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Background <p>Micro-implant assisted rapid palatal expansion (MARPE) and maxillary skeletal expanders (MSE) have broadened the age range for nonsurgical maxillary expansion, with cone-beam CT (CBCT) documenting predominantly skeletal effects in late adolescents and adults. Whether alternate expansion-constriction (AEC/ALT-RAMEC) cycles add incremental benefits when paired with MARPE/MSE remains less clear.</p> Objectives <p>To map and summarize CBCT-derived skeletal, sutural, dentoalveolar, and volumetric changes after MARPE/MSE with particular focus on studies employing AEC/ALT-RAMEC style activation. Eligibility (PCC): Population-humans ≥ 12&#xa0;years.</p> Concept <p>CBCT-assessed effects after MARPE/MSE, with or without AEC.</p> Context <p>nonsurgical orthodontic expansion.</p> Sources of evidence <p>PubMed/MEDLINE, Scopus, Web of Science, and Cochrane (2015–Aug 2025) plus citation chasing. Reporting follows PRISMA-ScR. Charting &amp; synthesis: Two-stage screening and standardized charting of study characteristics, device/protocol, CBCT parameters, outcomes, and adverse events; narrative synthesis due to heterogeneity.</p> Results <p>CBCT studies consistently show that MARPE/MSE produces parallel midpalatal opening, measurable circummaxillary suture changes, and clinically meaningful transverse gains with less dental tipping than tooth-borne RPE. Evidence specifically combining AEC/ALT-RAMEC with MARPE/MSE is limited but includes a young-adult randomized controlled trial indicating reduced molar tipping and greater zygomaticomaxillary suture widening versus conventional MARPE, without greater total transverse gain.</p> Conclusions <p>MARPE/MSE are well supported by CBCT evidence. Adding AEC/ALT-RAMEC appears promising for biomechanical optimization (e.g., tipping control), but standardized protocols and long-term outcomes are needed.</p>

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CBCT-based evidence on alternate expansion-constriction (AEC) protocols with micro-implant assisted/skeletal expanders (MARPE/MSE): a scoping review

  • 期刊论文

  • 发表日期：

    2026年2月9日

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  • Rahma Hazim Alhussainy,
  • Norma Ab Rahman,
  • Abbas AlZubaidi,
  • Hakam H. Alfakhry,
  • Basaruddin Ahmad,
  • Fakhri Alfatlawi,
  • Bahaa Ali Sameer

摘要

Background

Micro-implant assisted rapid palatal expansion (MARPE) and maxillary skeletal expanders (MSE) have broadened the age range for nonsurgical maxillary expansion, with cone-beam CT (CBCT) documenting predominantly skeletal effects in late adolescents and adults. Whether alternate expansion-constriction (AEC/ALT-RAMEC) cycles add incremental benefits when paired with MARPE/MSE remains less clear.

Objectives

To map and summarize CBCT-derived skeletal, sutural, dentoalveolar, and volumetric changes after MARPE/MSE with particular focus on studies employing AEC/ALT-RAMEC style activation. Eligibility (PCC): Population-humans ≥ 12 years.

Concept

CBCT-assessed effects after MARPE/MSE, with or without AEC.

Context

nonsurgical orthodontic expansion.

Sources of evidence

PubMed/MEDLINE, Scopus, Web of Science, and Cochrane (2015–Aug 2025) plus citation chasing. Reporting follows PRISMA-ScR. Charting & synthesis: Two-stage screening and standardized charting of study characteristics, device/protocol, CBCT parameters, outcomes, and adverse events; narrative synthesis due to heterogeneity.

Results

CBCT studies consistently show that MARPE/MSE produces parallel midpalatal opening, measurable circummaxillary suture changes, and clinically meaningful transverse gains with less dental tipping than tooth-borne RPE. Evidence specifically combining AEC/ALT-RAMEC with MARPE/MSE is limited but includes a young-adult randomized controlled trial indicating reduced molar tipping and greater zygomaticomaxillary suture widening versus conventional MARPE, without greater total transverse gain.

Conclusions

MARPE/MSE are well supported by CBCT evidence. Adding AEC/ALT-RAMEC appears promising for biomechanical optimization (e.g., tipping control), but standardized protocols and long-term outcomes are needed.