A retrospective analysis of the complications associated with miniscrew-assisted rapid palatal expansion

Abstract

Miniscrew-assisted rapid palatal expansion (MARPE) has recently been advocated as a treatment option for older adolescents and adult patients with maxillary transverse deficiencies. This study aimed to identify the complications associated with MARPE and the frequency of their occurrences. A retrospective analysis was conducted on 256 patients (mean age, 18.8 ± 8.6; 126 females and 130 males) who underwent MARPE at a private practice and a graduate orthodontic clinic. Specific complications and their severity were identified by reviewing clinical notes and photographs. Asymmetric expansion was measured for patients who had cone-beam computed tomography scans taken before MARPE and immediately after expansion. The midpalatal suture was separated in 87.8% of patients. The most common complication was gingival inflammation around the appliance, found in 83.9% of patients. 45% of patients reported some form of pain during and after expansion. Appliance breakage occurred in 10% of patients. 47.8% of patients showed >1 mm of asymmetric expansion. Rare complications included tooth discoloration (potentially indicative of tooth vitality loss), temporary hearing loss, numbness, swelling, severe gag reflex, and sinus infection. The most common complication was gingival inflammation followed by pain; major and long-term complications were rare with MARPE. Overall, patients should be informed that gingival inflammation and pain are common side effects of MARPE and that rare complications can occur. Although asymmetric expansion was common after the palatal split, most patients were managed with orthodontic treatment.