MISMARPE protocol: minimally invasive surgical and miniscrew-assisted rapid palatal expansion.

The purpose of this article is to present the MISMARPE technique, a new minimally invasive surgical procedure to treat maxillary transverse atresia in adult patients under local anesthesia and on an outpatient basis. The technique consists of miniscrew-assisted rapid palatal expansion (MARPE) associated with a minimally invasive approach using maxillary osteotomies, latency and activation periods until the desired expansion is achieved. The present MISMARPE technique was performed in 25 consecutive cases with a success rate of 96%, yielding good skeletal outcomes with minimal trauma. The expander appliances, with their anchorage types, and a description of the surgical steps of the MISMARPE technique are presented. MISMARPE is a new and effective alternative for less invasive treatment of maxillary transverse deficiency in adults, compared to conventional surgery. Emphasis is placed on the importance of systematic and well-established protocols, for executing the procedures safely and predictably.