Many “innovators” create specific MARPE designs and claim superiority over current products currently available on the market. They present a lot of positive results claiming expansion cures all sleep apnea/OSA; however, there are numerous side effects of mini-screw assisted rapid palatal expansion (MARPE) and many of the failure cases are ignored and discarded. There is a great importance to fully understand MARPE and indications of use in order to predict and avoid potential side effects, just as we do in biomechanics for orthodontics. Once complications do occur, it is just as important to understand how to best manage the case to prevent further iatrogenic damage.
In this lecture, I will review the biomechanical advantages/disadvantages of each MARPE design and technique. Also, I will present cases that demonstrate the complications of MARPE and how to troubleshoot and manage each complication. I will discuss my recent publication of MARPE complications to determine what factors lead to successful clinical improvements, and what factors may create adverse iatrogenic consequences of MARPE. The goals of this presentation are to guide the orthodontist in selecting the best MARPE option for individual cases and properly treatment plan the biomechanics to avoid clinical complications.
- Understand the risk and complications of MARPE and TAD for airway improvement.
2. Use critical thinking to anticipate complications and troubleshoot.
3. Understand how to prevent and minimize the complication and come up with alternative treatment plans.
Dr. Audrey Yoon is a dual trained orthodontist and pediatric dentist. She graduated from Seoul National Dental School and completed her orthodontic, pediatric and craniofacial training at the University of California, Los Angeles. She obtained a master degree completing extensive research in obstructive sleep apnea (OSA). She is also a diplomat of American Board of Dental Sleep Medicine and diplomat of American Board of Orthodontics. She is an adjunct assistant professor at Stanford University Sleep Medicine Center, an adjunct assistant professor in Orthodontics at University of Pacific and also a co-director of Pediatric Dental Sleep Mini-residency program at Tufts University.
Dr. Yoon is a leading collaborative team member at Stanford Medical Center in the sleep apnea research. She has worked on a pioneering technique, performing maxillary distraction osteogenesis for the treatment of OSA and has co-authored chapters on this subject in several leading textbooks. Currently her active areas of research include craniofacial growth modification, surgery-first approach of maxillomandibular advancement surgery technique, OSA genomic study to identify genetic factors.