Skeletal palatal anchorage is rapidly becoming a fundamental part of orthodontic treatment. It is now possible to obtain orthopaedic effects in terms of maxillary expansion in adolescent and adult patients, where classical non-surgical treatments based on tooth-borne appliance failed. Age remains a crucial issue, making the orthopaedic expansion less predictable in older patients. The knowledge of prediction factors, along with the avoidance of specific technical failures, may increase notably the success of the MARPE. Protocols may thus be adapted to the difficulty of the case from adolescents to very adult patients. Moreover, digital orthodontics is an integral part of MARPE, whereby miniscrew insertion may be planned and fully custom-made appliances are 3D designed and printed. This lecture resumes main evidence, along with its limits, and some opposing concepts such as the anatomy-driven and appliance-driven concepts. An additional more recent procedure referred to as corticopunctures/corticoperforation is also shown. A MARPE reasonable approach mostly evidence-based is finally reported.


Learning Objectives
After this lecture, you will be able to know of the potential of palatal anchorage in maxillary expansion
After this lecture, you will be able to discriminate cases according to the different predictability
After this lecture, you will be able to know how best to plan insertion of miniscrews and designing the expander