Prospective Comparison of Micro-osteoperforations and Miniscrew Assisted Rapid Palatal Expansion in Maxillary Transverse Deficiency

Introduction: This prospective study compared the efficacy of micro-osteoperforations-assisted rapid palatal expansion (MOP-RPE) and miniscrew-assisted rapid palatal expansion (MARPE) for treating maxillary transverse deficiency (MTD) in skeletally mature patients. Methods: Thirteen adults with MTD were allocated to MOP-RPE (n=7, 22.14± 5.40) or MARPE (n=6, 21.50 ± 4.04) groups. MOP-RPE employed corticopunctures guided by 3D-printed guide plate, while MARPE used four paramedian miniscrews, followed by custom palatal expansion appliances.Skeletal/dental changes were quantified via pre-/post-expansion CBCT. Root resorption was assessed via 3D volumetric analysis; patient satisfaction and pain were evaluated anonymously. Results: Both groups achieved significant transverse expansion (P<0.05) with no intergroup differences in skeletal expansion and a higher dental expansion in MARPE group. MOP-PRE demonstrated greater proportional skeletal contribution at the posterior maxilla and reduced proportion of dental compensation; similar phenomena were also observed in the anterior section. Root resorption was comparable between groups (P>0.05). Patient-reported outcomes showed equivalent satisfaction and pain levels. Conclusions: MOP-RPE achieved satisfying total expansion, higher skeletal and smaller dental proportion to MARPE while minimizing dental side effects and eliminating miniscrew-related complications, offering a viable minimally invasive alternative for adult MTD.