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oai:recercat.cat:20.500.12328/52362026-03-26T19:51:57Zcom_2072_67741col_2072_484352

Unwanted creaniofacial fractures in MARPE/ MASPE patients: a hidden risk? Walter Solana, André Winsauer, Heinz Crespo, Eduardo Arcos, Ignacio Valls-Ontañón, Adaia Puigdollers, Andreu Hernandez Alfaro, Federico MARPE MASPE SARPE Miniscrews Expansion Cranial fractures Minitornillos Expansión Fracturas craneales Minitorns Expansió Fractures cranials 616.3 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 info:eu-repo/semantics/publishedVersion 2025-12-05 info:eu-repo/semantics/article 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 eng Progress in Orthodontics 26;51 © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. http://creativecommons.org/licenses/by-nc-nd/4.0/. info:eu-repo/semantics/openAccess 10 Springer