Treatment
Custom miniscrew MARPE
A stock expander is fitted to a palate. A custom expander is designed from one. The difference shows up in where the miniscrews end up and how much of the force reaches bone.
Why a custom design matters
Miniscrew-assisted expansion depends on the screws achieving stable purchase in palatal bone. Bone thickness varies markedly between individuals and across the palate in the same individual, and the safest, thickest sites are not in the same place in everyone. A stock appliance places the screws where the appliance happens to put them; a custom appliance places them where the scan says the bone is.
- Screw positions are planned on the CBCT volume, avoiding the incisive canal, the nasal floor and tooth roots.
- The appliance body is designed to the shape of your palatal vault, so it seats accurately and does not need bending at the chair.
- Anchorage can be shifted more anteriorly or posteriorly depending on where the expansion is needed and where bone allows.
- Fit is verified digitally before manufacture, which reduces chair time and adjustment.
How the workflow runs
- Digital scan and CBCT
Both are needed: the scan gives the soft tissue and dental surface, the CBCT gives the bone.
- Virtual planning
The two datasets are merged, screw sites selected on bone thickness, and the appliance designed around them.
- Manufacture
The appliance is produced to that design.
- Fitting
Seated and screwed under local anaesthetic, then activated on the prescribed schedule.
Frequently asked questions
Is a custom appliance better than a standard one?
For miniscrew-assisted expansion it allows screw placement to be planned to your own bone rather than dictated by a stock frame, which is a meaningful advantage. It does not change whether expansion will work — that depends on the suture.
Does it take longer to start treatment?
Yes, somewhat. There is a design and manufacturing interval between the records appointment and fitting. The trade is less chairside adjustment and better-placed anchorage.
Page last reviewed: 2026-09-10. This page is general health information about orthodontic care and is not a diagnosis, a treatment plan, or a substitute for an in-person clinical examination. Suitability for any treatment described here can only be established after a consultation, clinical assessment and the appropriate records. If you have symptoms that concern you, seek advice from a qualified clinician.
Appointments
Arrange a specialist orthodontic assessment in Dubai
Consultations take place at Manhal Medical Center, Al Safa 1, Dubai, in English or Arabic. Every assessment begins with a full clinical examination and, where indicated, 3D imaging — not a treatment quote.