Maxillary Skeletal Expansion (MSE)
Minimally Invasive Maxillary Skeletal Expansion (MSE)
A Powerful Solution for Adult Airway and Skeletal Issues
For patients who are too old for traditional expansion methods, Maxillary Skeletal Expansion (MSE) offers a game-changing approach to correcting narrow upper jaws and improving overall airway function. MSE and MARPE are two terms that are used relatively interchangeably.
Unlike conventional expanders that rely on the teeth for anchorage, MSE uses temporary anchorage devices (TADs) — small, biocompatible screws placed temporarily directly in the palate bone — to anchor the expander and achieve true skeletal expansion. This means the upper jaw is widened at the midpalatal suture, allowing for more dramatic, stable, and adult-friendly changes that were once only possible with surgery.
Dr. Decker is the only provider in the Tucson area who regularly uses the MSE appliance to expand adults. His residency program was an early pioneer of MSE appliances, and he has completed several additional programs and certifications to sharpen his skills.
Why Consider MSE?
Many adults and older teens with a narrow upper jaw experience:
- Crowding or crossbite
- Nasal airway obstruction
- Mouth breathing or snoring
- Sleep-disordered breathing or sleep apnea
- Tension in the face, jaw, or head
- TMJ problems
Because the upper jaw forms the floor of the nasal cavity, widening it has a direct effect on airway volume, often helping patients breathe and sleep better.
Do I need an MSE or MARPE?
MSE is sometimes referred to as a MARPE- Miniscrew-Assisted Rapid Palatal Expander, and the terms are used relatively interchangeably. While the two terms often confuse patients, it’s quite simple. The MSE Appliance is technically just a single brand of MARPE, but there are many other types of MARPE besides MSE at the bleeding edge of adult expansion research. MARPE is the sort of broad umbrella term encompassing TAD-supported expansion, and MSE is just one appliance under that umbrella. For example, the MSE always contains 4 TAD’s, but some new adult MARPE designs are designed for 6, 8, or even more custom TAD’s to maximize success of expansion. Whether MSE or MARPE, the mechanism remains identical- minimally invasive, TAD-supported adult expansion.
How MSE Works
- A 3D CT scan is taken to analyze the bone and plan the appliance and TAD placement.
- A 3D printed, custom-fitted MSE/MARPE appliance is glued to the first molars.
- It is then anchored to the palate- typically using four TADs
- Patients activate the expander at home over 2–4 weeks, gently opening the midpalatal suture.
- Expansion is monitored closely with 3D imaging as needed to ensure symmetry and progress.
- Once full expansion is achieved, the device is left in place for on average 9-12 months to allow for bone stabilization.
- Braces (or Invisalign in select cases), are utilized after expansion is complete to utilize the space created to resolve crowding and fix the bite.
Benefits of MSE
- True skeletal change, not just dental tipping of teeth like many “adult expanders” often advocated by non-orthodontist “airway dentists” (such as DNA appliance, ALF, etc)
- Non-surgical option for many adult cases
- Improved nasal breathing
- More facial balance and symmetry
- Enhanced smile width and aesthetics
- Often complements airway-focused orthodontic treatment or orthognathic surgery
Who Is a Candidate?
MSE is ideal for:
- Adults or teens who are past the window for traditional expansion
- Patients with obstructed nasal breathing or airway concerns
- Individuals preparing for jaw surgery who need transverse correction
- Patients with narrow jaws and crowding
- MSE is most predictable for ages 15-30, depending on gender and some other skeletal features. Past age 30, MSE can be done but often requires a minor surgical assist like DOME or a midpalatal suture piezoelectric cut. The risk of complications rises quickly past age 30, and as such Dr. Decker is careful to recommend MSE or older adults.
What to Expect
The procedure to place MSE is minimally invasive and done in-office, under local anesthetic. Most patients experience some pressure or soreness and are able to return to daily activities right away. Dr. Decker and our team at Braces520 will walk you through every step—from placement to activation and retention—with your comfort and safety as our top priority.
Ready to Breathe Easier?
Maxillary Skeletal Expansion can dramatically improve your breathing, facial harmony, and quality of life—especially when airway health is a concern. If you’ve been told you’re not a candidate for traditional expansion, MSE may be the solution you’ve been waiting for.
Contact us today to schedule a consultation and learn more about airway-focused treatment with MSE.
