Understanding Your Expander Options: RPE, IPE, MSE, SARPE, and DOME Explained
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- 3 days ago
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Maxillary Expansion: A Guide to Your Treatment Options
The upper jaw, or maxilla, is made up of two bones that are joined at the roof of the mouth. The midpalatal suture, which connects these two bones,
gains structural integrity and becomes more complex as a person matures into their mid-teenage years.
A narrow maxilla can leave insufficient space for teeth to align. This condition can also affect the width of the nasal floor, which may impact a patient's breathing. Fortunately, the bones are adaptable and can be expanded, allowing new bones to naturally form and fill the space
For these reasons, maxillary expansion is a crucial step in orthodontic treatment for patients with a narrow upper jaw. A patient's age and skeletal maturity are key factors in choosing the right type of expander. This article will guide you through the different types of maxillary expanders available.
What is a Palatal Expander?
A palatal expander is an orthodontic appliance used to widen the upper jaw. Typically, the appliance is attached to the molar teeth. Some devices may be secured directly to the palatal bone using miniscrews. A small joint in the center of the device applies outward pressure through wires. To activate the expansion, a special key is inserted into the joint and turned daily (or as prescribed by an orthodontist), gradually moving the back teeth outward.
Types of Palatal Expanders Used by Orthodontists
RPE (Rapid Palatal Expander): The traditional expander for children and adolescents whose midpalatal suture has not yet fully interlocked. It can expand the jaw rapidly.
How it Works: The appliance is attached to the permanent molars and has a central joint for a key. The orthodontist will instruct a parent or guardian on how to turn the key as prescribed (e.g., once or twice a day). Each turn applies outward pressure, which separates the midpalatal suture, causing the upper jaw to widen.
IPE (Invisalign Palatal Expander): The Latest Expander from Invisalign, More Comfortable Than Ever
The IPE is a removable appliance that uses the same technology as clear aligners. Unlike traditional expanders, patients do not need to turn a key. This appliance is specifically designed for children and adolescents.
How it works:The IPE is a series of 3D printed customized plastic expanders. Each one is worn in sequence, the next one slightly wider than the previous. This gradual process helps separate midpalatal sutures and expand the upper jaw step by step.
MARPE (Miniscrew-assisted Rapid Palatal Expander) or MSE (Maxillary Skeletal Expander):
A New Option for Teenagers and Adults, No Surgery Required
The MSE was developed to address narrow maxilla cases in late adolescents and adults, where the midpalatal suture becomes more complex and harder to separate.
How it works:The appliance is anchored to the molars and palate with four miniscrews, directing expansion forces straight to the bone. Patients (or parents) are instructed to activate it as prescribed, typically once or twice a day. Each activation applies lateral force to gradually separate the midpalatal suture, enabling effective maxillary expansion without relying solely on the teeth, unlike traditional RPE.
SARPE (Surgically Assisted Rapid Palatal Expander): Surgical-Assisted Maxillary Expansion for Severe CasesSARPE is a treatment option for patients whose midpalatal suture has greater maturity and integrity, making expansion with appliances alone insufficient.
How it works:
In this approach, an orthodontist first places an RPE appliance, or in cases of a thicker palate, an MSE may be considered instead. Then, an oral and maxillofacial surgeon performs a minor surgical procedure to loosen the palatal suture. After surgery, the patient follows the orthodontist’s instructions to activate the expander in the usual manner.
DOME (Distraction Osteogenesis Maxillary Expansion): Maxillary Expansion to Improve Breathing
DOME is a surgical method of maxillary expansion that stimulates the body to form new bone in the gradually separated space. Its primary goal is to address airway issues, such as nasal obstruction and obstructive sleep apnea (OSA). This technique is particularly suited for adults with more complex midpalatal sutures.
How it works:The orthodontist places a bone-borne maxillary expander, such as the MSE, which is anchored directly into the palate using miniscrews. The oral and maxillofacial surgeon then performs a minor surgical procedure. Following surgery, the patient activates the appliance as instructed by the orthodontist, gradually expanding the maxilla and increasing the nasal airway space.
To select the right palatal expander, your orthodontist will consider several factors, including your age, bone structure, tooth condition, and cooperation level. This ensures the safest and most effective results.
If you have a narrow upper jaw, you should consult an orthodontist to create a suitable treatment plan for you. Our clinic is ready to provide services from certified orthodontic specialists who have been accredited by the American Board of Orthodontics (ABO), guaranteeing quality, expertise, and extensive experience to give you a confident smile.
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