MARPE: Miniscrew Assisted Rapid Palatal Expansion (Live webinar)

[@DrAras-hm4ck]

I believe, this is the most useful webinar I have ever seen. Wish you all the success and prosperity dear professor.. 🙏🌺

[@alhuwaizi]

You are welcome

[@artinwords3787]

The veracity of MARPE usage in your practice is what makes this presentation extremely reliable and trustworthy .. Loved the way how you pragmatically explained it.. Kudos...

[@alhuwaizi]

Glad you liked it

[@arpanbiswas5899]

good afternoon, I'm not a doctor but wanted to know about this for my 25 year old fiance. The lecture was really informative and I would like to congratulate you for your excellent work.

[@alhuwaizi]

Welcome

[@kassandaraa]

I really love this presentation 👏 I'm seeing from Chile I hope I can do this for my patients soon. Regards

[@alhuwaizi]

Glad it helped

[@osmiledentallab7195]

Thank you for so well provided webinar, this was so useful.

[@allenvalentinem.d6067]

Hi doc I have a few questions for you 1) does MARPE expands assymetrically or symmetrical expansion 2) also if a patient has facial assymetry like a crooked nose and deviated septum with asymmetrical crooked mid face does it correct it? 3) after the split of Palatine suture and expansion does the bone material gets filled properly in between the suture and what are the cbct results after the treatment 4) does MARPE expansion with the holdings arms do teeth tipping or after the expansion Is there any loosening of teeth for a lifetime? 5) how much mm intermolar expansion can you achieve before and after the treatment ? 6) also after using MARPE can you bring the maxilla forward and upward and not just the transverse expansion 7) and what if we expand upto 45 mm or more intermolar width in the palate with MARPE so how do we expand the mandible also and not just expanding the mandibular arch(teeth borne) only 8) also can you guide us on Homeoblock appliance if it is good or not like is it bone borne expander or tooth borne expander and also does it correct facial assymetry Thank you in advance doc

[@zakisudo9611]

Good questions, I really hope that doctor Akram answers. I myself have a deviated septum and asymmetrical face and poor nasal Airways I really want to know if MARPE would help,wish you all the best .

[@allenvalentinem.d6067]

@@zakisudo9611 bro I just learned facial assymetry & septum deviation are because of incorrect posture on one side, if you can correct your body posture and oral posture you can correct your facial symmetry over time I promise

[@zakisudo9611]

@@allenvalentinem.d6067 i have noticed that myself in my own posture too , it seems to me that facial and body asymmetry comes from poor tongue posture and that leeds to poor breathing and that it just affects the entire body. By the way my deviated septum came from an accident that broke my nose when i was 11 years old so i grow up like this.

[@alhuwaizi]

MARPE usually expands symmetrically but one side can be affected more than the other side if it offers less resistance to expansion. But there is little control over than so i can not recommend it to treat midfacial asymmetry. You need surgery for that. After the split, blood fills the space which becomes bone and matures by 6 months. The holdings are soft and not hard and so should not push the teeth out that much. But if it did the teeth usually relapse to their position with in the jaw and there is no lifetime loosening of teeth. The intermolar expansion is from 8 to 12mm. After using MARPE, the maxilla comes forward and downward Mandibular expansion is usually done by uprightening the posterior teeth

[@asma-se9hv]

thank you so much it helped me figure out my problem and now I'm getting a expander

[@farrahagahi6215]

Thank you for sharing your knowledge with us. Many blessings and please continue with your teachings!

[@alhuwaizi]

You're welcome

[@shiasoi]

Really good information here, thanks. One thing you should probably check is about how many turns per day, I saw the interview with Dr. Ting from California who had over 300 cases and he said that most failures were from fast expansion of more than one turn per day. so he suggest only one turn a day for adults.

[@alhuwaizi]

Thank you for bringing that. I will check Dr. Ting but I have had more success with adults when 3 turns per day were used

[@ortolasersc3603]

Thank you Doctor Akram, this is important and valuable information

[@jvaraneta]

Wow, doctor, good job!!! I'm going to try this if I have a similar case. Thank you!!!

[@alhuwaizi]

Wonderful, ask if you need any help

[@jvaraneta]

Akram Alhuwaizi doctor, if youre not too busy, can you send me a link onhiw you slowed down the RPM of your handpiece? Thank you!

[@cianlewis-hughes5172]

@@alhuwaizido you do MARPE?

[@alhuwaizi]

@@jvaraneta I used a 1:20 handpiece. It slows the RPM 20 times

[@alhuwaizi]

@@cianlewis-hughes5172 yes I do

[@الدكتوراحمدعبيد]

Huge information for free... Thanx a lot doctor.

[@alhuwaizi]

You are welcome

[@lobnashalaby6107]

Thank you so much for sharing all your experience with MARPE honestly

[@alhuwaizi]

My pleasure!!

[@leisamaribekkers312]

I love this video - thankyou. It makes sense that you can expand the maxilla with forces just like the tongue. Please recommend somebody in Australia or i may have to come and visit you ha ha

[@marlesajmad4845]

Excellent ! If we need to change the screw for another expansion , how much time to wait in the midline area to reposition the screws screws

[@alhuwaizi]

I prefer to change the position of the screw

[@ahmedraad7776]

دكتور عندي سؤال انت تعرف بالبيشنت العراقيين شلون تقنع البيشنت مالتك ان يخلي tad الي يجوني للعيادة من اگلة اخليلك برغي بالفك يرفض شلون اسلوبك الاقناعي بالعيادة مالتك يقتنع يخلي tad

[@alhuwaizi]

الافضل عدم الخوض بالتفاصيل مع المراجع - لو شرحت كيف نعمل حشوات الجذور وقلع الاسنان ..... لما اقتنع المراجع

[@darknight3050]

Shookran ekteer Doctor! To all reading this, I am a patient that succeeded in maxillary expansion. It improved my nasal breathing and craniofacial complex. Cheekbones are more prominent, eyes are hooded, face changed and I’m sleeping much better. I have a question for you doctor and I would be happy to share my pictures and progress. I’m at the phase where my orthodontist installed the Damon braces system.

[@alhuwaizi]

That is very inspiring feedback

[@Unlimited0X]

Congratulations...what appliance did you use to expand and how old are you?

[@patrickpat8878]

At 33:00 , i’m 54 years old , I needs that kind of expander soon , in marsh 2023 my appointment, my problem is I needs more space in my mouth for my tongue, I bite it very often . According to my dentist my jaw and my palatal is in the normal size and my tongue is just I little bit large but yes I have lot of bite scars on my tongue , so I have asked him if it’s possible to do something, i’m really tired to bite my tongue for no reason, so he talk to me about this possible solution.

[@alhuwaizi]

It is possible but you will need corticotomy which is cutting the bone to facilitate the maxillary expansion

[@deezuschrist]

I just got MSE installed 3 days ago, and I am 34 year old male. My orthodontist told me to turn it once every other day. And now I’m hearing you say turn 2 or more times per day, especially initially. Now this has me worried my case will fail if I don’t turn quicker. My orthodontist said she’s never had a failed case so I am inclined to trust her but I’m concerned that I’m hearing a lot of other people say older patients need to turn more. What should I do?

[@Unlimited0X]

How do you feel so far? You think it’s gonna work?

[@Ghost572]

The thing is if it doesn't work, then you can say look we need to turn it fast in order to get this to work properly.

[@alhuwaizi]

Sorry for my late reply. There are points of view and their is no one opinion. I have had better success in adults with more turns. How did you case workout??

[@umpus]

How did it go?

[@tjam4229]

Hello, Thank you for posting this valuable information! At 48:00 you discuss patients that are older than 30 yrs old. What is the oldest patient YOU have treated with this procedure? What is the oldest patient that you have HEARD-OF being treated with this procedure? I am a 56 yr old male with mild-moderate bony architecture...By this, I mean, my bones aren't like a thick male. They probably mimic an average, or slightly athletic female. I know some people can have thick-dense bone. I would say I'm on the lighter side of normal for a male my age. Hearing this, would you 'guessimate' that this no-surgical procedure would work for me?

[@alhuwaizi]

The oldest patient I successfully treated is 26. I have heard of successful results with patents 50 and 60 years old but tge odds of success are slim. I would put 2 screws in your case one in the front of the palate and one in the back

[@tjam4229]

@@alhuwaizi, thank you for your response. I wish you were closer. I may seek treatment from Dr Marianna Evans Near Philadelphia PA USA. She has similar treatment thoughts.

[@thinkgrowhealthy2137]

@@tjam4229 Dr. Akram Alhuwaizi is a gem. I too wish he was closer but glad his patients have him. Have you been able to work with Dr. Evans in PA?

[@tjam4229]

@@thinkgrowhealthy2137, I’ve talked with her. Still trying to figure out what’s best for me.

[@josephryan9871]

Great presentation, thanks for sharing!!

[@jlc5271]

Probably not, but does this have any effect on the eye sockets and on the distance between the eyes?

[@alhuwaizi]

No it does not

[@dr.gayatrimoghe5317]

I happened to come across this presentation and absolutely admire your honesty

[@alhuwaizi]

Thank you for your kind words

[@omarfadaam5482]

So proud of you prof.

[@alhuwaizi]

Welcome

[@surajorthodont]

Thank you Dr Akram for the honest presentation and your first hand experience. I would like to ask how the screws are removed after the expansion and stabilization period. Since the screw is flush with the guide holes, will the ratchet be able to engage the screw to unscrew. Thank you in advance and stay safe.

[@alhuwaizi]

Excellent question. I wish you asked that online. In many situations you don't fully screw the TAD in so a small catch remains. But even where it is flush things change after expansion and the TAD may extrude.

[@alhuwaizi]

But even if it did not and there is no catch, I cut the guiding wires and push the MARPE up a little to grasp the TAD

[@TheNarcisse6]

Sorry can you translate in French or arabic? I didn't get that part

[@avanishkadu5268]

Very informative sir.

[@gregducati999]

thanks for your videos they really help others

[@alhuwaizi]

Glad to hear that!

[@drrawan9230]

Very informative dr Akram

[@alhuwaizi]

You are welcome

[@aishaalsafran3377]

I got the expansion protocol and the size of the TAD but what is the brand of the expander and the TAD from which company? Thank you for

[@alhuwaizi]

Biomed korea

[@ronaldmacdonald1268]

Hello sir, What are the consequences of palatal expansion on facial structure? I mean on the shape of the face, particarly the nose. What about the holes left by screws? Do they close themselves? Kind regards

[@ronaldmacdonald1268]

What I mean is does the nose and face widen?

[@alhuwaizi]

Not much facial diffrence. Yes the holes are filled with clot and seal in a few days

[@paranajape]

Well done sir!

[@aishaalsafran3377]

Could you please tell me What is the brand and the size of the TAD and what is your expansion protocol?

[@alhuwaizi]

The TADs come with the MSE. Mafe by Biomed Korea.

[@Sara-v8n]

Hi doctor I just want to ask if removing the marpe hurts or not?

[@abubakermohammedali6315]

شكرا جزيلا دكتور اكرم جزاك الله خيرا على كل المعلومات القيمة , عندي سؤال بخصوص ال MARP Or Expansion in general what will happen if there is an impacted anterior tooth or shifted midline that position the central at the suture path ? hope my question is clear

[@mehmetaydin9370]

Great video with very useful content. Dear Mr. Dr. I was recommended to get a SARPE, which I denied last minute. I am 41 years old, male, would like to have MARPE, if it is possible in Germany. Do you think that MARPE is the best way for me? I am wondering why my orthodontist / doctor did not inform me about this option. Thanks a lot!

[@alhuwaizi]

Yes I think it is a very good option

[@askm13061995]

Hi doc, does this work with patient with upper palate torus

[@marekskotarski374]

Amazing channel, please keep on making new videos

[@minanagy174]

Simple and Amazing

[@alhuwaizi]

Thank you! Cheers!

[@mldn007]

What happens if a tad screw gets stuck in bone upon insertion? How to remove?

[@alhuwaizi]

Reverse the handpiece rotation

[@mldn007]

@@alhuwaizi the orthodontist did that but it still was stuck. He couldn’t screw it more and he couldn’t unscrew it out either.

[@alhuwaizi]

@mladend6481 they usually come out easily, but if it is stuck, using a lot of force can break it. I would use an uktrasonic scaler to loosen it

[@mldn007]

@@alhuwaizi Ill bring up that idea to the dr thank you. Do you think it could be the ratchet wrench that possibly stripped the head of the screw? It was done manually by hand screw insertion, there was no pilot hole drilling. It wouldnt be possible to just yank it out ?

[@ryammemo1474]

Hi doctor really thanks for this informative lecture I enjoyed although I'm a medical doctor👏🏻 I have class 3 malocclusion, age is 24, the doctor advised me to have MARPE, but I'm really afraid 😨, are there any advices? About pain of the screws, and pain of expansion???

[@alhuwaizi]

The pain is easily managed by analgesics

[@karolann17]

Bonjour, je suis dans le cas n3, le côté droit de mon appareil est en train de « rentrer » dans mon palais. On ne voit même plus les deux vis du côté droit. Pourtant mon docteur me dit de continuer à l’activer. Que dois-je faire ? Merci beaucoup

[@leisamaribekkers312]

I came across HIMAME have you used this?

[@leisamaribekkers312]

Apparrently you can place the screws down the midsuture on either side.

[@amroyounis6339]

you are amazing sir .. sir how to decide the length of the screw 11 or 13 ?

[@alhuwaizi]

Ideally this should be done by CBCT, but clinically I would use 13mm if the MARPE does not seat well

[@o.l.ssalman1673]

A wonderful lecture thank u prof.

[@alhuwaizi]

Welcome

[@TheNarcisse6]

Amazing 😍😍

[@AnnaMmyFyz]

dr. Al Huwaizi, does this MARPE also widens the lower jaw at the same time with the upper jaw? I have a narrow palate and mild crowding on lower jaw, i wish i could correct them simultaneously using MARPE.

[@jlc5271]

No, you need a lower arch expander of some sort, or a surgery like MSDO

[@JosephAmodeo-u2n]

This guy is a mad scientist with these failure cases

[@Bionicleforever]

Where can you get this done? none of my orthodontics do this?

[@alhuwaizi]

Where do you live?

[@Bionicleforever]

@@alhuwaizi ottawa

[@leisamaribekkers312]

Thankyou so much. I have been researching this topic for years! I am an 50 year old adult in Australia. I have an edge to edge bite due to being kicked by a horse when i was eleven when i broke my mandible. I have three missing upper teeth due to incorrect bite and mid face deformity. I do not wish to have Jaw Surgery. Does an Orthodontist do MARPE? Can you recommend anybody in Australia. Does Marpe allow you to be screw free at the end.

[@alhuwaizi]

Sorry I really don.t know

[@jlc5271]

Marpe is offered by some orthodontists, but look for an MSE (maxillary skeletal expander) provider specifically. And no, there are no screws left after treatment. The mini implants are removed along with the appliance after new bone has filled the gap

[@sgdsggd9956]

رائع جدا دكتور اتمنالك كل التوفيق والنجاح ان شاء الله

[@alhuwaizi]

الله يسلمك

[@hortonsstuff6948]

I need it lol mouth breathing as an infant caused by a deviated septum at birth.Your tongue is actually what shapes your mouth if your mouth is shut as a baby your tongue is keeping your jaw and maxilla open and not narrow.

[@maysaadeh2740]

Thank you , Dr Akram for this informative lecture, is it possible to share a video of placing a MARPE.🙏

[@alhuwaizi]

You are welcome - Soon

[@halinallet652]

How many days of 3 turns per day until suture should split?

[@dr.islamghorab1045]

Greet lecture

[@nagwaenany2906]

thanks for your presentation

[@gregducati999]

im 37 and marpe worked, but it was with cortical puncture,

[@alhuwaizi]

Congratulations

[@yazanessa3839]

its really great lecture with huge information. actually my dear prof i wonder about how can we contact with the factory that can make MARPE coz i think its not easy to done by normal technicians. i saw this video twice coz i have one case and i would like to start treat it in this methods with class 3 maxillary origin. so please pro can you provide me for contact information with this company!

[@alhuwaizi]

biomk.com/

[@drsarialmashahdani3771]

Thank you so much vary useful informations... Allah save you Prof. 🌷🌷💐💐

[@alhuwaizi]

You are welcome

[@ahmedraad7776]

Very useful lecture thank you

[@alhuwaizi]

Welcome

[@Dr.Susu.]

Excuse me doctor, you did a mistake with the title of the video MARPE. and thaaaaanks a lot for this wonderful video👍

[@alhuwaizi]

Thank you so much- I corrected it

[@alanrafyq]

Thanks for your information

[@karecherania1450]

thank you very much doctor

[@dentmahmoud]

Thanks very useful lecture Prof

[@alhuwaizi]

@@dentmahmoud Welcome

[@koyakuttyputhukayil7611]

Very good dr

[@ShivamSingh-gi8xf]

What if the patient doesn't have first molars??

[@alhuwaizi]

We can pit it on the second molar or premolar

[@ShivamSingh-gi8xf]

@@alhuwaizi Sir, do you know any articles about it please.

[@leisamaribekkers312]

Do you have to go under general anaesthetic for this?

[@alhuwaizi]

No just a few drops of local anaesthesia

[@platewarrior]

is 31 years old a good age for MARPE?

[@alhuwaizi]

Need coticipuncture of osteotomy

[@coolguy4151]

Respect to u

[@EyeBrainRam]

Does MARPE move the upper teeth forward ? I have a slight underbite about 1-2mm .

[@jlc5271]

Only when combined with face mask. MSE is the ideal form of marpe though. Also look into the alt ramec protocol

[@EyeBrainRam]

@@jlc5271 I’m going Tuesday for my appointment. I’ve heard Mse it self gives .5-1 mm forward. I might have to get facemask and pull -15 degree .

[@jlc5271]

@@EyeBrainRam yeah it's a downward and forward movement though. Upward is ideal. But 0.5 - 1mm is unnoticeable anyway so it doesnt matter. Is your ortho providing u with the face mask? Do they expect it to help?

[@jlc5271]

@@EyeBrainRam nvm u didnt mention that. Yeah I would try face mask. But look into alt ramec. It's basically turning the screw to open the suture for a few days, and then turning backwards in the closing direction for a day or two, and then repeat. It's to loosen the other sutures around the maxilla and provide more protraction

[@EyeBrainRam]

@@jlc5271 I’m gonna have to research Alt ramec protocol. My front teeth a retroclined . I have to get my bite to open up. My lower jaw gets trapped behind the upper teeth. I have good ccw rotation I really just need some forward growth .

[@sherinablessing8442]

Oooh my God 1200 undergrad students😲😲this is great

[@CroElectroStile]

What is the usual cost of this procedure?

[@alhuwaizi]

Depends on the clinician, but the MARPE costs from 100 to 200 Dollars

[@klikkerTV]

Somebody please do a TL;DR ?

[@sm1320]

is 26 years old a good for marpe

[@sm1320]

في فمي يوجد منذ ثلاثة عشر ايام من مربه، يشمل فوق اسناني كلها و عمري ست و عشرون هل اجدى

[@parasjoshi7018]

What is maximum expansion?

[@alhuwaizi]

12mm

[@jp-jv8fc]

❤❤❤💕

[@alhuwaizi]

Welcome

[@CroElectroStile]

Is there MARPE procedures in Europe? i can't find annything about it :(

[@alhuwaizi]

I don't know. They have legal and insurance issues

[@CroElectroStile]

@@alhuwaizi what is the difference between MSE and 4miniscrew MARPE?

[@alhuwaizi]

@@CroElectroStile Branding and design

[@Al_My-isn]

4/9/2020 Friday 186. Likes ❤️❤️❤️💚💚💚💙💙💙💛💛💛💛👍👍👍👍🧡🧡🧡

[@КотЛеапольд-х7р]

i hope one day this procidure will be ordinary!

[@leisamaribekkers312]

And you may put more screws!

[@alhuwaizi]

You need to make a modification to add more screws