MSE or MARPE

[yorker12]

I was under the impression that I would be getting MSE or something similar, but today I found out that I will be getting an 12mm MARPE appliance and the expander will be using 2 micro implants(like MSE, but MSE has 4 screws and bicortical engagement) and I do not know if they plan on drilling the screws deep enough for bicortical engagement.

Should I try to push for MSE?

I will write my surgeon an email asking the details, maybe there was a specific reason they went marpe/sarpe route instead of MSE.
But the best part is that the surgeon is on vacation till the 10th of July, but my surgery date is planned on the 15th JFL.

What are your thoughts on SARPE vs MARPE vs MSE?

Both the orthodontist and maxfac have PhD's, teach lectures in med school, seem pretty knowlegeable about modern techniques and the before/afters I have seen are pretty good, which is why I am surprised they do not know about or do not work with Won Moon MSE.

In the end, if the surgeons want to stay on the current plan, should I go with it or are there some big drawbacks with sarpe/marpe which would make it worth it to do MSE instead?

In Europe btw.

 

[Deleted member 3990]

SARPE is bollocks

MSE is a bit more modified MARPE
MARPE is Mini-implant assisted rapid palatal expander

 

[yorker12]

SARPE is bollocks

MSE is a bit more modified MARPE
MARPE is Mini-implant assisted rapid palatal expander

Yep, first they wanted to do SARPE, then I talked to them about MSE and they agreed that bone borne expansion is better.
The thing I will try to find out is how the surgeon wants to do the cuts. Either LeFort type SARPE cuts or coricotomies/cortipunctures. The ortho said that with this expander a non surgical approach most likely wont work at my age.

 

[Deleted member 3990]

Yep, first they wanted to do SARPE, then I talked to them about MSE and they agreed that bone borne expansion is better.
The thing I will try to find out is how the surgeon wants to do the cuts. Either LeFort type SARPE cuts or coricotomies/cortipunctures. The ortho said that with this expander a non surgical approach most likely wont work at my age.

SARPE is LeFort1 tier downtime and risk but doesnt reap as much positive results than a LeFort1

and on the other hand, I argue that MSE should be publicly free for everyone

 

[Sergio-OMS]

4 bicortical screws are far better. And sometimes the appliance can be modified to use more screws, if considered.

Doing the horizontal cut isolates the bone under the cut, meaning no changes are produced above the cut. This can be a good thing in opinion of some surgeons, and a bad thing in opinion of others.

I do a vertical cut + cortipunctures and it works well, although I don’t know how stable are the results.

 

[yorker12]

4 bicortical screws are far better. And sometimes the appliance can be modified to use more screws, if considered.

Doing the horizontal cut isolates the bone under the cut, meaning no changes are produced above the cut. This can be a good thing in opinion of some surgeons, and a bad thing in opinion of others.

I do a vertical cut + cortipunctures and it works well, although I don’t know how stable are the results.

Yeah, from what I read, bicortical implants were far better, safer, had less of a chance fracturing the bone and less bending force on screws.

What do you mean by vertical cut + cortipunctures? Do you not cut fully through the palate, where are the cortipunctures performed?

I was under the impression that the horizontal cut was for safety, because the old method was only a vertical cut, but apparently it can lead to complications or the skull fracturing from the forces.

If they do not want to do MSE, would MARPE + vertical cut + cortipunctures achieve the closest to MSE midfacial expansion and potentially zygo expansion?

 

[spark]

4 bicortical screws are far better. And sometimes the appliance can be modified to use more screws, if considered.

Doing the horizontal cut isolates the bone under the cut, meaning no changes are produced above the cut. This can be a good thing in opinion of some surgeons, and a bad thing in opinion of others.

I do a vertical cut + cortipunctures and it works well, although I don’t know how stable are the results.

What do you think of IMDO as a modern way of doing a lower jaw surgery?

 

[000]

I was under the impression that I would be getting MSE or something similar, but today I found out that I will be getting an 12mm MARPE appliance and the expander will be using 2 micro implants(like MSE, but MSE has 4 screws and bicortical engagement) and I do not know if they plan on drilling the screws deep enough for bicortical engagement.

Should I try to push for MSE?

I will write my surgeon an email asking the details, maybe there was a specific reason they went marpe/sarpe route instead of MSE.
But the best part is that the surgeon is on vacation till the 10th of July, but my surgery date is planned on the 15th JFL.

What are your thoughts on SARPE vs MARPE vs MSE?

Both the orthodontist and maxfac have PhD's, teach lectures in med school, seem pretty knowlegeable about modern techniques and the before/afters I have seen are pretty good, which is why I am surprised they do not know about or do not work with Won Moon MSE.

In the end, if the surgeons want to stay on the current plan, should I go with it or are there some big drawbacks with sarpe/marpe which would make it worth it to do MSE instead?

In Europe btw.

Push for MSE

 

[Sergio-OMS]

What do you think of IMDO as a modern way of doing a lower jaw surgery?

I love IMDO, it’s the best way to treat a small lower jaw, as it enlarges it in every dimension. But I must admit I’m biased, I learnt it from Paul Coceancig and became friends after that.

It has some cons, though. It’s really designed for teenagers, although adults up to 35-40 can be treated at the risk of needing a conventional orthognathic surgery after IMDO to be able to finish the case with a correct occlusion.

I recommend IMDO instead of BSSO in every patient under 25 with a small mandible

 

[MentalistKebab]

I love IMDO, it’s the best way to treat a small lower jaw, as it enlarges it in every dimension. But I must admit I’m biased, I learnt it from Paul Coceancig and became friends after that.

It has some cons, though. It’s really designed for teenagers, although adults up to 35-40 can be treated at the risk of needing a conventional orthognathic surgery after IMDO to be able to finish the case with a correct occlusion.

I recommend IMDO instead of BSSO in every patient under 25 with a small mandible

Seems interesting. Can it be used as an alternative to BSSO after LF1 ? You know, an alternative way for double jaw surgery

 

[hopelessphoenix]

I love IMDO, it’s the best way to treat a small lower jaw, as it enlarges it in every dimension. But I must admit I’m biased, I learnt it from Paul Coceancig and became friends after that.

It has some cons, though. It’s really designed for teenagers, although adults up to 35-40 can be treated at the risk of needing a conventional orthognathic surgery after IMDO to be able to finish the case with a correct occlusion.

I recommend IMDO instead of BSSO in every patient under 25 with a small mandible

Can you do IMDO and Lefort1 at the same time?

 

[Sergio-OMS]

Can you do IMDO and Lefort1 at the same time?

Yes

 

[Sergio-OMS]

Seems interesting. Can it be used as an alternative to BSSO after LF1 ? You know, an alternative way for double jaw surgery

Yes, or simultaneously.

 

[Sergio-OMS]

Yes, or simultaneously.

I meant simultaneously to a Le Fort I.

 

[Incoming]

Yes, or simultaneously.

Can I pm you?

 

[Sergio-OMS]

Can I pm you?

Sure

 

[Sergio-OMS]

If they do not want to do MSE, would MARPE + vertical cut + cortipunctures achieve the closest to MSE midfacial expansion and potentially zygo expansion?

MSE is a type of MARPE.

 

[ChristianChad]

I love IMDO, it’s the best way to treat a small lower jaw, as it enlarges it in every dimension. But I must admit I’m biased, I learnt it from Paul Coceancig and became friends after that.

It has some cons, though. It’s really designed for teenagers, although adults up to 35-40 can be treated at the risk of needing a conventional orthognathic surgery after IMDO to be able to finish the case with a correct occlusion.

I recommend IMDO instead of BSSO in every patient under 25 with a small mandible

Big if true

 

[ChristianChad]

SARPE is bollocks

MSE is a bit more modified MARPE
MARPE is Mini-implant assisted rapid palatal expander

Why is SARPE bollocks?

 

[CLO1]

Will MSE work for somebody that's 33 years old or would the results be minimal and not worth it?