Best MARPE clinic in Dubai: what to check before adult palatal expansion

Key facts

• MARPE uses miniscrews to widen the upper jaw bone in adults
• CBCT decides suitability, not age alone
• A temporary front-tooth gap during expansion is expected
• MARPE alone does not cure sleep apnoea
• Dr. Moaiyad Pacha: airway-focused consultant orthodontist

What MARPE is and who it suits

MARPE is a palatal expander anchored to the bone of the palate with two to four small miniscrews, so expansion force goes to the bone rather than tipping the teeth. Conventional tooth-borne expanders work mainly while the mid-palatal suture is still open, typically in children and younger teens. In mature patients they mostly tip teeth. MARPE was developed to achieve skeletal widening in late adolescents and adults with a narrow upper jaw, posterior crossbite, a narrow arch or airway concerns. Suitability depends on suture anatomy and bone quality seen on a CBCT scan, not on age alone. When the suture is too mature, surgically assisted expansion may still be needed.

CBCT planning is essential

A CBCT 3D scan shows the thickness and quality of palatal bone, the shape of the mid-palatal suture and the position of the roots and nasal floor. This information guides where miniscrews can be placed safely and whether MARPE is likely to separate the suture. Custom MARPE appliances can be designed from the CBCT and a digital intraoral scan so the miniscrews engage the strongest available bone. Ask whether the clinic uses CBCT for every MARPE case, who reads the scan and whether you will receive an explanation of the findings. A clinic that offers MARPE without 3D imaging is skipping an important safety and planning step.

Experience with mini-implants and expansion

MARPE placement is done under local anaesthesia, followed by gradual activation as the patient or parent turns the screw on a set schedule. A temporary gap between the upper front teeth is expected during active expansion and closes later during alignment. The appliance is then left in place to let new bone consolidate before a retention phase. Ask how many MARPE or MSE cases the orthodontist has treated, how they monitor expansion, how they manage asymmetric expansion or a loose miniscrew and how braces or aligners are planned afterwards. Experience with temporary anchorage devices (TADs) and bone-anchored expanders matters for predictable results.

Airway, bite and honest expectations

Many people consider MARPE because of crossbites, a narrow smile or breathing concerns. A thorough clinic assesses the bite, jaw joints, facial pattern and nasal breathing, and works with ENT or sleep specialists when needed. MARPE may increase nasal cavity volume in some patients, but it does not on its own treat or cure obstructive sleep apnoea, and outcomes vary. Discomfort during activation, gum irritation and, rarely, screw loosening or uneven expansion are possible. An honest orthodontist explains what MARPE can realistically achieve in your case, what alternatives exist, including surgically assisted expansion, and how expansion fits into the overall orthodontic plan.

MARPE with Dr. Moaiyad Pacha at Manhal

At Manhal Medical Center in Dubai, MARPE is provided by Dr. Moaiyad Pacha, Consultant Orthodontist and Partner (DHA licence 52229421-001, Specialist Orthodontics). He holds a clinical PhD from Queen Mary University of London focused on jaw growth modification, the M.Orth from the Royal College of Surgeons of Edinburgh and the F.Orth from the Royal College of Surgeons of England, and received the AAO David L. Turpin Award (2021) and the B.F. & Helen E. Dewel Award (2024). His practice focuses on airway, sleep and TMJ orthodontics, MARPE, MSE, the Facegenics midface expander and TADs. Each case is planned from CBCT and a digital scan, and a plan is confirmed only after an in-person consultation in Dubai.

In adults the midline suture of the palate has usually fused, so traditional expanders mostly tip teeth instead of widening the jaw. MARPE anchors the expander to the palatal bone with small miniscrews, allowing skeletal expansion in many adults without surgical expansion. Published clinical studies, including randomised trials, report improvements in nasal airway dimensions and, in selected patients, in sleep-disordered breathing measures.

Prepared by the Manhal Medical Center editorial team · Updated: 2026-10-18 · Treating specialist: Dr. Moaiyad Pacha

This page is general information and does not replace a consultation. Suitability, risks and results vary between patients.