When treating a narrow upper jaw (maxillary constriction), three commonly discussed approaches are RME, MARPE, and SARPE.
While they all aim to widen the upper jaw, they differ in how they work, who they are suitable for, and where the treatment is carried out.
In this blog, we will discuss the differences between each option.
⚠️ Important Notes
RME and MARPE provided at Aligned Orthodontics are not stand alone treatments and are used prior to a full course of orthodontic treatment.
MARPE is not available through the NHS.
We cannot provide this appliance prior to treatment elsewhere (private or NHS).
Additional clinical guidance:
This treatment is only appropriate at our practice for patients under the age of 25, and only if clinically necessary.
If you are exploring this appliance due to breathing issues, we recommend that you speak with an ENT specialist beforehand to rule out any other causes.
This appliance is used in conjunction with a comprehensive brace system (fixed braces or aligners), which is charged additionally.- https://www.alignedorthodontics.com/fees
A specialised CBCT X-ray is required to enable placement of the TADs (temporary anchorage devices) and this is charged at £240 prior to starting MARPE treatment.
Treatment Overview by Age
Invisalign First → Early guidance and space creation (Ages6–10)
RME → Younger children / early teens (Typically under 14)
MARPE → Older teens and young adults (Under 25)
SARPE → Hospital-based adult cases (Over 25)
🔹Invisalign First Early Orthodontic Treatment
Can my child have orthodontic treatment with baby teeth?
Yes Invisalign First is designed for young children with a mix of baby and adult teeth.
Best suited for:
Ages 6–10 years
Early mixed dentition
Key features:
Clear removable aligners
Comfortable and discreet
Helps guide jaw growth and tooth eruption
Can reduce the need for more complex treatment later
Invisalign First is often recommended before considering expansion options like RME.
Cost: £3,500
🔹RME Rapid Maxillary Expansion
What is RME?
RME uses an expander fixed to the upper teeth. The appliance gently separates the mid-palatal suture while a child is still growing.
Best suited for:
Children and young teenagers
Typically under 14 years old
Key features:
Non-surgical treatment
Relies on natural growth
Expansion achieved relatively quickly
RME is usually the first-line option for younger patients.
Cost: £750
🔹 MARPE Mini Screw Assisted Rapid Palatal Expansion
What is MARPE?
MARPE is a more advanced expansion method using mini screws placed in the palate. This anchors the appliance to bone rather than just teeth.
⚠️ Tooth extractions may sometimes be needed after expansion to avoid gum recession in certain individuals.
Best suited for:
Older teens and young adults
Typically late teens up to 25, depending on bone maturity
Key features:
Non-surgical
Greater skeletal bone-based expansion
Reduced unwanted tooth tipping
May avoid the need for surgery
Cost: £6,000
MARPE is ideal for patients who are no longer suitable for RME but want to avoid surgery.
🔹 SARPE Surgically Assisted Rapid Palatal Expansion
What is SARPE?
SARPE combines orthodontics with a surgical procedure performed in a hospital. The jaw is released surgically to allow safe expansion in adults.
Best suited for:
Adults with fully fused jaw bones
Typically 18+ when non-surgical options are no longer viable
Key features:
Requires hospital-based surgery
Performed under local or general anaesthetic
Expansion begins after surgery
⚠️ We do not provide SARPE at our practice. This is carried out in a hospital setting.
Cost: Varies depending on provider
✅ Which Option Is Right?
The best option depends on:
Age
Jaw maturity
Clinical findings
A full orthodontic assessment including X-rays or scans is essential before deciding on treatment.
📞 Next Steps
If you or your child has a narrow upper jaw and would like to explore RME or MARPE, our practice can assess suitability and discuss options in detail.
For cases requiring SARPE, we can advise and refer to appropriate hospital specialists.
To book a consultation or ask questions, please get in touch with our team. - https://www.alignedorthodontics.com/contact
