Comparison of Side Effects Between Miniscrew-Assisted Rapid Palatal Expansion (MARPE) and Surgically Assisted Rapid Palatal Expansion (SARPE) in Adult Patients: A Scoping Review.

Background/Objectives: The aim of this study is to investigate the side effects of two techniques of rapid maxillary expansion-Surgically Assisted Rapid Palatal Expansion (SARPE) and Miniscrew-Assisted Rapid Palatal Expansion (MARPE)-in adult patients, to guide the selection of the most cost-effective clinical treatment plan. Methods: The review protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-extension for Scoping Reviews (PRISMA-ScR) guidelines. Eligibility criteria were defined based on the study objectives. The research team formulated a PICO question to identify relevant studies in the literature. Five databases were queried: MEDLINE (via PubMed), Scopus, Cochrane Library, Web of Science, and Embase. Additionally, a manual search was conducted. Results: The computer-assisted search identified 746 articles, of which only 26 fully met the inclusion criteria and were included in the scoping review. Among the included studies, 11 were retrospective, 12 were prospective, and 3 were randomized clinical trials. SARPE was evaluated in 21 studies, MARPE in 4 studies, and 1 article reported complications associated with both techniques. The side effects described in the studies were synthesized and categorized into five groups: expansion failure, asymmetric expansion, dentoalveolar issues, surgical complications, and appliance-related problems. Conclusions: The results indicate that both techniques involve risks. The most reported adverse effects were dentoalveolar and surgical in nature. Dentoalveolar side effects, such as dental tipping, were predominantly associated with the MARPE technique, while surgical complications were more commonly observed with the SARPE technique. Patient age is crucial for treatment choice as well as proper design and planning of the expansion device. Consequently, careful patient selection and treatment planning are essential to minimize the side effects of maxillary expansion in adult patients.