Success and Failure of MSE II Assisted MARPE: Comparative Evaluation of Two Cases

Mini-implant-assisted rapid palatal expansion (MARPE) offers a less invasive option for management of skeletal maxillary transverse discrepancy in advanced stages of palatal sutural maturation that cannot be optimally addressed by conventional rapid maxillary expansion techniques. This article briefly discusses two cases of transverse skeletal maxillary discrepancy matched for age and sutural maturation but with varied outcomes. One of the cases was successfully managed with MARPE using the maxillary skeletal expander II (MSE II) appliance, while the other failed. This communication also aims to highlight the possible cause–effect relationship and the caution required in case selection for such techniques. Since the technique is still in its infancy, MSE II should be avoided in palatal region with bone density below 1,000 HU to prevent inadvertent failure.