10 September, 2026

Specialized Airway Expansion in Massachusetts

Braces can move teeth, but they cannot always correct the structure beneath them. MARPE may help create a better foundation for the treatment that follows.

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A maxillary skeletal expander is a small, custom-fit appliance anchored to the roof of the mouth using several bone-anchored implants placed by the surgeon. Unlike a removable retainer, it applies steady pressure directly against the bone rather than against the teeth. Because the force is transmitted through the implants rather than the teeth, it’s often possible to achieve bone-level separation at the roof of the mouth with a smaller operative footprint than older techniques required. 

Traditional SARPE surgically releases the maxilla before placing the device, making it more involved. A MARPE expander uses an implant-anchored design to reach the bone with less release needed. It isn’t a universal replacement for SARPE; growth stage and other factors guide which approach a surgeon recommends.

About Us

Experts trained in palate expansion

As oral and maxillofacial surgeons, Dr. Ilya Garibyan and Dr. Tiffany Kuang regularly work alongside orthodontists and general dentists on cases involving surgical palate expansion. When a patient is referred for an evaluation of a narrow upper jaw, that existing relationship with your provider in Massachusetts carries into the care you receive from our surgeons, so timing and treatment goals are reviewed together rather than in isolation.

Oral & Maxillofacial Surgeon

Dr. Ilya Garibyan

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Meet Dr. Garibyan

Oral & Maxillofacial Surgeon

Dr. Tiffany Kuang

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Meet Dr. Kuang

Why does the width of the upper jaw matter in the first place?

The relationship between the upper and lower arches can affect how comfortably and effectively the bite comes together. When the upper jaw is too narrow, orthodontic movement may have to work around a structural limitation rather than simply repositioning teeth. Crossbite, limited room for alignment, and difficulty maintaining previous orthodontic changes can all point to a width concern that deserves a closer look.

For appropriate patients in Massachusetts, palate expansion may create a more suitable foundation for the orthodontic work that follows. The upper jaw also forms part of the nasal cavity, which is why breathing concerns can sometimes enter the conversation as well. These issues do not automatically mean someone needs MARPE, but together they can help explain why an orthodontist, dentist, or physician recommends a more detailed evaluation.

Where a MARPE expander can make a difference

The value of palate expansion is not simply that it creates more room. For the right patient, addressing insufficient upper-jaw width can change the foundation on which later orthodontic correction depends and reduce the need to work around an unresolved structural discrepancy.

It can also broaden the options available when a more involved approach has already been discussed. Dr. Garibyan and Dr. Kuang compare the clinical findings with the patient’s wider treatment goals before recommending which route should come next.

Correct a crossbite

When the upper arch is too narrow relative to the lower one, the back teeth may not meet properly. For appropriate patients, MARPE can address the underlying width difference and give later orthodontic work a better foundation for improving the bite.

Create more space

Limited space in the upper arch can make it harder to move teeth into their intended positions. Palate expansion may create additional room, giving the orthodontist greater flexibility when planning the alignment that follows.

A less invasive option

Some patients who might otherwise be considered for traditional SARPE may qualify for a MARPE expander instead. For selected cases in Massachusetts, this can provide a less invasive route, with the recommendation based on individual anatomy and the amount of correction needed.

What goes into deciding if MARPE is right for you?

Your orthodontist or dentist may recognize that a width problem is limiting what braces can accomplish and recommend that you see an oral and maxillofacial surgeon. That referral gives our lead surgeons at Premier Center for Oral, Dental Implant & Facial Surgery, Dr. Tiffany Kuang and Dr. Ilya Garibyan, a starting point, but the final recommendation comes only after they review your bite, imaging, medical background, and existing treatment goals.

There is no single finding that automatically determines the right approach. The doctors consider bone maturity, the degree of narrowing, and what the broader plan is intended to accomplish before deciding whether palate expansion belongs in your care. They can then discuss the recommendation with you and communicate with your referring provider about what should happen next.

Advanced MARPE expander in Groton, MA

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A well-rounded approach to palate expansion in Groton

Your first evaluation

We begin by reviewing why you were referred, your bite, medical history, existing orthodontic plan in Massachusetts, and any questions you have. If MARPE may fit your needs, we explain what the next stage could involve.

Imaging and planning

Detailed imaging helps Dr. Garibyan and Dr. Kuang assess the upper jaw and surrounding structures. They can also communicate with your orthodontist so the timing and goals are aligned before care begins.

Placing the appliance

If a maxillary skeletal expander is recommended, it is positioned according to the plan created for your case. You will receive clear instructions about what to expect and how progress will be monitored afterward.

Gradual adjustment

The device is adjusted over time rather than creating the full change at once. Follow-up visits allow our team to evaluate progress, check the surrounding tissues, and address questions that come up along the way.

Orthodontic follow-up

Once the intended change has been reached, the next phase can continue with the provider managing your alignment. Our surgeons can remain involved as needed so communication between offices in Massachusetts continues throughout your broader treatment plan.

Dedicated airway expansion near me

Talk with our surgeons about your options

If bite problems or breathing concerns seem connected to the width of your upper jaw, Premier Center for Oral, Dental Implant & Facial Surgery can help you understand what an evaluation or continued monitoring may involve. Dr. Ilya Garibyan and Dr. Tiffany Kuang are experienced oral and facial surgeons in Massachusetts who can review your concerns, explain the available options, and coordinate with your existing provider when needed.

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(978) 708 – 0080

Reasons an evaluation for MARPE might come up

Snoring or nasal obstruction

A sleep study or physician visit sometimes points to the upper jaw as a contributing factor, which can lead to a referral for airway expansion in Massachusetts.

Limited arch width

Sometimes an orthodontist identifies limited arch width partway through treatment, before all the permanent teeth have fully erupted or aligned.

Bilateral crossbite

A bilateral crossbite, affecting both sides of the arch, is one pattern that can indicate the upper jaw needs more than orthodontic movement alone.

Insufficient space

Permanent teeth that lack enough room to erupt properly can be a sign that the bone itself, not just the teeth, needs to be part of the conversation.

Orthodontic relapse

If braces alone can’t hold a wider arch in place, an underlying narrowness in the bone may be part of why the change isn’t lasting.

Nighttime nasal breathing

Some patients notice breathing through the nose is harder at night than during the day, which can be worth mentioning during an evaluation for palate expansion.

Local care for patients across the region

  • Groton
  • Chelmsford
  • Hudson
  • Westford
  • Leominster
  • Ayer
  • Littleton
  • Pepperell
  • Shirley
  • Townsend
  • Lunenburg
  • Sudbury
  • Acton
  • Fitchburg
  • Harvard

Frequently Asked Questions

MARPE is a method our surgeons use to widen the upper jaw at the level of the bone, rather than by moving teeth alone. We rely on a small appliance anchored to the roof of the mouth with several bone-anchored implants, which lets the applied force reach the bone more directly than a traditional retainer-style appliance can. 

We typically consider this approach for patients whose upper jaw is too narrow to correct through orthodontic movement, whether that’s affecting the bite, breathing, or how permanent teeth are erupting. Throughout Massachusetts, we coordinate closely with each patient’s orthodontist, since evaluation and planning happen together rather than in isolation.

There isn’t a single age cutoff that applies to everyone, since we look more at how mature the bone is than age alone. Once the suture connecting the two halves of the upper jaw becomes more firmly fused, which tends to happen as growth slows, we may still consider a bone-anchored approach to surgical palate expansion, though the specific technique and expected results can differ from what’s typical in a younger, still-growing patient. 

We can only determine whether someone is a good candidate after reviewing imaging and completing a full evaluation, since factors like the degree of narrowing and overall oral health also play a role. If you’re unsure whether you’ve “aged out” of treatment, we’d rather answer that directly than have you assume.

Whether it’s called “surgery” depends on how you define the term, but yes, placing a maxillary skeletal expander does involve a minor procedure. We position a small number of bone-anchored implants in the roof of the mouth, which we generally consider less involved than the bone release required for a traditional SARPE procedure. Because it’s less invasive, some patients require less sedation than they might expect, though we determine the right approach case by case during a consultation. Patients across Massachusetts sometimes assume this means no professional involvement is needed at all, but our surgeons handle placement and monitoring from start to finish.

For some patients, yes, though the relationship between jaw width and nasal breathing isn’t the same for everyone. Because the roof of the mouth also forms part of the floor of the nasal cavity, widening the upper jaw can sometimes create more room for air to move through the nose, which is why we discuss airway expansion alongside breathing concerns during an evaluation. That said, breathing difficulties can have several underlying causes, so we typically work alongside a physician or sleep specialist to determine whether jaw width is actually a contributing factor before recommending treatment based on that goal alone.

That’s exactly what we’re here for. At Premier Center for Oral, Dental Implant & Facial Surgery, Dr. Ilya Garibyan and Dr. Tiffany Kuang work closely with orthodontists and dentists throughout Massachusetts, from patients near the Fitchburg Art Museum to those closer to the Fruitlands Museum in Harvard. We use detailed imaging to plan every case individually, so if a MARPE expander is being considered, you’ll have a clear picture of what’s involved before deciding anything. 

Because timing can matter, especially for growing patients, we try to get evaluations scheduled without unnecessary delay. Think it might be time to find out more? Reach out, and let’s find out together.

Practical details that matter beyond the procedure itself

Many patients come to us after a referral for MARPE from their orthodontist or general dentist, though a referral isn’t required to schedule a consultation. Our team also treats concerns like facial trauma, performs frenectomy procedures, and manages dental pathology, so if something else comes up along the way, you’re already in the right place.

Our local clinic

Our Groton office provides access to Dr. Garibyan and Dr. Kuang along with modern diagnostic resources used throughout the practice. Patients can discuss their concerns directly with experienced oral and maxillofacial surgeons.

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Insurance and financing

Questions about coverage can add another layer to treatment decisions. We work with many insurance providers and can help you review available benefits, financing resources, and expected costs before moving forward.

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Coordinated care

Widening the upper jaw frequently sits within a broader orthodontic plan. When airway expansion is being considered, communication between your surgeon and other treating providers can help keep each phase aligned with the larger clinical objective.

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