When the upper jaw is too narrow, orthodontic treatment may require more than braces or a traditional expander alone. Miniscrew-assisted rapid palatal expansion and surgically assisted rapid palatal expansion are two approaches used to create more width in the upper jaw.
Schedule a consultation with our board-certified oral surgeons to discuss your treatment plan. Call (303) 444-2255.
Coordinated Care With Your Orthodontist
Upper-jaw expansion requires close coordination between the orthodontist and oral surgeon. Most patients are referred to Foley & Le by their orthodontist, and our surgeons work with orthodontists throughout Boulder and the surrounding communities to coordinate the appliance, surgical care, and timing of treatment.
Your surgical care is provided by our board-certified oral and maxillofacial surgeons:
Throughout treatment, we stay in communication with your orthodontist so the surgical and orthodontic phases of care remain coordinated.
When Upper Jaw Expansion May Be Needed
The upper jaw, or maxilla, should be wide enough to fit properly over the lower jaw. When the jaw itself is too narrow, the condition is known as maxillary transverse deficiency.
Upper-jaw expansion may be recommended when a narrow maxilla contributes to:
- A posterior crossbite
- Crowded upper teeth
- Limited room for orthodontic alignment
- A width difference between the upper and lower dental arches
- An asymmetrical bite
- The need for more space before additional orthodontic or jaw treatment
Traditional expanders work most predictably while the facial bones are still developing. As the upper jaw matures, miniscrew support or surgical assistance may be needed to create skeletal expansion.
Miniscrew-Assisted Palatal Expansion
MARPE uses an orthodontic expander secured to the palate with small temporary screws. This allows the appliance to widen the upper jaw without relying only on the teeth for support.
MARPE can be used for teens and adults, depending on the individual treatment plan. The amount of expansion needed, the anatomy of the upper jaw, and the goals of orthodontic treatment all help determine whether this approach is appropriate.
Surgically Assisted Palatal Expansion
SARPE combines an orthodontic expander with surgery to help widen the upper jaw. It is generally used for adults or patients with a mature upper jaw when miniscrew-assisted expansion alone is not expected to provide the necessary widening.
During surgery, the upper jaw is prepared so the orthodontic appliance can gradually expand it afterward. Unlike MARPE, which is performed in our office, SARPE is performed in the hospital and normally requires an overnight stay.
The MARPE Treatment Process
Patients are generally referred to our office by their orthodontist, who designs and places the expansion appliance before the surgical appointment. We then secure the appliance to the palate with temporary miniscrews.
MARPE is performed with IV sedation and typically takes one to two hours, depending on the complexity of the procedure.
Afterward, the appliance is gradually activated to widen the upper jaw. Your orthodontist manages the expansion and continues orthodontic treatment once the necessary width has been achieved.
The SARPE Treatment Process
SARPE is planned in coordination with your orthodontist, who prepares the expansion appliance as part of the overall treatment plan. During surgery, cuts are made in the upper jaw to allow the appliance to gradually widen the palate afterward.
The procedure is performed in the hospital, and patients normally stay overnight. Following surgery, your orthodontist manages the expansion process and continues orthodontic treatment once the necessary width has been achieved.
Recovery After MARPE or SARPE
Recovery depends on the type and extent of the procedure. After MARPE, temporary soreness, swelling, and minor bleeding may occur around the miniscrews or surgical areas. Recovery may be more involved when bone cuts are needed.
SARPE generally requires a longer initial recovery because it involves more extensive surgery. Swelling, soreness, nasal congestion, and temporary difficulty chewing are common during the early healing period.
We will provide instructions for eating, oral hygiene, and caring for the surgical areas. Follow-up with our office and your orthodontist helps ensure healing and expansion progress as planned.
Dental insurance generally does not cover MARPE. In some cases, we can attempt to obtain coverage through medical insurance, although approval cannot be guaranteed. Insurance coverage for SARPE may vary because the procedure is performed in a hospital.
If you have Delta Dental Premier or Cigna, your estimated portion is collected at the time of service. For all other plans, payment is due in full, and any insurance reimbursement will be sent to you once your claim is processed.
Financing options are also available through Cherry, which allows you to split treatment costs into manageable monthly payments.
Schedule a Consultation
If your orthodontist has recommended upper-jaw expansion, our surgeons will work closely with them to coordinate the surgical portion of your care. Your treatment will be planned around the type of expansion recommended and your overall orthodontic treatment plan.
To book a consultation at our oral surgery office in Boulder, CO, call (303) 444-2255 or visit us at 1420 28th St, UNIT 100, Boulder, CO.
Call UsFrequently Asked Questions
Does a palatal expander change your face?
Upper-jaw expansion can cause subtle changes in facial appearance as the width of the upper jaw increases. The amount of visible change varies depending on your anatomy and the amount of expansion needed.
How do I clean around a palatal expander?
Brush carefully around the appliance and miniscrews to prevent food and plaque from building up. Your orthodontist and surgical team will give you specific cleaning instructions based on your appliance.
Is the surgery painful?
The procedure itself is performed with anesthesia, so you should not feel pain during surgery. Soreness, swelling, and pressure are common afterward and generally improve as healing progresses.
Can I drive myself home after the procedure?
No. Because IV sedation is used, you will need a responsible adult to drive you home after the procedure and stay with you during the initial recovery period. You will also need to fast prior to the surgery.
Who provides MARPE and SARPE treatment in Boulder?
Foley & Le Oral & Maxillofacial Surgeons provides the surgical portion of MARPE and SARPE treatment in coordination with your orthodontist. MARPE is performed at our Boulder office, while SARPE is performed in a hospital.
