Dr. Marianna Evans | Midfacial Non-Surgical Expansion with MARPE: Periodontal perspective.

Maxillary hypoplasia is the most common form of skeletal jaw maldevelopment associated with the majority of malocclusions, increased periodontal and airway risks. Orthopedic maxillary skeletal expansion is the most effective treatment modality to resolve maxillary transverse deficiency. Historically optimal timing for maxillary skeletal expansion was determined to be in the mixed dentition due to midfacial sutural potency. Until recently maxillary skeletal expansion was only achievable with Le Fort I osteotomies in adults. Conventional tooth-supported palatal expanders are known to produce unfavorable periodontal outcomes with or without surgical facilitation.

Introduction of temporary anchorage devices (TADs) into expanders significantly reduces periodontal risks and broadens the envelop of non-surgical correction in skeletally mature patients. Fully customized 3D printed expanders in conjunction with TADs allow skeletal maxillary expansion in adults WITHOUT surgery.This is by far the greatest orthodontic innovation of the last century. This lecture with cover restorative and systemic benefits from non-surgical custom MARPE (Mini-screw Assisted Rapid Palatal Expansion).

1. Review clinical indicators of maxillary hypoplasia.
2. Review innovative protocol of non-surgical MARPE expansion, airway and dental benefits.
3. Review periodontal and occlusal implications resolving maxillary hypoplasia with MARPE in adults.

Marianna Evans, DMD is a board certified specialist in orthodontics and periodontics.She received her DMD and dual specialty training in orthodontics and periodontics at the University of Pennsylvania. To serve her patients better she joined the University of Pennsylvania Sleep Surgery Department as adjunct professor. She is a founder of OrthoPerio Institute, an educational platform offering advanced courses for dental practitioners with extensive emphasis on foundational health including MARPE, skeletal expansion for all ages and Airway. Dr. Evans is also the founder of Infinity Dental Specialists, an interdisciplinary practice focusing on orofacial development, periodontal, and airway health. Dr. Evans divides her time between her busy practice, teaching and conducting research on maxillary hypoplasia, skeletal expansion with MARPE, and their implications to oral and systemic health.