Soups: tomato, chicken broth, lentil, pea, Dairy: soft spreadable cheeses, cottage cheese
butternut squash, miso Breads and Grains: corn bread, soft thin sliced
● Yogurt and pudding bread, muffins, cooked beans, oatmeal, cream of
● Smoothies wheat, soggy cereal
● Jell-O Proteins:
● Applesauce and foods with similar ● Soft boiled eggs
consistency ● Cooked soft chicken, chicken nuggets
● Over cooked noodles and pasta ● Thin slices of lunch meat
● Scrambled eggs ● Meatballs, meatloaf, corned beef
● Mashed Potatoes/cauliflower ● Stewed meats, pot roast
● Oatmeal ● Tamales
● Tofu ● Salmon, tuna, fish sticks, fish salad, fish filets,
● Ice cream crab cakes
● Guacamole Fruits/Vegetables: steamed/cooked/cut up fruit and
● Hummus vegetables, corn cut off the cob, avocado, salsa
What To Expect After
● Tightness: As we expand, you may experience discomfort or tingling sensation under the
palate or under your nose. Occasionally, you may also experience headache on the side of
your forehead and transient changes in the nose area.
● Spaces: During expansion, you will develop a space between the front teeth and back
(posterior) teeth may not fit comfortably.
● Eating: Chewing forcefully with posterior teeth is not recommended because it reduces the
stability of the miniscrews and the MARPE device. Therefore, we recommend a softer diet and
it is best to avoid hard, sticky, and crunchy foods. Please refer to our food list for MARPE.
● Talking: At first, you may have trouble speaking but placing your tongue on the appliance and
practicing reading out loud will help your speech to adjust.
● Brushing: Proper oral hygiene and home is required to minimize possible infections or
loosening of the appliance. Continue to brush your teeth 3-4 times a day. When brushing your
teeth, make sure that you brush the appliance as well, utilizing the interproximal brushes in
your brushing kit to clean around the wires and remove any food that may be trapped in the
appliance. Expansion may fail if the sutures are too rigid or if inflammation occurs around the
miniscrews. In this case, we may have to replace the miniscrews or stop the procedure.
● Retention: When the expansion is completed, a minimum of 3-6 months and a maximum of
12-18 months of retention period are required to minimize relapse as the bone matures. After
completing the orthodontic treatment, retainer wear is required to minimize relapse. This is
particularly necessary when the upper jaw is widened with MARPE. This will improve the
long-term stability of the treatment.
