{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:08:04Z","timestamp":1793383684282,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Microimplant-assisted rapid palatal expansion (MARPE) has been demonstrated successfully in maxillary expansion in late adolescence and adulthood. The maxillary advancement accompanied by expansion is frequently anticipated, which is beneficial for the treatment of class III malocclusion. Airway volume increase can also be noted in some cases from the measurement of cone beam computerized tomography (CBCT) after expansion. The objective of this case report is to demonstrate the feasibility of applying MARPE on late adolescence patients with maxillary transverse deficiency and to present the changes in transverse and anteroposterior dimensions as well as the volume increase in velopharyngeal airway after MARPE. A 15-year-old female presented class III skeletal pattern. She had maxillary transverse deficiency with moderate crowding and posterior\/anterior crossbites. Maxillary Skeletal Expander (MSE; Biomaterials Korea Inc.) type-2 was used as a MARPE device in this case. After four weeks of maxillary expansion, a significant amount of expansion was achieved and the anterior crossbite was spontaneously corrected. Fixed appliance treatment was commenced four weeks after MARPE with 0.022-slot preadjusted brackets (MBT prescription). Temporary anchorage devices (TADs) were placed over the mandibular buccal shelves for posterior teeth distalization and crowding relief. After 25 months of treatment, the facial profile was improved with maxillary advancement (SNA: 83\u00b0 to 83.5\u00b0) and mandibular backward rotation (SNB: 83\u00b0 to 82\u00b0; SN-MP: 34.5\u00b0 to 35\u00b0). In this case, MARPE not only engenders significant transverse correction but also aids in anteroposterior change. The treatment effects of maxillary advancement and mandibular backward rotation can lead to a more esthetic profile in skeletal class III cases.<\/jats:p>","DOI":"10.3390\/medicina58081052","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T02:12:39Z","timestamp":1659665559000},"page":"1052","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Management of Class III Malocclusion and Maxillary Transverse Deficiency with Microimplant-Assisted Rapid Palatal Expansion (MARPE): A Case Report"],"prefix":"10.3390","volume":"58","author":[{"given":"Sin-Ni","family":"Shih","sequence":"first","affiliation":[{"name":"Department of Orthodontics, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwok-Hing","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Long","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun-Chu","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng-Ming","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"ref_1","first-page":"598","article-title":"An orthopedic approach to the treatment of Class III malocclusion in young patients","volume":"21","author":"McNamara","year":"1987","journal-title":"J. Clin. Orthod."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s40510-021-00392-2","article-title":"Dentoskeletal effects of early class III treatment protocol based on timing of intervention in children","volume":"22","author":"Nucci","year":"2021","journal-title":"Prog. Orthod."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1093\/ejo\/cju100","article-title":"Effects of rapid maxillary expansion on the midpalatal suture: A systematic review","volume":"37","author":"Liu","year":"2015","journal-title":"Eur. J. Orthod."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1093\/ejo\/cjy023","article-title":"Association between 3D palatal morphology and upper arch dimensions in buccally displaced maxillary canines early in mixed dentition","volume":"40","author":"Bizzarro","year":"2018","journal-title":"Eur. J. Orthod."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.ajodo.2009.10.004","article-title":"Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs. traditional rapid maxillary expansion: A randomized clinical trial","volume":"137","author":"Lagravere","year":"2010","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"206","DOI":"10.21307\/aoj-2021.018","article-title":"The role of micro-implant-assisted rapid palatal expansion (MARPE) in clinical orthodontics\u2014A literature review","volume":"37","author":"Chuang","year":"2021","journal-title":"Australas. Orthod. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.ajodo.2007.01.021","article-title":"Surgically assisted rapid palatal expansion: A literature review","volume":"133","author":"Suri","year":"2008","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.ijom.2019.08.011","article-title":"Surgically assisted rapid maxillary expansion: A systematic review of complications","volume":"49","author":"Carvalho","year":"2020","journal-title":"Int. J. Oral. Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/j.ajodo.2007.10.065","article-title":"Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism","volume":"137","author":"Lee","year":"2010","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_10","first-page":"12","article-title":"An interview with Won Moon. By Andre Wilson Machado, Barry Briss, Greg J Huang, Richard Kulbersh and Sergei Godeiro Fernandes Rabelo Caldas","volume":"18","author":"Moon","year":"2013","journal-title":"Dent. Press J. Orthod."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1093\/ejo\/cjab005","article-title":"Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: A systematic review and meta-analysis","volume":"43","author":"Kapetanovic","year":"2021","journal-title":"Eur. J. Orthod."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1590\/2177-6709.22.1.110-125.sar","article-title":"Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE)","volume":"22","author":"Brunetto","year":"2017","journal-title":"Dental Press J. Orthod."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1080\/27705781.2022.2051120","article-title":"Skeletal and dental changes after microimplant-assisted rapid palatal expansion (MARPE)\u2014A Cephalometric and Cone-Beam Computed Tomography (CBCT) study","volume":"81","author":"Liao","year":"2022","journal-title":"Clin. Investig. Orthod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.ajodo.2018.11.019","article-title":"Three-dimensional changes of the zygomaticomaxillary complex after mini-implant assisted rapid maxillary expansion","volume":"156","author":"Song","year":"2019","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1093\/ejo\/cju094","article-title":"Comparison of short-term effects of mini-implant-supported maxillary expansion appliance with two conventional expansion protocols","volume":"37","author":"Yilmaz","year":"2015","journal-title":"Eur. J. Orthod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/ejo\/21.2.175","article-title":"A comparison of sagittal and vertical effects between bonded rapid and slow maxillary expansion procedures","volume":"21","author":"Akkaya","year":"1999","journal-title":"Eur. J. Orthod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/0002-9416(77)90241-X","article-title":"Midpalatal suture opening: A normative study","volume":"71","author":"Wertz","year":"1977","journal-title":"Am. J. Orthod."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.ajodo.2003.10.035","article-title":"Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion","volume":"126","author":"Chung","year":"2004","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_19","unstructured":"Ricketts, R.M., Roth, R.H., Chaconas, S.J., Schulhof, R.J., and Engel, G.A. (1982). Orthodontic Diagnosis and Planning: Their Roles in Preventive and Rehabilitative Dentistry, Rocky Mountain\/Communicators."},{"key":"ref_20","first-page":"75","article-title":"Diagnosis and treatment of transverse maxillary deficiency","volume":"10","author":"Betts","year":"1995","journal-title":"Int. J. Adult Orthodon. Orthognath. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/0002-9416(75)90158-X","article-title":"Palatal growth studied on human autopsy material. A histologic microradiographic study","volume":"68","author":"Melsen","year":"1975","journal-title":"Am. J. Orthod."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Chen, C.L., Chen, C.H., Pan, C.Y., Chang, H.P., Chen, P.H., and Tseng, Y.C. (2020). Cone beam computed tomographic analysis of the spatial limitation during mandibular arch distalization. BMC Med. Imaging, 20.","DOI":"10.1186\/s12880-020-00441-y"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.ajodo.2014.04.021","article-title":"Mandibular posterior anatomic limit for molar distalization","volume":"146","author":"Kim","year":"2014","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.ajodo.2016.10.025","article-title":"Effects of monocortical and bicortical mini-implant anchorage on bone-borne palatal expansion using finite element analysis","volume":"151","author":"Lee","year":"2017","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1007\/s00276-020-02526-3","article-title":"Three-dimensional analysis of the velopharyngeal region in patients with cleft palate and healthy individuals","volume":"42","author":"Miller","year":"2020","journal-title":"Surg. Radiol. Anat."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"435","DOI":"10.2319\/092917-656.1","article-title":"Assessment of changes in the nasal airway after nonsurgical miniscrew-assisted rapid maxillary expansion in young adults","volume":"88","author":"Kim","year":"2018","journal-title":"Angle Orthod."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"432","DOI":"10.2319\/080919-522.1","article-title":"Comparison of dimensions and volume of upper airway before and after mini-implant assisted rapid maxillary expansion","volume":"90","author":"Li","year":"2020","journal-title":"Angle Orthod."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.ajodo.2013.04.022","article-title":"Midpalatal suture maturation: Classification method for individual assessment before rapid maxillary expansion","volume":"144","author":"Angelieri","year":"2013","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Almaqrami, B.S., Ngan, P., Alhammadi, M.S., Al-Somairi, M.A., Xiong, H., and Hong, H. (2022). Three-dimensional craniofacial changes with maxillary expansion in young adult patients with different craniofacial morphology. APOS Trends Orthod.","DOI":"10.25259\/APOS_177_2021"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.ajodo.2010.10.024","article-title":"Effects of rapid maxillary expansion on the cranial and circummaxillary sutures","volume":"140","author":"Ghoneima","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s40510-017-0188-7","article-title":"Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging","volume":"18","author":"Cantarella","year":"2017","journal-title":"Prog. Orthod."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"11","DOI":"10.38209\/2708-2636.1098","article-title":"Evaluation of Patients\u2019 Experiences after Microimplant-Assisted Rapid Palatal Expansion (MARPE) Treatment","volume":"33","author":"Tsai","year":"2021","journal-title":"Taiwan. J. Orthod."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.ajodo.2017.08.014","article-title":"Anatomic assessment of the mandibular buccal shelf for miniscrew insertion in white patients","volume":"153","author":"Elshebiny","year":"2018","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"745","DOI":"10.2319\/011117-34.1","article-title":"Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults","volume":"87","author":"Nucera","year":"2017","journal-title":"Angle Orthod."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.ajodo.2020.01.019","article-title":"Evaluation of interradicular space, soft tissue, and hard tissue of the posterior palatal alveolar process for orthodontic mini-implant, using cone-beam computed tomography","volume":"159","author":"Lee","year":"2021","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ajodo.2004.12.024","article-title":"Soft-tissue and cortical-bone thickness at orthodontic implant sites","volume":"130","author":"Kim","year":"2006","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"353","DOI":"10.4041\/kjod.2017.47.6.353","article-title":"Investigation of the effects of miniscrew-assisted rapid palatal expansion on airflow in the upper airway of an adult patient with obstructive sleep apnea syndrome using computational fluid-structure interaction analysis","volume":"47","author":"Hur","year":"2017","journal-title":"Korean J. Orthod."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/1052\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:04:08Z","timestamp":1760141048000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/1052"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,4]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["medicina58081052"],"URL":"https:\/\/doi.org\/10.3390\/medicina58081052","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,4]]}}}