MARPE and MSE Expanders for Older Teens and Adults in Shelby Township
A MARPE or MSE expander is a palatal expander held by small temporary screws in the roof of the mouth. Fredal Orthodontics offers it for older teens and adults, with care planned by orthodontic specialist Dr. Thomas Fredal Jr.
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.
Dr. Fredal uses MARPE expansion for skeletal cases in adults, where the problem lies in the jaw bones and not only in the teeth. He coordinates surgical care when a case needs it.
He diagnoses every case in three dimensions, using a CBCT scan (a 3D X-ray) and an iTero digital scan. Fredal Orthodontics takes the CBCT scan at every new-patient consultation.
What MARPE and MSE Are
MARPE stands for miniscrew-assisted rapid palatal expansion. MSE stands for maxillary skeletal expander. Both are expanders for the upper jaw, anchored by TADs (temporary anchorage devices): small mini-screws placed in the palate (the roof of the mouth).
Dr. Fredal does not place TADs himself. When a case needs them, he refers the placement to an oral surgeon outside the practice.
Timing and Growth
In Dr. Fredal’s view, one of the biggest mistakes in orthodontics is starting treatment before the timing is right. He weighs growth, dental development, skeletal relationships and the goals of treatment. That tells him how to treat and when to begin.
For children, he uses palatal expansion in early (Phase 1) treatment when early treatment is indicated. He follows the advice of the American Association of Orthodontists: every child should have an orthodontic check by age 7.
For adults, his specialty training means looking at the whole face, not just how the teeth line up. That covers how the jaws relate, gum and bone support, root position and the airway.
Who Plans and Oversees Your Care
Fredal Orthodontics is a private practice with one doctor. Dr. Fredal personally plans and supervises every patient’s treatment.
He personally runs every consultation. The visit takes 50 minutes in total, and 20 of those minutes are with Dr. Fredal.
Dr. Fredal has treated more than 2,000 orthodontic cases in his training and his practice. His specialty training was in orthodontics and dentofacial orthopedics.
Some cases need other specialists too. He then works with general dentists, gum specialists (periodontists), ENT (ear, nose and throat) doctors and others.
CBCT Planning at Fredal Orthodontics
CBCT stands for cone-beam computed tomography. The practice’s scanner is an i-CAT FLX V17, and Dr. Fredal merges its images with the iTero digital scan for a fully digital workflow.
The 3D records show more than the crowns of the teeth. Dr. Fredal uses them to look at the roots, the surrounding bone, the skeletal relationships, the airway and the facial structures.
These findings can change major decisions, such as whether to expand. Dr. Fredal judges where the teeth sit against the face, lips, smile, supporting bone and opposing teeth.
Tooth-Borne, Bone-Borne, and What That Means
Expanders differ in what holds them. A tooth-borne expander, such as the traditional rapid palatal expander (RPE), is attached to the teeth. A bone-borne expander, such as MARPE or MSE, is held mainly by mini-screws in the bone of the palate.
Fredal Orthodontics offers both kinds. It also coordinates DOME, a type of expansion that adds surgery on the upper jaw. It does not offer MASPE, a slow form of mini-screw expansion.
| Dimension | Traditional RPE | MARPE / MSE | DOME (with surgery) |
|---|---|---|---|
| What holds it | Attached to the teeth | TADs, small mini-screws in the bone of the palate | An expander used together with surgery on the upper jaw |
| At Fredal Orthodontics | Used for children in Phase 1 (early) treatment | Offered for older teens and adults | Coordinated with an oral and maxillofacial surgeon |
| Who is involved | Dr. Fredal plans and oversees it | An oral surgeon outside the practice places the mini-screws; Dr. Fredal plans and oversees the treatment | An oral and maxillofacial surgeon does the surgery |
Which route fits depends on the case. Dr. Fredal decides from your 3D records and explains his recommendation at the consultation.
Airway Screening at the Consultation
Airway screening is part of every comprehensive orthodontic consultation at Fredal Orthodontics. Dr. Fredal uses the CBCT scan to look at the upper airway in 3D, including its narrowest point.
He also checks the nasal airway, tongue posture and mouth-breathing patterns, and looks for large tonsils and adenoids when they can be seen. He reviews your history for signs such as habitual mouth breathing, snoring and disrupted sleep.
The screening does not diagnose obstructive sleep apnea (breathing that repeatedly stops during sleep). When Dr. Fredal finds worrying symptoms or findings, he refers the patient to an ENT doctor, typically Dr. Thottam. The airway and orthodontics page has more.
The Process at Fredal Orthodontics
The process starts with the consultation and your 3D records. If MARPE or MSE is part of the plan, an oral surgeon outside the practice places the mini-screws.
With braces, adjustment visits are every 6 to 8 weeks. Between visits, you can text photos and questions to the team through Weave, and the clinical team replies during business hours with next steps.
For discomfort, Dr. Fredal advises that Tylenol can be used as needed, following the recommended dosing instructions. Existing patients can call/text the main line after hours, and the team usually responds within 24 hours.
When Surgery Is Part of the Plan
Dr. Fredal decides case by case whether orthodontic treatment alone is enough. He weighs how severe the skeletal discrepancy is (the mismatch between the jaws).
He also weighs facial balance and profile, the bite, tooth position, function and your goals. When moving the teeth alone cannot properly treat the jaw problem, he may discuss jaw surgery (orthognathic surgery) as part of the plan.
For surgical cases, Dr. Fredal works with oral surgeons and uses Virtual Surgical Planning (VSP), a 3D computer plan of the surgery. The orthodontic care and the surgery are billed separately. The surgical coordination page has the details.
MARPE and MSE in Shelby Township
Fredal Orthodontics is at 7827 25 Mile Rd in Shelby Township, at the northwest corner of 25 Mile Rd and Van Dyke Ave. The office serves Shelby Township and Washington Township. It also serves Romeo, Macomb Township, Utica, Ray Township, Bruce Township and Armada.
Park in any open space in the lot next to the building. The entrance is on the southwest side. Expanders for younger children are covered on the palatal expander page.
Common Questions About MARPE and MSE Expanders
How does a MARPE expander differ from a child’s traditional expander?
A traditional rapid palatal expander (RPE) is attached to the teeth. A MARPE or MSE expander is held by TADs (temporary anchorage devices), small mini-screws in the bone of the palate. At Fredal Orthodontics, Dr. Fredal uses the RPE for children in Phase 1 (early) treatment. MARPE and MSE are offered for older teens and adults.
What age is MARPE or MSE for at Fredal Orthodontics?
Fredal Orthodontics offers MARPE and MSE for older teens and adults. Dr. Fredal uses MARPE expansion for skeletal cases in adults. At the consultation, he reviews your CBCT scan and iTero digital scan with you. You get his treatment recommendation, including whether MARPE fits your case, and the exact treatment cost in writing.
How much does MARPE cost at Fredal Orthodontics?
For adults, braces with MARPE start at $10,080, priced as one package. In-house financing has 0% interest and no credit check, with a $2,000 down payment. Treatment fees include every appliance a case needs, and the fee does not change with how long treatment takes. You get the exact cost in writing at the consultation.
Does Dr. Fredal place the mini-screws himself?
No. Dr. Fredal does not place TADs (temporary anchorage devices) himself. When a case needs them, he refers the placement to an oral surgeon outside the practice. Fredal Orthodontics is a private, single-doctor practice, and Dr. Fredal personally plans and supervises every patient’s treatment.
What happens if MARPE is not the right fit?
Dr. Fredal decides case by case. When the jaw problem cannot be properly addressed with tooth movement alone, he may discuss surgical orthodontic treatment, coordinated with an oral and maxillofacial surgeon. Fredal Orthodontics also coordinates DOME, a type of expansion that adds surgery on the upper jaw. It does not offer MASPE, a slow form of mini-screw expansion.
Book a MARPE Consultation in Shelby Township
There is no charge for a consultation about MARPE or other skeletal expansion. A return consultation before you start is also free, unless you missed one as a no-show; then it is $100.
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.