Peak Family Dentistry • Patient Education
Quick answer: MARPE (miniscrew-assisted rapid palatal expansion) widens a narrow upper jaw using mini-screws anchored in the palate, with no cut in the bone. SARPE (surgically assisted rapid palatal expansion) releases the bone surgically first, then widens it with an expander. The main difference is whether surgery is part of the plan. MARPE is generally favored in younger adults whose palate seam can still open, and SARPE is generally favored when the seam is fully mature. Your imaging, not your age alone, guides the choice, and neither option guarantees a result.
This article is for general education and isn't a substitute for an in-person evaluation.
What Is MARPE?
MARPE is a bone-anchored expander. Mini-screws placed in the palate connect the appliance directly to the bone, so expansion force works on the jaw itself instead of pushing mainly against the teeth. The expander is then adjusted gradually and stays in place afterward while the bone stabilizes. Peak Family Dentistry offers MARPE for adults in Albuquerque, NM. Our MARPE page describes the appliance.
What Is SARPE?
SARPE combines an expander with a surgical release of the bone, performed by an oral and maxillofacial surgeon. It follows four phases: the surgical cut (osteotomy), a short waiting period before adjustments begin, active expansion, and a consolidation period while new bone forms. Surgical techniques vary. A 2025 scoping review notes that the surgical step has no standardized protocol and no universally accepted "gold standard" technique, and that less invasive versions can be done under local anesthesia.
MARPE vs. SARPE Compared
| Comparison | MARPE | SARPE |
|---|---|---|
| Surgical bone cut | No | Yes |
| Who performs it | A dentist or orthodontist trained in MARPE | An oral and maxillofacial surgeon, coordinated with the appliance provider |
| How force reaches the jaw | Mini-screws anchored in palatal bone | An expander (tooth-borne or bone-borne) after the bone is released |
| Often favored when | The palate seam can still open, typically in younger adults | The seam is fully mature, or a larger or more reliable correction is needed |
| Main risks reported | Tipping of anchor teeth, screw loosening or inflammation, and the seam not opening | Pain, swelling, bleeding, numbness or altered sensation, infection, and rare serious complications |
| Recovery | No surgical recovery, though expansion causes pressure and soreness | Surgical recovery in addition to the expansion phase |
What the Research Shows
A systematic review and meta-analysis in the European Journal of Orthodontics, covering patients 16 and older, reported a mean MARPE success rate of 92.5%, with an average skeletal expansion of about 2.3 mm. The authors performed the meta-analysis only on an exploratory basis because the studies varied.
A 2025 scoping review of 26 studies compared side effects of both methods in adults. Dental tipping was mostly linked to MARPE, though it often improves during the retention phase. Surgical complications were mostly linked to SARPE, and the review notes that serious SARPE complications are rare but have been reported. In the MARPE studies it reviewed, failure rates were 15% to 17%. Overall, it concludes that both techniques carry risks and that careful patient selection and treatment planning are essential. The authors also caution that the studies were highly varied and that the review did not assess study quality.
How Age and Palate Maturity Affect the Choice
Success with MARPE falls as the palate seam matures. The scoping review cites evidence that success is high in adults under about 25 and drops sharply in older adults, to roughly 20% in one group aged 30 to 37 with a mature suture. That is why the 92.5% figure above shouldn't be read as a promise for every adult: the studies behind it centered on younger patients.
Maturity can be evaluated directly. CBCT imaging of the palatal suture classifies it in stages A through E. The review suggests MARPE may be advantageous at stages A to C, and that surgical weakening of the suture should be prioritized at stages D and E, partly to avoid a second procedure if MARPE fails. In one study it reviewed, patients whose suture didn't open with MARPE went on to surgically assisted expansion. Newer approaches, such as pairing a bone-anchored expander with a minimally invasive surgical release, are being studied, but the review notes small samples and limited long-term follow-up.
Where Peak Family Dentistry Fits
Dr. Billie Adams uses MARPE for adults whose palate seam has already fused, as described on our airway orthodontics page. SARPE is a surgical procedure performed by an oral and maxillofacial surgeon. If an evaluation suggests a surgical release would be more predictable for you, that decision involves a surgeon, and we'll discuss it before any treatment begins. For a broader look at all adult options, see our guide to adult palate expansion.
Questions to Ask Before Choosing
- What does my imaging show about the maturity of my palate seam?
- How likely is MARPE to open it, given my age and anatomy?
- If it doesn't open, what happens next, and what would that add to my timeline and cost?
- Which side effects are most likely in my case?
- Who would perform each step of treatment?
Frequently Asked Questions
Can MARPE fail?
Yes. The seam doesn't always separate, and failure rates of 15% to 17% appeared in the MARPE studies in the scoping review. If it fails, surgically assisted expansion may be recommended.
Does SARPE have a higher success rate than MARPE?
In adults with a fully mature palate seam, studies in the review generally reported lower failure rates with SARPE. It also involves surgery and its risks, so the choice weighs predictability against invasiveness.
Does either option require braces afterward?
Many patients need braces or aligners afterward to finish aligning the teeth. Your provider will advise based on your bite after expansion.
Getting an Individualized Answer
Which option fits depends on your palate's maturity, your goals, and your anatomy, and only an exam with imaging can show it. To discuss your options with Dr. Adams, contact Peak Family Dentistry in Albuquerque or call (505) 293-2211.
References
- Sicca N, Benedetti G, Nieri A, Vitale S, Lopponi G, Mura S, Verdecchia A, Spinas E. Comparison of Side Effects Between Miniscrew-Assisted Rapid Palatal Expansion (MARPE) and Surgically Assisted Rapid Palatal Expansion (SARPE) in Adult Patients: A Scoping Review. Dentistry Journal. 2025;13(2):47. https://pubmed.ncbi.nlm.nih.gov/39996921/
- Kapetanović A, Theodorou CI, Bergé SJ, Schols JGJH, Xi T. Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis. European Journal of Orthodontics. 2021;43(3):313–323. https://academic.oup.com/ejo/article/43/3/313/6244623