CCW MAXILLARY ROTATION

[AscendingHero]

1988 jfl. Age makes all the difference man, BAMP or FM alone gives excellent results on children and even early teens. Give me a 7 year old and i'll turn him into a model.

This

 

[noprogressno]

Wdym? I dont understand this part. Aren't we looking for pure displacement and remodeling of the maxila? sub 18 or even 20 it's possible to displace the maxila positively forward via saggital protraction of an appliance if consistent+high forces+decent sutures.

Well I think most people in this forum believe that bone remodelling for adults is a meme to be honest(Other than malleable bones like alveolar bone, which doesn't bear interest of anyone since if maxilla bone is recessed alveolar bone remodeling won't do much)
If you know how expanding with mse works, theoretically if you could distrupt(or split/seperate/displace whatever you want to call it...)all of the sutures the maxilla is connected to, then as you put forward force new bone would start to fill in, just like how new bone fills in after expansion with mse. But this never happened because no one is able to put enough force directly onto bone. MSE for protraction doesn't work since the force doesn't get transfered onto the anchor point. Bollard plates don't work because the amount of force required to gain any protraction on adults is at least minimum 1kg and bollard plates will remain stable up to 350-400 grams, which isn't enough for an adult(I didn't make up the 1kg part Dr. Ting said that in an interwiev...). N2 implant doesn't even exist... Hopefully you got the unfortunate picture...

 

[spark]

Well I think most people in this forum believe that bone remodelling for adults is a meme to be honest(Other than malleable bones like alveolar bone, which doesn't bear interest of anyone since if maxilla bone is recessed alveolar bone remodeling won't do much)
If you know how expanding with mse works, theoretically if you could distrupt(or split/seperate/displace whatever you want to call it...)all of the sutures the maxilla is connected to, then as you put forward force new bone would start to fill in, just like how new bone fills in after expansion with mse. But this never happened because no one is able to put enough force directly onto bone. MSE for protraction doesn't work since the force doesn't get transfered onto the anchor point. Bollard plates don't work because the amount of force required to gain any protraction on adults is at least minimum 1kg and bollard plates will remain stable up to 350-400 grams, which isn't enough for an adult(I didn't make up the 1kg part Dr. Ting said that in an interwiev...). N2 implant doesn't even exist... Hopefully you got the unfortunate picture...

If it doesn't work then why do people get results?

&
https://minerva.usc.es/xmlui/bitstr...ez_varela_skeletal.pdf?sequence=1&isAllowed=y

Explain?

 

[noprogressno]

If it doesn't work then why do people get results?
View attachment 1445087

&
https://minerva.usc.es/xmlui/bitstr...ez_varela_skeletal.pdf?sequence=1&isAllowed=y

Explain?

If you call this a skeletal result I say get your eyes checked. Her upper teeth are flared way too forward and her lower teeth was pushed backwards. If its really hard for you to see, you can check how her upper teeth are angled forwards compared to the before results. You can also check how there is no difference in the upper maxillary area, so the only reason why her side profile looks different than the first photo is dental changes and alveolar bone remodeling.The only thing that happened is flared teeth plus alveolar bone remodeling at the end. Alveolar bone remodeling is not what gives aesthetic results. I am not saying that protraction for adults will never work. It will probably become an available treatment once someone creates an appliance to directly pull from the bone itself. However no one will be able to achieve skeletal change pulling from mse molar bands. You are pulling from molars after all. Before you say "but mse is bone anchored" let me tell you nobody is sure about if the protraction force from the molar bands actually transfers to the anchor point itself

 

[noprogressno]

Also you don't need MSE to achieve flared teeth. Braces can do that also. It'c called "camouflage treatment" and while it corrects the oclussion it has little to no benefits for facial profile

 

[spark]

Also you don't need MSE to achieve flared teeth. Braces can do that also. It'c called "camouflage treatment" and while it corrects the oclussion it has little to no benefits for facial profile

So you are saying you never bothered to click on the link I posted right?

 

[noprogressno]

So you are saying you never bothered to click on the link I posted right?

my bad. Didn't see the second link as I was viewing from my phone and it didn't appear. It seems like a much better approach since miniplates directly pull from bone. Unfortunately however, you still cannot deny that again most of the changes were from dental changes... They put braces on the lower teeth which tipped the lower teeth backwards. Yes there is a little change in the bone itself but still, it is not significant comparing to the movement of lower teeth.
In fact it's even present in one of the photos from the link. You can see how much the position of lower teeth was brought backwards comparing to upper teeth. And you can see that upper changes are again, mostly from dental tipping and rest is mostly from alveolar bone remodeling itself...

 

[Edgar]

How does CCW rotation work without removing a part of the maxilla? Do you just push the bone upwards jfl?

 

[spark]

How does CCW rotation work without removing a part of the maxilla? Do you just push the bone upwards jfl?

if you tilt a straight line it becomes vertically shorter

 

[spark]

my bad. Didn't see the second link as I was viewing from my phone and it didn't appear. It seems like a much better approach since miniplates directly pull from bone. Unfortunately however, you still cannot deny that again most of the changes were from dental changes... They put braces on the lower teeth which tipped the lower teeth backwards. Yes there is a little change in the bone itself but still, it is not significant comparing to the movement of lower teeth.
In fact it's even present in one of the photos from the link. You can see how much the position of lower teeth was brought backwards comparing to upper teeth. And you can see that upper changes are again, mostly from dental tipping and rest is mostly from alveolar bone remodeling itself...

You don't even need to push the upper maxilla forward that much imo. 1mm in the upper maxilla for every like 5mm of the alveolar should be enough.

 

[spark]

Also the second case used SARPE so upper maxillary expansion didnt happen. Sergio said it did.

 

[noprogressno]

You don't even need to push the upper maxilla forward that much imo. 1mm in the upper maxilla for every like 5mm of the alveolar should be enough.

That change in the alveolar bone is definetely not 5mm of alveolar bone remodeling... Maybe 1mm or 2mm at best. Braces can chance and cause alveolar bone remodeling as well, thats how braces works. But there is no result from any protraction protocol for adults that gives as good result as lefort or superior results yet

Also the second case used SARPE so upper maxillary expansion didnt happen. Sergio said it did.

How does upper maxillary expansion not happen with SARME? Isn't that what the surgery is for, surgeons cut through the midpalatal suture during that surgery, if SARME didn't seperate the midpalatal suture the only changes would be dental?

 

[spark]

That change in the alveolar bone is definetely not 5mm of alveolar bone remodeling... Maybe 1mm or 2mm at best. Braces can chance and cause alveolar bone remodeling as well, thats how braces works. But there is no result from any protraction protocol for adults that gives as good result as lefort or superior results yet

Lefort moves the alveolar part only as well. Upper maxilla doesn't move one bit. Why are facemasks even used if what they achieve can be done by braces? I call bs on that one.

How does upper maxillary expansion not happen with SARME? Isn't that what the surgery is for, surgeons cut through the midpalatal suture during that surgery, if SARME didn't seperate the midpalatal suture the only changes would be dental?

It was a SARPE, they make a "lefort" style cut which prevents upper expansion.

 

[noprogressno]

Lefort moves the alveolar part only as well. Upper maxilla doesn't move one bit. Why are facemasks even used if what they achieve can be done by braces? I call bs on that one.


It was a SARPE, they make a "lefort" style cut which prevents upper expansion.
View attachment 1446743

That wasn't what I meant with upper maxilla. I don't know how to refer to each area of maxilla. I know lefort doesn't move the maxilla as a whole, there is a cut made after all. What I meant is that protraction with mse doesn't move the maxilla as high as lefort does(Well it doesn't ''move'' maxilla as in sutural seperation, displacement type of movement, but alveolar bone remodeling around the teeth roots, thats what I mean by moving, obviously there is no actual movement that is taking place...). Thats what I meant by that. The only alveolar bone remodeling that takes place is the bone around the roots. Braces works this way too, If bone didn't fill in after a tooth movement took place, braces would never work for adults. Camouflage treatment would never work as well, because the roots would be simply pushed out of the alveolar bone if new bone didn't remodel. In fact this is also the reason why so many people are dissatisfied with AGGA, it simply pushes the teeth so much that roots get pushed out of the alveolar bone sometimes, and obviously this is not reversible. If protraction for adults that gets any support from teeth would work, AGGA would work as well, but it never happens with any AGGA cases and yes, there is alveolar bone remodeling with AGGA too but no actual change in the upper maxilla(again I am referring to the higher parts of the lefort cut area by upper maxilla. Obviously there is no change on that area with any protraction cases that gets support from teeth, be it AGGA or MSE+facemask...)
Bollard miniplates are a whole different topic though, let's not put it in the same category with AGGA or MSE+ facemask, bollards are completely bone anchored and they don't get any support from teeth but the link you sent is not relevant because thats just another form of camouflage... I highly doubt that the bollards were the cause of tilting of the upper teeth. No, probably as they tilted the lower teeth backwards with braces and as the occlusion came to an ''edge to edge bite'' slowly, lower teeth started to push the upper ones outwards and thats probably why upper teeth tilted/flared outwards. Lower teeth tilting much more than the upper ones kind of proves my point as there was braces put on the lower teeth to tilt them backwards but the only thing pushing the upper teeth was the lower teeth itself. The end result? Camouflage.
Now if there was any cases that only got movemen't from bollards without any support from braces or other things with minimal dental movement that would be a real ''result'' of an adult moving their maxilla with protraction to see. The link you sent is not, again its just another form of camouflage, it's not that hard to see, just look a little careful, I don't think you can not notice the amount of tilting that took place
Whats really weird to me is that there is a paralel cut that took place yet there is still no actual movemen't in the upper lefort area. AFAIK not all SARPE surgeries have this type of parallel cut, am I wrong? Because thats what I assumed when I talked about upper maxillary expansion...

 

[noprogressno]

Upper maxilla doesn't move one bit. Why are facemasks even used if what they achieve can be done by braces?

Well,they are usually not used because they don't give any skeletal result for adults, Apply the force onto a hyrax or onto a rapid palatal expander or mse and you would just end with camouflage, after all they are just pulling from tooth. Why use such a torture device like facemask when you can do the same thing with braces(camouflage). Thats why they are not used...

 

[spark]

Well,they are usually not used because they don't give any skeletal result for adults, Apply the force onto a hyrax or onto a rapid palatal expander or mse and you would just end with camouflage, after all they are just pulling from tooth. Why use such a torture device like facemask when you can do the same thing with braces(camouflage). Thats why they are not used...

They are used though virtually every MSE doctor utilizes facemasks.

 

[noprogressno]

They are used though virtually every MSE doctor utilizes facemasks.

And yet still we don't see any skeletal result...
Plus mse is not widely available in every country yet. I heard of so many orthodontists who has no idea what mse is, laughing at the possibility of adult non-surgical palatal expasion...

 

[spark]

That wasn't what I meant with upper maxilla. I don't know how to refer to each area of maxilla. I know lefort doesn't move the maxilla as a whole, there is a cut made after all. What I meant is that protraction with mse doesn't move the maxilla as high as lefort does(Well it doesn't ''move'' maxilla as in sutural seperation, displacement type of movement, but alveolar bone remodeling around the teeth roots, thats what I mean by moving, obviously there is no actual movement that is taking place...). Thats what I meant by that. The only alveolar bone remodeling that takes place is the bone around the roots. Braces works this way too, If bone didn't fill in after a tooth movement took place, braces would never work for adults. Camouflage treatment would never work as well, because the roots would be simply pushed out of the alveolar bone if new bone didn't remodel. In fact this is also the reason why so many people are dissatisfied with AGGA, it simply pushes the teeth so much that roots get pushed out of the alveolar bone sometimes, and obviously this is not reversible. If protraction for adults that gets any support from teeth would work, AGGA would work as well, but it never happens with any AGGA cases and yes, there is alveolar bone remodeling with AGGA too but no actual change in the upper maxilla(again I am referring to the higher parts of the lefort cut area by upper maxilla. Obviously there is no change on that area with any protraction cases that gets support from teeth, be it AGGA or MSE+facemask...)
Bollard miniplates are a whole different topic though, let's not put it in the same category with AGGA or MSE+ facemask, bollards are completely bone anchored and they don't get any support from teeth but the link you sent is not relevant because thats just another form of camouflage... I highly doubt that the bollards were the cause of tilting of the upper teeth. No, probably as they tilted the lower teeth backwards with braces and as the occlusion came to an ''edge to edge bite'' slowly, lower teeth started to push the upper ones outwards and thats probably why upper teeth tilted/flared outwards. Lower teeth tilting much more than the upper ones kind of proves my point as there was braces put on the lower teeth to tilt them backwards but the only thing pushing the upper teeth was the lower teeth itself. The end result? Camouflage.
Now if there was any cases that only got movemen't from bollards without any support from braces or other things with minimal dental movement that would be a real ''result'' of an adult moving their maxilla with protraction to see. The link you sent is not, again its just another form of camouflage, it's not that hard to see, just look a little careful, I don't think you can not notice the amount of tilting that took place
Whats really weird to me is that there is a paralel cut that took place yet there is still no actual movemen't in the upper lefort area. AFAIK not all SARPE surgeries have this type of parallel cut, am I wrong? Because thats what I assumed when I talked about upper maxillary expansion...

Not the same angle but it doesn't look like the after is just her teeth excessively tilting

 

[spark]

even the crowding of the wisdom tooth is reduced

 

[noprogressno]

Not the same angle but it doesn't look like the after is just her teeth excessively tilting
View attachment 1447206

Its not the upper teeth its the lower ones. Look at this one and you can clearly see the upper teeth were not the ones that got tilted significantly. (and in the second picture we can't even see the lower teeth properly since it would be impossible due to upper ones,so look at the tracings of the before and after picture.)
Yes she definetely looks much better in the end picture but thats due to having more harmony, not due to her maxilla moving forwards

 

[noprogressno]

even the crowding of the wisdom tooth is reduced
View attachment 1447227

obviously that would happen since her teeth moved and tilted forwards, so there is now more space

 

[spark]

Its not the upper teeth its the lower ones. Look at this one and you can clearly see the upper teeth were not the ones that got tilted significantly. (and in the second picture we can't even see the lower teeth properly since it would be impossible due to upper ones,so look at the tracings of the before and after picture.)
Yes she definetely looks much better in the end picture but thats due to having more harmony, not due to her maxilla moving forwards

and even her ANS moves forward...

Also how would bone borne protraction cause the forward movement of teeth? Or are you assuming the guy merely faked the whole thing and just used braces to move the teeth and then claimed a new method? LOL

 

[noprogressno]

and even her ANS moves forward...

Also how would bone borne protraction cause the forward movement of teeth? Or are you assuming the guy merely faked the whole thing and just used braces to move the teeth and then claimed a new method? LOL

Bone protraction didn't happen... Its just tilting of teeth and some alveolar bone remodeling around the roots. Even the tracings show that... Blue markings are the before and the red markings are after, you can see how much the teeth has tilted. Exact same thing happens with camouflage treatment as well...
Yes the orthodontist is definetely delusional as there is no real skeletal ''movement'' or whatsoever in this case. Its not an incredibly uncommon thing with orthodontists... There are orthodontists who believe that AGGA works, there are orthodontists who believe that extraction and rectraction with braces on young patients doesn't affect facial profile and airway size, there is Mike Mew who believes that even adults can change their skeletal facial structure just by putting their tongue on their palate, having correct posture and breathing through nose etc... I am not shocked with this one, it happens all the time
At this point I am very sure that the sole reason why the computer simulation for the N2 implant showed real skeletal results was because of the amount of protraction force that was put onto actual bone thanks to that implant. Would it really stable as showed in the simulation or would it not, no one knows because there isn't a lot of detail about that study, its just 1 simulation after all. But what we know is that all the studies(including the very old ones) we have now, which actually achieved real skeletal results be it a simulation or an animal experiment, had one thing in common and that is the amount of force that was put onto bone
The N2 implant simulation put 2kg's of force in total onto the implant to achieve forward movement and ccw movement
Remember this monkey study(first picture)? a total of 1.2 kg of force was put onto the implants and with that they were able to achieve significant amount of forward growth in a matter of 4-5 months. And by significant I mean nearly a centimeter. Plus it was a real ''skeletal'' result, not just some bone remodeling around teeth roots(However the monkeys were young so thats not completely relevant. Had they been an adult they would need a much higher amount of force to achieve something like this which is also a +1 for my point again...)
Another monkey experiment. But this one wasn't bone borne however the animals were adults this time. Again by putting heavy forces they were able to achieve protraction on adult monkeys. However, as teeth was involved in it there were also significant dental changes as well which is not ideal.
Another thing that I will tell you is the amount of force palatal expanders put onto palate with each complete turn(mse is also a palatal expander so this one is important as the only thing we have right now that gives any ''real'' non-surgical skeletal results in adults is mse) This is from an article: ''RPE appliances require frequent activations and generate heavy forces―as much as 2-5 kg per quarter-turn with accumulated loads of more than 9 kg''. MSE puts all that force onto the bone itself without any force lost on teeth. I bet that is the reason why is is able to open the midpalatal suture. Now the other sutures of the skull are much more resistant and would probably require higher amounts of force for an adult to be able to get opened

Back onto the article you linked. Between 200-400 grams of force was put onto each side(as how it is normally with miniplates, you can't go higher than that otherwise they get loose, their anchorage is not that strong...). That equals to a total of 400-800 grams of force put onto maxilla. Thats not enough for an adult, obviously that is why there isn't significant movement of maxilla... In fact your tongue is capable of exerting 500 grams of force. So the same amount of force that was put onto the miniplates can be applied via tongue huh? But why do we see no results from any adult who is mewing then? Because first, that force is not enough to open any sutures including the midpalatal suture; second,the amount of remodeling that takes place on adult bones are not significant to correct an underlying skeletal issue and third, some real bone remodeling take place in adult bones too, but low forces are not enough to trigger that process for an adult significantly(if that was the case mewing would trigger that process as well...)
In fact the article you linked classifies the treatment as something in between camouflage and orthognatic surgery. ''...but decide not to undergo orthognathic surgery, despite being the ideal option, for different reasons explained above, we decided to devise an intermediate option between camouflage and orthognathic surgery''
I didn't make it up myself, the article that you linked says it...

So if at any point there will be a treatment that would be able to cause maxillary protraction for an adult would come from something that can stay stable under the same amount of forces MSE is able to withstand,. Because thats the amount of force that achieves sutural seperation. If we want to see a '' real'' non-surgical ''skeletal'' result, our best bet is sutural seperation, not some bone remodeling or alveolar bone remodeling...

(If you have a malloclusion that enables you to get this type of treatment I would say go for it. But personally I would never be satisfied with a nearly completely dental result like this one... My personal opinion only.)

 

[noprogressno]

Miniplates work for children with real counter clockwise result. Real skeletal result. You know why? Because they are children. Do you know what else works to correct skeletal issues and malloclusion on children if caught early enough? Mewing. The amount of force miniplates are able to withstand is very close to the range of force that the tongue is able to exert. Hopefully you get the picture. Miniplates on children is like an external version of correct oral posture that is lacking,which caused the malloclusion at first place(The reasons of malloclusion can root from incorrect swallowing pattern, incorrect tongue posture, tongue thrust etc. on a children...)The force range is nearly the same...

 

[spark]

Miniplates work for children with real counter clockwise result. Real skeletal result. You know why? Because they are children. Do you know what else works to correct skeletal issues and malloclusion on children if caught early enough? Mewing. The amount of force miniplates are able to withstand is very close to the range of force that the tongue is able to exert. Hopefully you get the picture. Miniplates on children is like an external version of correct oral posture that is lacking,which caused the malloclusion at first place(The reasons of malloclusion can root from incorrect swallowing pattern, incorrect tongue posture, tongue thrust etc. on a children...)The force range is nearly the same...

How can bone borne protraction which isn't even touching the teeth merely tip the teeth and in such a manner where it's not even visible? It's clear her maxilla moved forward...

 

[spark]

Regarding the tongue its irrelevant is anyone pushing as hard as they can for 24 hours straight? Not to mention this was done with SARPE nobody thinks it could work without loosing up of the sutures.

 

[noprogressno]

How can bone borne protraction which isn't even touching the teeth merely tip the teeth and in such a manner where it's not even visible? It's clear her maxilla moved forward...

it isn't the protraction that tipped the teeth, protracton didn't even cause anything here. Protraction didn't do anything, braces tilted the lower teeth backwards and the tilted lower teeth pushed the upper teeth forwards therefore tilted the upper teeth forwards. Simple.

 

[noprogressno]

even the crowding of the wisdom tooth is reduced
View attachment 1447227

crowding of the wisdom teeth was solved due to transversal palatal expansion, not due to the ''protraction'' that you are talking about. If protraction was what fixed the crowding,the upper molars would moved alongside the maxilla as well. Upper molars didn't move a single bit, as you can see in the picture

 

[spark]

it isn't the protraction that tipped the teeth, protracton didn't even cause anything here. Protraction didn't do anything, braces tilted the lower teeth backwards and the tilted lower teeth pushed the upper teeth forwards therefore tilted the upper teeth forwards. Simple.

That is simply impossible. Stop making retarded conspiracy theories about how every doctor is faking their studies. Dr. Varela says he achieved maxillary protraction. Sergio said bollards even protracts the whole maxilla including the orbitals. Dr. Derek Mahony uses protraction methods and said he only uses CT scans to assess the results.

 

[noprogressno]

It just doesn't give any significant results for adults. I hope that you get this type of treatment. I would like to see your own results when you do

 

[noprogressno]

I know Sergio says that and I agree with him. However he is saying this saying this for children. When did he say something like ''yes, it will definetely work'' or did I miss something. All he said was ''it might work''

 

[noprogressno]

Sergio said bollards even protracts the whole maxilla including the orbitals. Dr. Derek Mahony uses protraction methods and said he only uses CT scans to assess the results.

I know the working mechanism, obviously it would protract the whole maxilla if it would work for adults, it works that way for children after all. Derek Mahony uses bollards on adults too? I thought he only used them on children...

 

[spark]

I know the working mechanism, obviously it would protract the whole maxilla if it would work for adults, it works that way for children after all. Derek Mahony uses bollards on adults too? I thought he only used them on children...

He claims he gets CT scan visible results even from the facemask

 

[noprogressno]

He claims he gets CT scan visible results even from the facemask

from an adult patient?

 

[noprogressno]

Dr. Varela says he achieved maxillary protraction.

Also a while ago I sent a message to Dr. Varela about bollards and protraction but he didn't respond.
Anyways there is another thing I want to mention as well, as the topic has already opened up
This is a type of anchorage used for mesialization of teeth






Bollards require surgery to flap open gums. This one could potentially eliminate that leaving all the work to the orthodontist? It looks like there is a wide range of lenght and width available. However as far as I know this is not used for protraction purposes, yet... It seems like a very stable implant since it has a longer lenght. I think it might even provide better anchorage
A while ago I was talking about bollards with longer screws but after some conversations we came to a conclusion using such long screws on infrazygomatic crest would risk damaging it. But it seems like thats not the case? Look at the first photo? Wasn't that screw used on infrazygomatic crest or am I wrong?
@ropemax , @spark ?
It has been a while since @ropemax has messaged ronald ead about the N2 implant, he hasn't replied yet right?
In the meantime let's discuss an alternative like this
This is the only thing we have right now, that is as close to the N2 implant imo

 

[spark]

from an adult patient?

Yeah. I'll try to ask him for further information.

 

[spark]

Also a while ago I sent a message to Dr. Varela about bollards and protraction but he didn't respond.
Anyways there is another thing I want to mention as well, as the topic has already opened up
This is a type of anchorage used for mesialization of teeth






Bollards require surgery to flap open gums. This one could potentially eliminate that leaving all the work to the orthodontist? It looks like there is a wide range of lenght and width available. However as far as I know this is not used for protraction purposes, yet... It seems like a very stable implant since it has a longer lenght. I think it might even provide better anchorage
A while ago I was talking about bollards with longer screws but after some conversations we came to a conclusion using such long screws on infrazygomatic crest would risk damaging it. But it seems like thats not the case? Look at the first photo? Wasn't that screw used on infrazygomatic crest or am I wrong?
@ropemax , @spark ?
It has been a while since @ropemax has messaged ronald ead about the N2 implant, he hasn't replied yet right?
In the meantime let's discuss an alternative like this
This is the only thing we have right now, that is as close to the N2 implant imo

I also messaged Varela on two different accounts but I questioned him about his own protraction results from tads. He never responded to any of my questions. Nevertheless I'd want bollards over tads as bollards seem more bone driven.

 

[Fart mic]

mewing>mse,and mse is probably the best thing for maxilla,much less invasive than lf3

what is mse

 

[noprogressno]

I also messaged Varela on two different accounts but I questioned him about his own protraction results from tads. He never responded to any of my questions. Nevertheless I'd want bollards over tads as bollards seem more bone driven.

this ones screw lenght and width looks much more wider and longer than bollards screw lenght though. Thats why I said it might provide better anchorage then bollards but again I am not sure since there is a wide range available as I said... For higer force loading purposes of course...

 

[spark]

this ones screw lenght and width looks much more wider and longer than bollards screw lenght though. Thats why I said it might provide better anchorage then bollards but again I am not sure since there is a wide range available as I said... For higer force loading purposes of course...

In the pictures it looks like the bollards are much higher positioned and it's three screws.

 

[noprogressno]

Hmmm... I actually think the opposite. Now mandible will be something else as placing any sort of screw there must be harder but I wish that there was an x-ray of the first picture so that we could see where the screw was actually anchored onto. Also this type of screw has a long cylindrical part that is not a part of the anchorage for some reason, so deciding if anchorage is strong or not just by looking how long the external part looks wont be accurate. What matters is how much of the screw actually went into the bone

 

[spark]

Hmmm... I actually think the opposite. Now mandible will be something else as placing any sort of screw there must be harder but I wish that there was an x-ray of the first picture so that we could see where the screw was actually anchored onto. Also this type of screw has a long cylindrical part that is not a part of the anchorage for some reason, so deciding if anchorage is strong or not just by looking how long the external part looks wont be accurate. What matters is how much of the screw actually went into the bone

Btw you said only the front part moved forward but according to the diagram there is clearly forward movement at the back too

 

[noprogressno]

Btw you said only the front part moved forward but according to the diagram there is clearly forward movement at the back too
View attachment 1456360

I see it but it doesn't make sense to me. If the whole maxilla was moved forwards why are upper molars are still at the same place then? Because if the maxilla moved forwards they should move forwards alongside maxilla and palate as well?

 

[spark]

I see it but it doesn't make sense to me. If the whole maxilla was moved forwards why are upper molars are still at the same place then? Because if the maxilla moved forwards they should move forwards alongside maxilla and palate as well?

the whole picture is weird tbh ngl

 

[AscendingHero]

1988 jfl. Age makes all the difference man, BAMP or FM alone gives excellent results on children and even early teens. Give me a 7 year old and i'll turn him into a model.

What procedure/protocol would you do on a 7 y/o to turn him into a model?

 

[Anchor_Ship]

f

Bone protraction didn't happen... Its just tilting of teeth and some alveolar bone remodeling around the roots. Even the tracings show that... Blue markings are the before and the red markings are after, you can see how much the teeth has tilted. Exact same thing happens with camouflage treatment as well...
Yes the orthodontist is definetely delusional as there is no real skeletal ''movement'' or whatsoever in this case. Its not an incredibly uncommon thing with orthodontists... There are orthodontists who believe that AGGA works, there are orthodontists who believe that extraction and rectraction with braces on young patients doesn't affect facial profile and airway size, there is Mike Mew who believes that even adults can change their skeletal facial structure just by putting their tongue on their palate, having correct posture and breathing through nose etc... I am not shocked with this one, it happens all the time
At this point I am very sure that the sole reason why the computer simulation for the N2 implant showed real skeletal results was because of the amount of protraction force that was put onto actual bone thanks to that implant. Would it really stable as showed in the simulation or would it not, no one knows because there isn't a lot of detail about that study, its just 1 simulation after all. But what we know is that all the studies(including the very old ones) we have now, which actually achieved real skeletal results be it a simulation or an animal experiment, had one thing in common and that is the amount of force that was put onto bone
The N2 implant simulation put 2kg's of force in total onto the implant to achieve forward movement and ccw movement
Remember this monkey study(first picture)? a total of 1.2 kg of force was put onto the implants and with that they were able to achieve significant amount of forward growth in a matter of 4-5 months. And by significant I mean nearly a centimeter. Plus it was a real ''skeletal'' result, not just some bone remodeling around teeth roots(However the monkeys were young so thats not completely relevant. Had they been an adult they would need a much higher amount of force to achieve something like this which is also a +1 for my point again...)
Another monkey experiment. But this one wasn't bone borne however the animals were adults this time. Again by putting heavy forces they were able to achieve protraction on adult monkeys. However, as teeth was involved in it there were also significant dental changes as well which is not ideal.
Another thing that I will tell you is the amount of force palatal expanders put onto palate with each complete turn(mse is also a palatal expander so this one is important as the only thing we have right now that gives any ''real'' non-surgical skeletal results in adults is mse) This is from an article: ''RPE appliances require frequent activations and generate heavy forces―as much as 2-5 kg per quarter-turn with accumulated loads of more than 9 kg''. MSE puts all that force onto the bone itself without any force lost on teeth. I bet that is the reason why is is able to open the midpalatal suture. Now the other sutures of the skull are much more resistant and would probably require higher amounts of force for an adult to be able to get opened

Back onto the article you linked. Between 200-400 grams of force was put onto each side(as how it is normally with miniplates, you can't go higher than that otherwise they get loose, their anchorage is not that strong...). That equals to a total of 400-800 grams of force put onto maxilla. Thats not enough for an adult, obviously that is why there isn't significant movement of maxilla... In fact your tongue is capable of exerting 500 grams of force. So the same amount of force that was put onto the miniplates can be applied via tongue huh? But why do we see no results from any adult who is mewing then? Because first, that force is not enough to open any sutures including the midpalatal suture; second,the amount of remodeling that takes place on adult bones are not significant to correct an underlying skeletal issue and third, some real bone remodeling take place in adult bones too, but low forces are not enough to trigger that process for an adult significantly(if that was the case mewing would trigger that process as well...)
In fact the article you linked classifies the treatment as something in between camouflage and orthognatic surgery. ''...but decide not to undergo orthognathic surgery, despite being the ideal option, for different reasons explained above, we decided to devise an intermediate option between camouflage and orthognathic surgery''
I didn't make it up myself, the article that you linked says it...

So if at any point there will be a treatment that would be able to cause maxillary protraction for an adult would come from something that can stay stable under the same amount of forces MSE is able to withstand,. Because thats the amount of force that achieves sutural seperation. If we want to see a '' real'' non-surgical ''skeletal'' result, our best bet is sutural seperation, not some bone remodeling or alveolar bone remodeling...

(If you have a malloclusion that enables you to get this type of treatment I would say go for it. But personally I would never be satisfied with a nearly completely dental result like this one... My personal opinion only.)

really informative read

 

[Deleted member 17829]

1988 jfl. Age makes all the difference man, BAMP or FM alone gives excellent results on children and even early teens. Give me a 7 year old and i'll turn him into a model.

whats BAMP or FM?

 

[ChristianChad]

crowding of the wisdom teeth was solved due to transversal palatal expansion, not due to the ''protraction'' that you are talking about. If protraction was what fixed the crowding,the upper molars would moved alongside the maxilla as well. Upper molars didn't move a single bit, as you can see in the picture

well said brah