Airway Orthodontics · Phase II Therapy
The DOME Palatal Expander
Adult expansion is now possible. And it is revolutionary.
Many adults have been told they cannot have palatal expansion at their age. Thankfully, advances in orthodontics have changed everything. We are excited to offer what we consider a truly revolutionary treatment — the DOME Palatal Expander.
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A trusted TMJ, Sleep & Airway Doc in Scottsdale, Arizona
What Is the DOME?
Expansion and alignment. Together.
The DOME Palatal Expander works by opening the palatal suture — the midline of the upper jaw — to create more width between the molars. Like other advanced adult expanders, the DOME does use mini screws placed in the palatal bone — but what sets it apart is the design of the appliance itself and the expansion it achieves.
Rather than pushing the molars apart to gain alveolar width, the DOME is designed to separate the two palatal bones, achieving true skeletal expansion. It then combines that expansion with Spark Clear Aligners into one integrated system.
This means the arch is being broadened and the teeth are being straightened at the same time — in a single, comfortable, removable appliance. It is a more elegant, more efficient, and more complete solution than anything previously available for adult expansion.
"The DOME expander opens the palatal suture, broadens the upper arch, creates a more beautiful wide-arch esthetic, and allows more airway space for breathing — all in one treatment."
DOME Expander — Palatal Suture Opening
Upper Arch Width — Before & After
What the DOME Accomplishes
One appliance. Transformational results.
01
Opens the Palatal Suture
Gently separates the midpalatal suture to create real, permanent skeletal width — not just dental tipping. This is true expansion of the bone itself.
02
Broadens the Upper Arch
Creates more width between the molars and across the full arch — producing a broader, more beautiful smile esthetically and providing the tongue with the space it needs to rest correctly in the palate.
03
Opens the Airway
As the palate widens, the floor of the nasal cavity simultaneously expands — dramatically improving airway space for breathing, reducing nasal obstruction, and supporting better sleep.
04
Straightens the Teeth
The DOME system integrates clear aligner therapy — straightening the teeth simultaneously as the arch expands. Two treatments. One system. No additional appliances required.
05
Reduces TMD Pressure
By giving the tongue its correct resting position and removing the forces that drive the mandible posteriorly, DOME addresses one of the key structural contributors to TMD pain at its root.
06
Works for Adults
Unlike traditional expanders that work only in growing patients, DOME is specifically designed to achieve skeletal expansion in adult patients — the group most often told expansion is no longer possible.
Over 16,000+ Transformations ★★★★★
DOME vs MARPE
The modern alternative to MARPE.
MARPE (Miniscrew-Assisted Rapid Palatal Expansion) has been the standard for adult expansion — effective, but requiring temporary anchor screws placed into the bone. The DOME system achieves the same structural expansion goals without the need for miniscrews, making it more comfortable, less invasive, and simpler for patients.
DOME
- No miniscrews required
- Removable appliance
- Expands + aligns simultaneously
- More comfortable for patients
- Revolutionary adult option
MARPE
- Miniscrews anchored in bone
- Fixed appliance
- Expansion only - aligners separate
- More invasive procedure
- Proven adult option
DOME Expander in Treatment
Before & After — DOME Case
Why We Love the DOME · Reason 2
Combined with Spark Aligners.
The DOME protocol is uniquely combined with Spark Clear Aligners — allowing us to straighten the teeth progressively as the expansion takes place. Rather than completing expansion first and then starting aligner treatment separately, everything happens together in one integrated process.
Spark Aligners are among the clearest, most comfortable aligners available — making the combined DOME + Spark protocol both effective and a genuinely pleasant treatment experience for our patients.
"Expand the arch. Straighten the teeth. One protocol. One process. Spark Aligners make it seamless."
- Spark Aligners are combined with the DOME protocol from the start of treatment
- Teeth straighten simultaneously as the arch expands — no waiting, no gaps
- Spark Aligners are among the clearest and most comfortable available
- One integrated process — more efficient and a better patient experience
Spark Aligners + DOME — Combined Protocol
Spark Clear Aligners
Why We Love the DOME · Reason 3
Created by the best minds in the field.
The DOME expander was not developed by a single discipline — it was born from the collaboration of world-class specialists who recognized that upper arch expansion is a medical problem, not just a dental one.
The Creator
Dr. Liu
Ear, Nose & Throat Physician · Oral Surgeon · Sleep Medicine Physician · Stanford University
The DOME Palatal Expander was created by Dr. Liu — an Ear, Nose and Throat physician from Stanford University who is also a trained oral surgeon and sleep medicine doctor. With this rare combination of disciplines, Dr. Liu uniquely understood the relationship between narrow arches, airway restriction, and sleep disorders.
Recognizing the critical need for a better upper arch expansion solution for adults, Dr. Liu developed both the DOME appliance itself and all of the protocols that accompany it — grounding the treatment in ENT science, surgical precision, and sleep medicine outcomes.
The Orthodontic Protocols
Dr. Claudia Pinter
Orthodontist · Austria · Spark Aligner Protocol Developer
The integration of Spark Aligners with the DOME expander is overseen by Dr. Claudia Pinter — an orthodontist from Austria who helped develop the aligner movement protocols specifically designed to work in coordination with DOME expansion.
Dr. Pinter’s contribution ensures that the tooth movement happening alongside the expansion is precise, coordinated, and clinically sound — producing a beautiful, stable result at the end of treatment.
ENT science. Surgical expertise. Sleep medicine. Orthodontic precision. All in one system.
The Story Behind the Name
From Istanbul to your palate.
Here is an interesting detail that speaks to the elegance behind the name. Dr. Liu grew up in Istanbul, Turkey — home of the famous Blue Mosque, also known as Hagia Sophia, one of the world’s most iconic domed structures. Dr. Liu noted that not only is DOME an acronym for the expansion system, but it is also a perfect way to describe the ideal shape of the human palate.
Think about it this way: a narrow upper arch creates a V-shape at the top of the palate — pointed and steep, with no room for the tongue. What we are working toward with the DOME expander is a wide, flattened, dome-shaped palate — broad and open, with ample room for the tongue to rest correctly in its natural position.
"A V-shaped narrow arch has nowhere for the tongue. A wide, domed palate gives the tongue its home — and gives the body what it needs to breathe, rest, and heal."
- V-shaped narrow arch — tongue forced low, mandible driven back, airway compressed
- Wide domed palate — tongue rests correctly, jaw in proper position, airway open
The Blue Mosque · Istanbul, Turkey
V-Shape vs Dome — The Palate We Are Working Toward
Frequently Asked Questions
DOME Expander FAQ
The questions we hear most often — answered honestly.
Am I too old for palatal expansion?
Most often — no! This is one of the most common concerns we hear, and we love being able to reassure patients on this point. The DOME expander was specifically designed to work for adults, and age alone is rarely the determining factor.
As long as you have good, healthy bone and strong teeth, we are good to go. During your consultation, Dr. Patrice will evaluate your bone quality and anatomy to confirm candidacy — but in the vast majority of cases, adults who want expansion can have it.
What if the bones don't separate?
In rare circumstances, this can happen. Approximately 1 in 10 patients will have palatal sutures that cannot be separated with the DOME expander alone. In these cases, we don’t simply stop there.
We work closely with Dr. Liu himself to identify surgical solutions that can assist with suture separation — ensuring that even in these uncommon situations, our patients have a path forward. You are never left without an answer.
How long does the DOME expander take?
We begin DOME treatment as early as age 6. The DOME system has been thoughtfully designed with age-specific versions to accommodate patients at every stage of development:
Starting expansion early — when the palatal suture is still more pliable — produces faster results with greater ease. However, as the DOME Zero demonstrates, meaningful expansion is achievable at any age with the right protocol.
What is the youngest age we can start with the DOME expander?
We begin DOME treatment as early as age 6. The DOME system has been thoughtfully designed with age-specific versions to accommodate patients at every stage of development:
Starting expansion early — when the palatal suture is still more pliable — produces faster results with greater ease. However, as the DOME Zero demonstrates, meaningful expansion is achievable at any age with the right protocol.
Have more questions? We’d love to answer them at your consultation.
Don't Accept "You Can't"
Adults can expand. Come find out how.
If you’ve been told palatal expansion isn’t possible at your age, we’d love to evaluate you. Dr. Patrice Winterholler will review your case and let you know whether the DOME expander is right for you — and what the full treatment process would look like.
How We Use the DOME
Expand and straighten. At the same time. No gaps.
In our practice, we use the DOME to widen the arches for adults — many of whom have struggled for years to find a lasting solution.
One of the most common frustrations we hear is recurrent crowding over time after orthodontic treatment. The reason this happens so often is simple: the arch was never properly widened to begin with. Without adequate arch width, teeth have nowhere to go — and crowding returns.
By creating the proper structure first, we can finally straighten those teeth once and for all. And because we use the DOME expander together with clear aligners, we are expanding and straightening simultaneously — meaning no unsightly gaps between your teeth during treatment. You go through the process looking good the entire time.
No gaps. No embarrassing smiles during treatment. Just steady, beautiful progress.
DOME + Aligners — Treatment in Progress
Recurrent Crowding — Corrected for Good
Why the DOME Is Different
Slow and steady wins the expansion.
The DOME expander is often compared to other expanders on the market — particularly the MARPE and the MASPE. (In fact, the DOME was formerly known as a MASPE before the technology evolved.) However, the DOME represents the most advanced expansion protocol currently available, and there is one critical reason we prefer it above all others.
The DOME Protocol
Slow, Continuous Expansion
The DOME protocol calls for slow, continuous expansion using smaller, more frequent turns. This gradual approach allows the bone to separate gently — and crucially, to begin filling in, repairing, and remodeling right away as expansion continues.
The result is stronger new bone, better integration, and significantly less relapse over time. The body is given time to heal as it expands.
"Smaller turns. Continuous separation. Bone repairs itself as it expands. Less relapse. Better long-term results."
Rapid Palatal Expanders
Rapid Expansion
Many other expanders on the market — including traditional rapid palatal expanders — use a protocol of wider, faster turns. The bone is split rapidly, creating a wide gap that then has to fill in on its own by second intention healing.
This approach often leads to a larger gap, less predictable bone fill, and a higher rate of relapse over time — meaning the teeth and arch may shift back more readily after treatment is complete.
"Wide gap created rapidly. Bone fills in by second intention. Higher risk of relapse."
