Diary of a palatal expander patient

[jfbjfb]

Damn so does widening the palate increases mouth width too(lips length)? I kinda have narrow lips.

I did not notice any significant improvement in this direction, although I had full lips from the start. If you want to change your lips I would say the way to proceed is by having soft tissue work as it is mostly not about the underlying bone.

What I did notice an improvement on is my side profile. The mandible seems to be rotating a bit and the chin becomes more defined. Still some more months to go before the open bite is fully solved.

 

[polishcel]

So I eventually got the palatal expander I had been long waiting for. The model is the so-called DS expander. It was custom-made from my CBCT scans and installed just today. I have been bleeding for hours, and so while I would like this thread to be a sophisticated one, I feel like I am too tired to write much.

View attachment 2286639

Things I am expecting:

- Move from a 30 mm IMW to 37.5 mm.
- Enhance the midface by making it wider, thus having a bizygomatic width that is larger than the bigonial width, and not the other way around as of now.
- Improve the undereye support thanks to the lateral expansion of the cheekbones.
- Wider smile, ideally it should be a 10-teeth smile.

I hope to update the forum regularly on the process, like showing the resulting diastema and what effects it has exerted on my face aesthetics. I will be taking any question you may have.

damn so did your palatal expansion with schwarz appliances fail or something? would you still recommend a toothborne expander for an adult?

 

[ABCDEFGHIJKLMNOP]

My chin is considerably recessed and I have a high gonial angle, I am not denying that. But strangely enough my maxilla is correctly projected. This same surgeon said he was not willing to give me more than 3 mm at max of lefort 1 because I did not need it.

Who was it? Alfaro? That's the only surgeon that really works with the Ortho that does the Power Xpander as far I know

 

[PrinceofDarkness]

did you notice asymmetry, or alar base getting wider? That issue comes from this type of procedure.

 

[jfbjfb]

damn so did your palatal expansion with schwarz appliances fail or something? would you still recommend a toothborne expander for an adult?

Kind of because I did not stick to it once the expansion was completed. That is, I should have left the appliance more time for the bone to fully solidify.

Anyway, the MSE or any kind of variation is superior to toothborne expanders.

 

[jfbjfb]

Who was it? Alfaro? That's the only surgeon that really works with the Ortho that does the Power Xpander as far I know

Someone who wrote his PhD thesis under Alfaro. But the ortho who treated me collaborates with another surgeon (kind of mediocre to say the least).

 

[jfbjfb]

did you notice asymmetry, or alar base getting wider? That issue comes from this type of procedure.

Not really. I had a bit of asymmetry before the treatment started, maybe 1 or 2 mm on my arch, relatively hard to notice for the untrained eye. It stayed the same after expansion. I think the planning is crucial here, as the expander was attached to the right spots and everything was carefully planned. The alar base had very minimal changes. When I was turning the expander I could notice my nose becoming a bit larger, but once the suture fused and the diastema disappeared, the change is imperceptible.

You are right on the fact that these are some of the potential drawbacks of MSE. Fortunately I was lucky and it turned alright.

 

[ABCDEFGHIJKLMNOP]

Someone who wrote his PhD thesis under Alfaro. But the ortho who treated me collaborates with another surgeon (kind of mediocre to say the least).

Got it.

How is the long term outcome. Ant noticeable alveolar or tooth degradation.

From reading your post it looks like Varelas BAME approach is to turn it as fast and aggressive as possible to overcome the suture and split effectively which isn't necessarily the healthiest thing for the roots and palate

 

[jfbjfb]

Got it.

How is the long term outcome. Ant noticeable alveolar or tooth degradation.

From reading your post it looks like Varelas BAME approach is to turn it as fast and aggressive as possible to overcome the suture and split effectively which isn't necessarily the healthiest thing for the roots and palate

I had my suture artificially split with a piezoelectric, so the speed is not that criticial. They told me we had 3 months to expand before the bone was fused.

Overall the process went smooth. No degradation afaik. I am now getting aligners to finish the treatment and hopefully by the time summer ends I can show you all the before and after of my palate

 

[ABCDEFGHIJKLMNOP]

I had my suture artificially split with a piezoelectric, so the speed is not that criticial. They told me we had 3 months to expand before the bone was fused.

Overall the process went smooth. No degradation afaik. I am now getting aligners to finish the treatment and hopefully by the time summer ends I can show you all the before and after of my palate

When you do before and afters ensure you get an updated CBCT so we can compare the ACTUAL skeletal expansion vs dental expansion

So many of these expansion devices claim to expand skeletally when they're really just pushing teeth outwards in the alveolus / tipping them as you see in so many MARPE cases

More importantly, it helps quantify what the rotation movement of the *zygomas* was - did they move up or did they move down. One is a looksmin the other a looksmax.

I don't think that's the case with this device but without an updated CBCT you can't quantify this, the airway change, any induced asymmetry at the maxilla level etc

Honestly, you could probably do it now. The aligners are just moving your teeth. The skeletal change at the mid face is already done (if there was any) and is quantifiable but cosmetic change isn't until aligners are done

Looking forward to the update before I do this myself