Three-Dimensional Facial Soft Tissue Changes and Clinical Perception Following MARPE

October 3, 2026 updated by: Hasan KILINÇ, Adiyaman University

Evaluation of Three-Dimensional Facial Soft Tissue Changes and Their Clinical Perceptibility Following Miniscrew-Assisted Rapid Palatal Expansion (MARPE)

This prospective, controlled observational study aims to evaluate three-dimensional (3D) facial soft tissue changes following miniscrew-assisted rapid palatal expansion (MARPE) and determine whether these changes are clinically perceptible to orthodontic specialists and patients.

A total of 55 postpubertal participants aged 16-25 years will be included: 40 patients undergoing MARPE as part of their routine orthodontic treatment and 15 control participants who will not undergo maxillary expansion. Treatment decisions will be made independently of study participation.

Facial soft tissue changes will be assessed using 3D facial scans. The MARPE group will be scanned before expansion (T0), immediately after active expansion (T1), and three months after expansion (T2). The control group will undergo two facial scans at comparable baseline and follow-up intervals.

Changes in facial regions, including the nose, paranasal area, midface, and upper lip, will be evaluated. Blinded orthodontic specialists will assess the clinical perceptibility of changes using standardized facial images, while participants will provide their own perception of facial changes through questionnaires. When available from routine clinical records, skeletal and dental expansion measurements will also be analyzed in relation to the observed soft tissue changes.

The study aims to clarify the magnitude, distribution, and clinical relevance of facial soft tissue changes associated with MARPE.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

his single-center prospective controlled observational study will investigate facial soft tissue changes associated with miniscrew-assisted rapid palatal expansion (MARPE) in postpubertal individuals.

Three-dimensional facial images will be obtained using the MetiSmile facial scanning system (Shining 3D, Hangzhou, China) under standardized conditions, including natural head position, neutral facial expression, and relaxed lips.

The MARPE group will be evaluated at three time points: before appliance activation (T0), following completion of active expansion (T1), and after a three-month retention period (T2). The control group will undergo facial scanning at baseline and at a follow-up interval corresponding to the T0-T2 observation period.

Regional soft tissue changes will be assessed in the nasal, alar base, paranasal, nasolabial, midfacial, and upper lip regions. Clinical perceptibility will be investigated through blinded orthodontic specialist assessments of standardized facial image pairs. Patient-reported perception of facial changes will also be recorded using structured questionnaires.

Where routine clinical CBCT records are available, skeletal expansion and intermolar width changes will be measured and their relationships with regional facial soft tissue changes will be investigated. No additional radiographic examinations will be performed solely for research purposes.

Comparisons between the MARPE and control groups will be used to distinguish expansion-associated facial changes from changes occurring during the observation period.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
60

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Turkey (Türkiye)
    • Adıyaman Province
      • Adıyaman, Adıyaman Province, Turkey (Türkiye), 02040
        • Adiyaman University Faculty of Dentistry, Department of Orthodontics
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

16 years to 25 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The study population will consist of 60 postpubertal orthodontic patients aged 16-25 years recruited from the Department of Orthodontics, Faculty of Dentistry, Adiyaman University, Türkiye. The MARPE group will include 40 patients undergoing clinically indicated maxillary expansion, while the control group will consist of 20 age- and skeletal maturation-matched orthodontic patients who will not receive maxillary expansion during the observation period. All participants will be prospectively followed using three-dimensional facial scans. Treatment decisions will be made independently of study participation.

Description

Inclusion Criteria:

  • Individuals aged 16-25 years.
  • Postpubertal skeletal maturation confirmed by cervical vertebral maturation (CVM) assessment using existing lateral cephalometric radiographs.
  • Patients with a clinical indication for miniscrew-assisted rapid palatal expansion (MARPE), determined independently of the study (MARPE group).
  • Orthodontic patients matched for age and skeletal maturation who will not undergo maxillary expansion during the observation period (control group).
  • Willingness to participate and provision of informed consent (and parental/legal guardian consent for participants under 18 years).

Exclusion Criteria:

  • History of previous maxillary expansion treatment.
  • Previous or planned orthognathic surgery during the observation period.
  • Facial aesthetic procedures or surgical interventions that may influence soft tissue morphology during follow-up.
  • Systemic diseases or craniofacial conditions affecting bone or soft tissue development.
  • Maxillary expansion performed in control participants during the observation period.
  • Inability to complete the required facial scans or follow-up assessments.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: COHORT
  • Time Perspectives: PROSPECTIVE

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
MARPE Group

Participants aged 16-25 years with a clinical indication for miniscrew-assisted rapid palatal expansion (MARPE). A total of 40 participants will undergo routine MARPE treatment independently of the study. Three-dimensional facial scans will be obtained before expansion (T0), immediately after active expansion (T1), and at the third month of retention (T2).
Device: Miniscrew-Assisted Rapid Palatal Expansion (MARPE)

MARPE is performed as part of routine orthodontic treatment based on an independent clinical indication. The study does not assign or modify the treatment. Three-dimensional facial scans are obtained before expansion (T0), immediately after active expansion (T1), and at the third month of retention (T2) to evaluate facial soft tissue changes.
Control Group

Twenty age- and skeletal maturation-matched orthodontic patients who will not undergo maxillary expansion during the observation period. Routine orthodontic treatment may continue. Three-dimensional facial scans will be obtained at two time points corresponding to the baseline and three-month retention follow-up interval of the MARPE group.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Three-Dimensional Facial Soft Tissue Changes Following MARPE
Time Frame: Baseline (T0), immediately after active expansion (T1), and 3 months after active expansion (T2). Control participants will be assessed at two corresponding time points.

Three-dimensional facial soft tissue changes will be evaluated using MetiSmile facial scans. Regional changes in the nasal, paranasal, midfacial, zygomatic, and upper lip areas will be quantified in millimeters (mm) by comparing baseline and follow-up scans. Changes from T0 to T2 will be compared between the MARPE and control groups. Additional changes between T0-T1 and T1-T2 will be assessed in the MARPE group.
Baseline (T0), immediately after active expansion (T1), and 3 months after active expansion (T2). Control participants will be assessed at two corresponding time points.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Expert Assessment of Perceived Facial Changes
Time Frame: Baseline (T0) to 3 months after active expansion (T2).

Blinded orthodontic experts will evaluate paired three-dimensional facial images to assess the perceptibility and magnitude of facial changes. Assessments will include identification of the later time point, confidence level (0-10), perceived change severity (0-4), and facial regions showing the most noticeable changes.
Baseline (T0) to 3 months after active expansion (T2).

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Patient-Reported Perception of Facial Changes
Time Frame: 3 months after active expansion (T2).

Participants will complete a self-assessment questionnaire to evaluate their perceived facial changes following MARPE treatment. Patient-reported perceptions will be assessed and compared with objectively measured three-dimensional facial soft tissue changes.
3 months after active expansion (T2).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Adiyaman University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Nihal HAMAMCI, Professor Doctor, Adiyaman University
  • Study Director: Hasan Kılınç, research assistant, Adiyaman University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 1, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 1, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 29, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 29, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 5, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
October 6, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 3, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • ADIYAMAN-MARPE-2026-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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