So what is the correct Forward Pulling angle with a MSE/MARPE after all?

[thetaflow]

Hi everyone,

I am currently going through alt-ramec with my MARPE, and am trying to maximize protraction via the Bow puller (i've modified it).

I saw most of the the papers on the topic, Won Moon's simulation, etc. - some conclude that +30° is the way to go, which I've tried, and ended up intruding my premolars on one side, which are connected.

The problem here, is that they use 2 single metal implants in the simulation, which gives a specific point which they're pulling from.

In my case, I've got 6 screws in my palate, and 4 teeth connected in bands - 4 screws just behind canines, and 2 more at molars - this gives a somewhat complicated force distribution, and it's not 100% clear how it affects the maxilla with this setup.

Just recently, I had a breakthrough by trying a different angle, and my mandible 100% came forward some (Yes it's possible at 31, it's not cope, better believe it. I'll make a whole other post with before/after pics once I'm through these testing grounds and maximize my results, but I need some ideas in the meantime). The issue is, one of my attachments broke off, so now I'm anchoring behind the back molars, and it certainly changes the force dynamics some, as the attachments themselves were acting as levers, and putting rotational force on the molars, which then got distributed to the rest of the device, and then maxilla. Now, I've eliminated this variable, and have to make sure to pull correctly.

I read some really old comments in threads, of certain nerds on here figuring out the correct pulling angle etc, but I couldn't always find the details. So please, tag, link, comment, as to what you know - this topic is very much alive and will be lifefuel for many. I think of this community when I pull daily, and use all of the mods and tricks to make it work - I will come back and share what I've learned when I've final results (perfect angles, none of that lens distortion shit). I don't have all of the answers and issues ironed out, but I promise I'm working on them, so just help me get clear with the angle for now, and the other details I'll share after.

Respons, thnx

 

[Deleted member 17429]

(Yes it's possible at 31, it's not cope, better believe it. I'll make a whole other post with before/after pics once I'm through these testing grounds and maximize my results, but I need some ideas in the meantime).

placebo

 

[Mongrelcel]

only real data we have is from the simulation in the study, but MSE doesent make it possible to pull at an angle so positive

 

[thetaflow]

only real data we have is from the simulation in the study, but MSE doesent make it possible to pull at an angle so positive

Yes the fulcrum point of the force is different, because it's positioned much further back than what they used in the anterior palate in the study.

Having said that, -15° also produced CCW rotation and protraction. I keep thinking of the idea that most of the sutures do indeed grow downward, and if we think of the maxilla that pivots at the top of the head as it opens, maybe to get that swing, indeed a downward and forward pulling force is needed? I've seen it on these forums.

 

[Tasty17]

 

[ascension!]

@Silver

 

[Deleted member 19064]

damon braces > invisalign > normal braces

I've been researching non-stop as i'm looking to fix my diestema. Basically, out of all the ortho procedures you can get to fix teeth(excluding MSE, palate expander), damon beats them all. Damon Braces push teeth from both side, is faster, more...

looksmax.org

Just made a post about this in this thread

 

[ascension!]

 

[mvp2v1]

placebo

Your a cockaroach that needs to be squashed.

 

[thetaflow]

damon braces > invisalign > normal braces

I've been researching non-stop as i'm looking to fix my diestema. Basically, out of all the ortho procedures you can get to fix teeth(excluding MSE, palate expander), damon beats them all. Damon Braces push teeth from both side, is faster, more...

looksmax.org

Just made a post about this in this thread

Thanks for this post, I seem to follow your line of thought. What angle are you more specifically thinking/have used? I personally think a bit below the occlusal plane might be optimal. Wasn't there some based poster on here a few years back, maybe "retard", who deducted that +15 was optimal? I've only seen someone mention it in a comment, not his original post/reasoning.

 

[thetaflow]

Your a cockaroach that needs to be squashed.

Results speak for themselves - this was not that kind of post, so he can talk all he wants.

 

[thetaflow]

damon braces > invisalign > normal braces

I've been researching non-stop as i'm looking to fix my diestema. Basically, out of all the ortho procedures you can get to fix teeth(excluding MSE, palate expander), damon beats them all. Damon Braces push teeth from both side, is faster, more...

looksmax.org

Just made a post about this in this thread

You also mention Mike Mew, and his inability to fully explain himself. Most if not all of those who've gotten great results through mewing recommend pressing upward on the back of the palate. Wouldn't that be the opposite of pulling down? I feel like I'm missing something.

 

[thetaflow]

Here Mike Mew mentions his earlier headpulling contraption having a net force vector of around +40. (timestamped)



Thoughts?

 

[ChristianChad]

Another @Scar tissue alt added to the list

 

[noprogressno]

Hi everyone,

I am currently going through alt-ramec with my MARPE, and am trying to maximize protraction via the Bow puller (i've modified it).

I saw most of the the papers on the topic, Won Moon's simulation, etc. - some conclude that +30° is the way to go, which I've tried, and ended up intruding my premolars on one side, which are connected.

The problem here, is that they use 2 single metal implants in the simulation, which gives a specific point which they're pulling from.

In my case, I've got 6 screws in my palate, and 4 teeth connected in bands - 4 screws just behind canines, and 2 more at molars - this gives a somewhat complicated force distribution, and it's not 100% clear how it affects the maxilla with this setup.

Just recently, I had a breakthrough by trying a different angle, and my mandible 100% came forward some (Yes it's possible at 31, it's not cope, better believe it. I'll make a whole other post with before/after pics once I'm through these testing grounds and maximize my results, but I need some ideas in the meantime). The issue is, one of my attachments broke off, so now I'm anchoring behind the back molars, and it certainly changes the force dynamics some, as the attachments themselves were acting as levers, and putting rotational force on the molars, which then got distributed to the rest of the device, and then maxilla. Now, I've eliminated this variable, and have to make sure to pull correctly.

I read some really old comments in threads, of certain nerds on here figuring out the correct pulling angle etc, but I couldn't always find the details. So please, tag, link, comment, as to what you know - this topic is very much alive and will be lifefuel for many. I think of this community when I pull daily, and use all of the mods and tricks to make it work - I will come back and share what I've learned when I've final results (perfect angles, none of that lens distortion shit). I don't have all of the answers and issues ironed out, but I promise I'm working on them, so just help me get clear with the angle for now, and the other details I'll share after.

Respons, thnx

Does your appliance have 6 screws? Can you show us a photo of it?

 

[thetaflow]

Does your appliance have 6 screws? Can you show us a photo of it?

Sure. Yes, 4 front, 2 back. You can see the spot in the middle where the MSE was initially installed, because of tipping before a confirmed split, it was decided to reverse turns, and use this custom MARPE instead. This device split the suture in the first 24 hours. (Yes the back screws are staggered purposely).

But in terms of pulling, you can also see that there is a distributed amount of contact with the maxilla, therefore I'm wondering what the most optimal pulling angle would be.

 

[noprogressno]

Sure. Yes, 4 front, 2 back. You can see the spot in the middle where the MSE was initially installed, because of tipping before a confirmed split, it was decided to reverse turns, and use this custom MARPE instead. This device split the suture in the first 24 hours. (Yes the back screws are staggered purposely).

But in terms of pulling, you can also see that there is a distributed amount of contact with the maxilla, therefore I'm wondering what the most optimal pulling angle would be.
View attachment 1891197

Who installed you this?

 

[thetaflow]

Who installed you this?

I'll speak with my provider about posting his name on forums when I get a chance, but he's done training with both Richard Ting and Ilya Lipkin.