New MSE paper

[Deleted member 4790]

Welp.

Yep.

if your maxilla is short and narrow and your teeth are crowded, it’s a good treatment to start with.

if you are biretruded then a bimax is better, or custom made (CAD-CAM) PEEK implants it’s a small correction (so it doesn’t look unnatural).

 

[Deleted member 3020]

Yep.

if your maxilla is short and narrow and your teeth are crowded, it’s a good treatment to start with.

if you are biretruded then a bimax is better, or custom made (CAD-CAM) PEEK implants it’s a small correction (so it doesn’t look unnatural).

Well I already am going under treatment for $6.7k on July 27. I expected MSE/FM to protract both my jaws, and actually that’s my main thing I need. I also had consideration about bimax surgery, but it was too expensive.

I guess I kinda did wishful thinking and thought the mandible would follow after FM protraction and I actually emailed Dr Richard Ting about this too.

He said it would follow. Are you a 100% sure it doesn’t?
I would also be facepulling upward, so the maxilla might translate upward, not sure if that does any forward movement to the mandible.
I’m going to get MSE anyway, maybe I might facepull still and get IMDO in the future? Or not facepull at all.
My orthodontist has also mentioned I do have bimax protrusion, and overprotruding my jaws might give me a bad lip seal and I end up with mentalis strain.

 

[Deleted member 4790]

Well I already am going under treatment for $6.7k on July 27. I expected MSE/FM to protract both my jaws, and actually that’s my main thing I need. I also had consideration about bimax surgery, but it was too expensive.

I guess I kinda did wishful thinking and thought the mandible would follow after FM protraction and I actually emailed Dr Richard Ting about this too.

View attachment 528431 View attachment 528432


He said it would follow. Are you a 100% sure it doesn’t?
I would also be facepulling upward, so the maxilla might translate upward, not sure if that does any forward movement to the mandible.
I’m going to get MSE anyway, maybe I might facepull still and get IMDO in the future? Or not facepull at all.
My orthodontist has also mentioned I do have bimax protrusion, and overprotruding my jaws might give me a bad lip seal and I end up with mentalis strain.

oh, “following” is such an inaccurate term that we might be referring to different things.

and it really depends on your previous situation, wether your mandible is “trapped” or not

 

[Deleted member 3020]

oh, “following” is such an inaccurate term that we might be referring to different things.

and it really depends on your previous situation, wether your mandible is “trapped” or not

That is true. My old ortho place doesn’t wanna send me the CBCT X-ray scans so I can’t see if my maxilla is clockwise rotated.
So it would follow if the maxilla isn’t clockwise rotated and has the mandible pushed back?

 

[Deleted member 4790]

Oh I just saw your msg with Dr. ting (screenshooting and publishing isn’t nice, by the way) and, as I though, I was referring to a different thing. So we both are correct.

“Moving forward” the lower jaw in this technique is by autorotation, after intrusion of posterior teeth (molars), thus shortening your face a bit. There is not much wiggle room for this effect (I mean it’s not very noticeable)

But as long as the TMJs stay in the correct position, everything would be fine and won’t work against a posterior orthognathic surgery.

But if you manage to protract your midface significantly you’ll need mandibular surgery. Or if you don’t feel like shortening (vertically) your lower third. Maybe the best approach is to actually extrude posterior upper molars and plan for a mandibular surgery from the very beginning to really advance the mandible ?. That would be up to you, of course, but would be needed to be planned beforehand.

 

[Deleted member 4301]

it’s a good procedure to expand the upper jaw and nasal passage (and even the rest of the midface, a bit). But only if needed of course.

it changes the bite, obviously.

I've read a study where the changes in bi-zygomatic width were about 5%, mean age of participants was 21.

Would you say that the changes in bi-zygomatic width are noticeable?

 

[Deleted member 4790]

I've read a study where the changes in bi-zygomatic width were about 5%, mean age of participants was 21.

Would you say that the changes in bi-zygomatic width are noticeable?

A bit, depending on the amount of expansion at the palate, which is limited by the bite.

You can guess more or less the amount of expansion at the zygoma with the angular data of the article I posted.

 

[spark]

Just a feeling. But that’s the correct way to think unless proven otherwise, isn’t it? At least considering the current knowledge.

Of course, people are free to keep some magical thinking.

But didn't this woman have a clear CCW rotation caused by the crane facemask?

403 Forbidden

Or do you think it's just a fake?

 

[Deleted member 5385]

But didn't this woman have a clear CCW rotation caused by the crane facemask?

403 Forbidden

Or do you think it's just a fake?

Does her lateral orbital change shape or its just different angle. But yeah ccw rotation of chin etc lower maxilla. Great

 

[Deleted member 4790]

But didn't this woman have a clear CCW rotation caused by the crane facemask?

403 Forbidden

Or do you think it's just a fake?

I can't tell, I can't compare those images.

 

[spark]

I can't tell, I can't compare those images.

How can't they be compared, there is a clear rotation:

 

[Deleted member 3020]

Oh I just saw your msg with Dr. ting (screenshooting and publishing isn’t nice, by the way) and, as I though, I was referring to a different thing. So we both are correct.

“Moving forward” the lower jaw in this technique is by autorotation, after intrusion of posterior teeth (molars), thus shortening your face a bit. There is not much wiggle room for this effect (I mean it’s not very noticeable)

But as long as the TMJs stay in the correct position, everything would be fine and won’t work against a posterior orthognathic surgery.

But if you manage to protract your midface significantly you’ll need mandibular surgery. Or if you don’t feel like shortening (vertically) your lower third. Maybe the best approach is to actually extrude posterior upper molars and plan for a mandibular surgery from the very beginning to really advance the mandible ?. That would be up to you, of course, but would be needed to be planned beforehand.

My brain hurts

 

[Deleted member 4790]

How can't they be compared, there is a clear rotation:
View attachment 530289View attachment 530290

Yes, even in the upper part of the CBCT reconstruction.

 

[spark]

Yes, even in the upper part of the CBCT reconstruction.

You are right... Seems like a different posture. Can something be read out of this or not?

 

[Deleted member 4790]

You are right... Seems like a different posture. Can something be read out of this or not?
View attachment 530401
View attachment 530402

Not really. These can be easily mistraced (misdrawn?) and I even recall having seen one paper published in a supposedly prestigious journal of orthodontics that presented these before and after cephalometric tracings clearly manipulated. Since that I no longer trust these tracings.