Miniscrew-Assisted Rapid Palatal Expansion (MARPE) for Obstructive Sleep Apnoea: A Narrative Review

(Pengembangan Lelangit Pantas Berbantukan Skru Mini (MARPE) untuk Apnea Tidur Obstruktif: Satu Ulasan Naratif)

MOHD ZAMBRI MOHAMED MAKHBUL¹ & WAN NURAZREENA WAN HASSAN^2,*

¹Orthodontic Unit, Klinik Pergigian Cahaya Suria (Sementara), Kementerian Kesihatan Malaysia, Bangunan Pudu Sentral, 55100 Kuala Lumpur, Malaysia

²Department of Orthodontic, Paediatric and Special Care Dentistry, Faculty of Dentistry, Universiti Malaya 50603 Kuala Lumpur, Malaysia

Diserahkan: 15 November 2025/Dterima: 8 Mei 2026

Abstract

Obstructive sleep apnoea (OSA) affects millions worldwide and significantly impacts cardiovascular health and quality of life. While continuous positive airway pressure remains the gold standard, poor compliance drives interest in alternative treatments. Miniscrew-assisted rapid palatal expansion (MARPE) has emerged as a promising non-surgical intervention for patients with OSA and transverse maxillary deficiency. This narrative review summarises the current literature on MARPE’s biomechanical principles, reported clinical outcomes, and long-term considerations. Available studies suggest that MARPE may achieve meaningful skeletal expansion and may be associated with improvement in apnoea-hypopnoea index (AHI) in carefully selected patients. Compared with some alternative expansion approaches, MARPE has been reported to show favourable periodontal outcomes and encouraging long-term stability in selected studies, although these findings should be interpreted cautiously. Complications have been reported in some case series, but many are manageable with appropriate planning, appliance design, and follow-up. This narrative review provides a clinically oriented overview of current evidence on case selection, treatment planning, and complication management.

Keywords: Maxillary expansion; miniscrew anchorage; obstructive sleep apnoea; rapid palatal expansion; sleep-disordered breathing

Abstrak

Apnea tidur obstruktif (OSA) menjejaskan berjuta-juta orang di seluruh dunia dan memberi kesan yang ketara terhadap kesihatan kardiovaskular dan kualiti hidup. Walaupun kaedah tekanan saluran udara positif berterusan kekal sebagai rawatan utama, pematuhan yang rendah telah mendorong kepada pilihan rawatan alternatif. Pengembangan aplians untuk meluaskan lelangit dengan sokongan skru mini (MARPE) telah muncul sebagai intervensi alternatif tanpa pembedahan bagi pesakit OSA dan mempunyai saiz maksila yang kecil. Ulasan naratif ini merumuskan kepustakaan semasa mengenai prinsip biomekanikal MARPE, hasil klinikal yang dilaporkan dan pertimbangan jangka panjang. Kajian yang tersedia menunjukkan bahawa MARPE berpotensi menghasilkan pengembangan skeletal yang bermakna dan mungkin dikaitkan dengan penambahbaikan dalam indeks apnea-hipopnea (AHI) dalam pesakit yang dipilih dengan teliti. Berbanding dengan beberapa pendekatan pengembangan alternatif, MARPE dilaporkan menunjukkan hasil periodontal yang memuaskan dan kestabilan jangka panjang yang menggalakkan dalam beberapa kajian terpilih, walaupun keputusan ini perlu ditafsirkan dengan berhati-hati. Komplikasi telah dilaporkan dalam beberapa siri kes, namun kebanyakannya boleh diuruskan dengan perancangan yang sesuai, reka bentuk aplians yang baik dan susulan yang rapi. Ulasan naratif ini memberi gambaran keseluruhan yang berorientasikan klinikal terhadap bukti semasa berkaitan pemilihan kes, perancangan rawatan dan pengurusan komplikasi.

Kata kunci: Aplians pengembangan lelangit pantas; aplians sokongan skru mini; apnea tidur obstruktif; gangguan pernafasan tidur; pengembangan maksila

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*Pengarang untuk surat-menyurat; email: wannurazreena@um.edu.my