2026-04-04T03:35:57Zhttps://recercat.cat/oai/requestoai:recercat.cat:20.500.12328/52362026-03-26T19:51:57Zcom_2072_67741col_2072_484352
RECERCAT
author
Walter Solana, André
author
Winsauer, Heinz
author
Crespo, Eduardo
author
Arcos, Ignacio
author
Valls-Ontañón, Adaia
author
Puigdollers, Andreu
author
Hernandez Alfaro, Federico
2025-12-05
Walter, Andre; Winsauer, Heinz; Crespo, Eduardo [et al.]. Unwanted craniofacial fractures in MARPE/ MASPE patients: a hidden risk?. Progress in Orthodontics, 2025, 26(51). Disponible en <https://link.springer.com/article/10.1186/s40510-025-00592-0>. Fecha de acceso: 5 mar. 2026. DOI: https://doi.org/10.1186/s40510-025-00592-0
http://hdl.handle.net/20.500.12328/5236
https://doi.org/10.1186/s40510-025-00592-0
Background Miniscrew-assisted palatal expansion techniques such as MARPE (Miniscrew-Assisted Rapid Palatal
Expansion) and MASPE (Miniscrew-Assisted Slow Palatal Expansion) represents non-surgical alternatives for the
correction of transverse maxillary deficiencies in adults. However, concerns have arisen regarding their potential to
cause craniofacial complications due to the high forces applied for midpalatal suture opening in skeletally mature
patients.
Methodology This article aims to present and describe isolated clinical cases of cranialfacial complications observed
in adult patients following MARPE and MASPE procedures, and to discuss the potential biomechanical mechanisms
behind these events. Eleven clinical cases involving adult patients who underwent skeletal midface expansion with
miniscrew-assisted devices are presented. All cases exhibited craniofacial unwanted dislocations identified through
CBCT imaging, including zygomatic fractures, parasutural bone fractures, and asymmetrical disjunction of craniofacial
sutures. These events were retrospectively documented through clinical follow-up and radiographic analysis.
Results Among the eleven cases presented, complications included seven asymmetric fractures of the frontonasal
process, two orbital fractures, one zygomatic bone fracture, and one parasagittal fracture of the palatine bone. These
complications were primarily observed in patients who underwent MARPE with rapid activation protocols. One minor
complication occurred in a MASPE case, where the patient followed the prescribed slow activation schedule.
Conclusion Non surgical mid facial expansion is a potential source of unwanted and unpredicted dislocations in the
craneofacial complex. According to this report the observed complications do not seem to be age related and are
difficult to predict from the CBCT. A close clinical follow up including force monitoring and force limitation should
be mandatory when performing MARPE. MASPE and minimally invasive SARPE could be alternatives to minimise the
incidence of creaniofacial complications
eng
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MARPE
MASPE
SARPE
Miniscrews
Expansion
Cranial fractures
Minitornillos
Expansión
Fracturas craneales
Minitorns
Expansió
Fractures cranials
Unwanted creaniofacial fractures in MARPE/ MASPE patients: a hidden risk?
info:eu-repo/semantics/article