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DNA Appliance Thread  

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toomer
Estimable Member
Posted by: @thesnari

Why the homeoblock over the DNA if I may ask? (Belfor over Singh)

Either appliance is potentially very useful for a lot of similar cases.  They are actually covered under the same joint patent that Drs. Belfor (lead) and Singh (co-author) filed back in 2004.  The implementation styles are slightly different, but there are far more similarities mostly.

Probably the biggest difference is that Dr. Belfor seemed very very focused overall on facial asymmetry, and so he was a big advocate of an occlusal bite block only on one side of the appliance.  He believes that stimulates the deficient side a little bit better.

Dr. Singh was very focused on airways and airway improvements - so he was more of an advocate of having occlusal bite blocks on both sides.  Maybe because he wanted to target the center of the body a little bit more than one side or another.  However, that's not to say that DNA won't help correct some problems with asymmetry too.

Beyond that, it starts to get much less significant in terms of differences - I believe for Homeoblock it typically only has 5 axial springs in the front (the front two incisors share the same spring) whereas DNA has six.  Not a huge difference.

And the treatment protocol should probably be identical with both - same expansion schedules, same grinding it down to make sure the acrylic is not making contact with the roof of the mouth so that the palate has room to drop down, etc.

I'd say if it was a tossup between the two ... maybe do a home sleep test and see if you have sleep apnea.  If you do, maybe lean a bit more towards DNA.  If you don't then give Homeoblock a shot ... but all of that should be secondary towards your comfort level with a provider.  Even though I am a sleep apnea case, I would absolutely lean more towards a rockstar Homeoblock provider that had turned their entire practice over to airway ... over a DNA provider that seemed like they were flying by the seat of their pants, and it was just a secondary treatment in addition to all the cleanings, whitening, etc. typical dental services they do.

Hope that helps!  You could also read this great post by @greyham here on the forums - he does a deep dive on everything: https://cfs-survivors.org/blog/2020/10/27/why-i-chose-dna-over-homeoblock-mse-dome-mma-and-agga/

 

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Posted : 10/12/2020 11:28 am
skinny7 liked
thesnari
New Member

@toomer I see, thank you for your in depth response!

I actually got in touch with Dr Belfor and he (or one of his team) gave me a referral to the only practitioner who has be trained by Dr Belfor. in the UK

These are the details:

- Dr Imran Rangzeb 

http://www.townhalldental.co.uk/&source=gmail&ust=1607593856064000&usg=AFQjCNGF-4l8grYb4psFxxOo5MylU1pth w">www.townhalldental.co.uk

I already sent an email over asking to speak directly with the Dr so I will see what happens, but I'd like to hear your take on their website 

It doesn't mention Homeoblock anywhere as far as I know and like you mentioned they seem to be focused on traditional dentistry so that's why I'm keen to see what you think of them.

What would you say are the most important factors when telling the difference between a good and bad practitioner?

Also, I have read that mans blog and it is fascinating. 

Cheers. 

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Posted : 10/12/2020 1:50 pm
toomer
Estimable Member

@thesnari Not really a whole lot I can discern from that web page, unfortunately.  Looks like a standard multiple-services dentist, who is adding in a few more treatments here and there.  So I guess the question is whether he's done 1 Homeoblock ... or 100 ... there would just be no way for you to know.

Unfortunately in the UK I am not sure there are any Vivos-trained providers currently ... so Homeoblock might be your only choice.

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Posted : 10/12/2020 5:39 pm
thesnari
New Member

@toomer They don't have to be in the UK necessarily. Anywhere in Europe is ideal honestly. 

 

I guess I'll speak to the guy who was supposedly trained by Dr Belfor and see what he says. 

 

One issue for me is that I'm sure my wisdom teeth are coming in. Would the Homeoblock/DNA be able to make enough room for them? I'd rather not have to extract them. 

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Posted : 10/12/2020 6:40 pm
toomer
Estimable Member

@thesnari It has happened to at least one Vivos DNA/MRNA patient who I think was about 30 years old that I have spoken with - they ended up having 2 wisdom teeth come in ... 1 upper, 1 lower, and on different sides!  So, it might help.  Generally more jaw space should be better for them.

I am several decades older than you, and I still have all my original wisdom teeth ... I resisted the calls of dentists for decades telling me I absolutely positively had to get them taken out.  Unless they are intruding on the roots of the 2nd molars (and thus putting the health of those at risk) I think it's better to leave them in.   But I'm not a medical or dental professional.

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Posted : 10/12/2020 8:16 pm
Owp99
Active Member

So the last time I posted was about two months ago, and I figured I should share some of my progress since then, as I visited my dentist for the first time in multiple months. I’ve been wearing the appliance for roughly 5 1/2 months now, and in that time I have seen roughly 5 MM of expansion of my IMW. More impressive than that however was the expansion of my airway. According to CT scans taken, the volume of my airway has increased 10ccs. Now I’m not sure exactly what that means, but my dentist was shocked and said she hadn’t seen anything like it. 

In terms of changes I’ve noticed myself, I think my face is still asymmetrical, although it was never too terribly asymmetrical, I’m not certain that the appliance has helped improve that much. My sleep has improved - I had extremely mild sleep apnea according to the sleep test I took before getting the appliance, which I guess could best be exemplified by my constant waking up still feeling tired and groggy. That is not an issue anymore.

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Posted : 18/12/2020 5:51 pm
aleksandr444200
Active Member

Small update from me - i'm a month into my upper DNA appliance, having done 4 turns (1mm) width wise and 2 (0.5mm) front.

I think I need less frontal expansion and more width expansion, so I might even just stop at 1 or 2mm for the front turns.

Its been very easy - very little pain, just my teeth are a bit sore. More so after the turn. I've been wearing it while I sleep (8-10hrs) and on and off a few more hours during the day, trying to get the 12-16hrs a day down.

I talked about getting a lower appliance with my orthodontist too, but he said to expand the top first. Because the bottom jaw doesn't have a suture, what is the lower appliance doing? is it just tipping teeth?

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Posted : 18/12/2020 11:29 pm
toomer
Estimable Member

@aleksandr444200 Thanks for the update!

In regards to the teeth being a bit sore, make sure you keep to the proscribed wear time / turn schedule guidance!  One of the things Vivos trains their doctors to be careful about, is patients that slip into a "mostly just overnight" wear time ... so they only do 8-10 hours a day, but then still advance the screw on the same 5-7 day schedule (as if they were getting 14-16) because they still want to get done with their treatment on the same schedule.  That seems to increase the chances of problems happening.

You could also look into more in-and-out time during the day.  If you look over on @greyham's blog - he's got a link to a video recorded by Dr. Ben Miraglia who treats patients, and he said that the alternate cycling of in-and-out time is what really makes a difference in terms of bone growth and development.

As for the bottom appliance, I too don't understand the mechanics on that.  If you watch the Thomas Colquette Homeoblock video on YouTube (search for it with those 3 words) and go the to the point where he shows the time lapse photos ... it absolutely looks like the entire mandible is getting larger.  These were professionally done photos by an orthodontist colleague of his (Dr. Colquette is a restoration dentist) who did a full set of intra-oral photos ever 3 months over an 18-month timespan.  It's amazing to watch in its time lapsed view - you'd swear the jaw itself is getting bigger and the teeth are "just going along for the ride" (as Dr. Belfor and Dr. Singh have both said before).

 

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Posted : 21/12/2020 10:55 am
toomer
Estimable Member

@owp99 Thanks for the update!  In addition to lateral expansion, are you also turning the forward expansion screw?  (assuming your DNA has one, sometimes they don't depending on the patient case)

What was your AHI on your pre-treatment sleep test, and is your provider going to set you up with another sleep test at some point to confirm that you have cured your sleep apnea?

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Posted : 21/12/2020 10:57 am
Owp99
Active Member

@toomer

I believe my AHI was somewhere in the range of 5-6 AHI - it was extremely, extremely mild sleep apnea. I am fairly certain they will have me take another sleep test at the end of my treatment, I’m just not sure when that will be. 

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Posted : 05/01/2021 6:34 pm
Thomas22
Estimable Member

When I started treatment I felt pressure on my nose bridge. I still feel that when I wear the appliance, but I’m also feeling pressure along the lower orbit of the eye socket now. 

 

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Posted : 16/01/2021 12:32 pm
toomer
Estimable Member
Posted by: @thomas22

When I started treatment I felt pressure on my nose bridge. I still feel that when I wear the appliance, but I’m also feeling pressure along the lower orbit of the eye socket now. 

 

Can you describe the pressure?  Does it feel like it's stretching "outward" or anything?

Interesting to feel pressure along the eye socket too.  All interesting signs of lateral expansion taking place.

How much have you expanded the appliance by now?

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Posted : 16/01/2021 9:27 pm
Thomas22
Estimable Member

@toomer Let me see if I have a measuring tape. 

It feels like compression.

I passed my one year mark. But with everything, I’m probably at the six month mark, minus not wearing the lower. 

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Posted : 17/01/2021 12:30 pm
Thomas22
Estimable Member

@toomer potentially 2mm, I would need to wind it back all the way to see. 

As far as the pressure goes, it’s one sided. I feel it on my left, but not on  my right. And it runs up into the TMJ. 

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Posted : 17/01/2021 7:31 pm
Thomas22
Estimable Member

https://www.youtube.com/watch?v=qkATISIKQCQ

 

This provider has his adult patients on a two week expansion cycle, and cautions that the lower appliance might need to be expanded even more slowly.

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Posted : 20/01/2021 12:59 am
toomer
Estimable Member

@thomas22

The two week cycle seems to pair with the lower daily wear time he advocates - 10-12 hours a day.

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Posted : 20/01/2021 5:13 pm
Thomas22
Estimable Member

My nose opens up when I wear the appliance in the evening. 

I have no idea what's going on, but it is much easier to breathe through my nose when I'm wearing it. Dramatic difference.

I continue to feel noticeable pressure in my face. Especially in my nose, running down the ridge into the cartilage.

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Posted : 23/01/2021 8:20 pm
Thomas22
Estimable Member

One theory?

Maybe my septum is straightening out. Perhaps the pressure from the appliance moves things, just enough, so that it starts to straighten out.

 

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Posted : 23/01/2021 10:12 pm
toomer
Estimable Member
Posted by: @thomas22

My nose opens up when I wear the appliance in the evening. 

You're making me really look forward to getting mine.  Nasal airflow is a major problem for me - and it's gotten worse in the last half of this past year it feels like.  I need something to make a difference, and soon.

Does that feeling start immediately, or within a few minutes?  Do you get that sensation even when you're on the tail end of an expansion turn, so like 4-5-6 days in and you're just about to turn again ... but you still detect a noticeable change once it's in?  Or do you only get it after an expansion cycle?

I'm hoping you say the former rather than the latter, because my provider wants me in a straight saggital Schwartz first for 2-3 months to "bump out the front" a little bit, before we switch over to DNA and we can work on forward and lateral expansion.  Extremely annoyed and frustrated with my provider, but it's his process and he's been doing it for a decade so I kind of have to see it through.  But I'm hoping the forward expansion, plus the swallow action creating the negative pressure against the palate, might be what does the trick.

Maybe my septum is straightening out. Perhaps the pressure from the appliance moves things, just enough, so that it starts to straighten out.

That would be an ideal outcome.  After all, if you think about it, if your maxilla is remodeling slightly downward and your palate is dropping, the maxilla is directly connected to the septum (through the maxillary crest) so you'd think it naturally would pull it a bit straight?  I've also read that cartilage has a bit of "memory" to it, so if it wasn't always deviated ... maybe it wants to go back to being slightly straighter.

However, I have a good contact who is a Homeoblock provider in my area, and she said that at my age (past my 40's) I shouldn't expect any straightening of my septum from a DNA or Homeoblock.  My deviation is "mild" (according to 2 dentists and 2 ENTs) so I guess that's not too bad.  But still, I'll take every fraction of a millimeter I can get.

One other question - were you one of the people who gets a small diastema that appears between your front teeth sometimes after activations?  Some patients report that result, others don't.  I have a theory that patients with sutures that are less fully fused (so, younger, and also female) might be more likely to have that kind of result which would seem to indicate some amount of expansion at the suture, whereas other patients might be getting predominantly alveolar expansion and unlikely to see that happen.

 

 

 

 

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Posted : 25/01/2021 4:07 pm
Thomas22
Estimable Member
Posted by: @toomer

Does that feeling start immediately, or within a few minutes?  

Within the first hour.

It's a recent development.

Posted by: @toomer

However, I have a good contact who is a Homeoblock provider in my area, and she said that at my age (past my 40's) I shouldn't expect any straightening of my septum from a DNA or Homeoblock.  My deviation is "mild" (according to 2 dentists and 2 ENTs) so I guess that's not too bad.  But still, I'll take every fraction of a millimeter I can get.

Have you considered surgery, when you finish treatment?

 

Posted by: @toomer

One other question - were you one of the people who gets a small diastema that appears between your front teeth sometimes after activations?  Some patients report that result, others don't.

I have a diastema

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Posted : 26/01/2021 12:02 am
Thomas22
Estimable Member

Stray observation

The fins on the DNA Appliance hold your jaw forward, but they also rotate it. 

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Posted : 26/01/2021 12:05 am
toomer
Estimable Member
Posted by: @thomas22

Within the first hour.

It's a recent development.

Have you considered surgery, when you finish treatment?

Interesting.  Now, you had noted before that overall your breathing was better - or at least your sense of smell had gotten better.  So this is in addition to the other benefits you feel you've received?

Is it every day when you put it in, or mostly only the day when you do an activation?  Dr. Singh - in one of his lectures - does talk about "proprioception" in the oral cavity, which is why you don't constantly chew your own tongue while eating - your teeth and tongue and everything else just kind of knows or "senses" where everything else is at.  So when you've got a big old acrylic appliance in there, which is spaced off of your palate just a bit ... your body is maybe perceiving that it's your tongue, and it's widening the teeth and maxilla out ... which gives a sensation of better breathing.

Yes, I absolutely have considered some nasal surgery at the end of this, and pretty much assume I'll probably get some work done.  Overall, it looks like I'm going to be working on my "upper airway" in thirds.  The lowest part (throat), we've improved through the use of the bite splint my provider started me off with - my mandible is no longer back in my throat due to my TMJs being out of position.  So that was stage one.  Stage two - once we start with the maxillary appliances in the next couple weeks - will hopefully help address the "middle third" of my airway over the next 12 months.  And depending on how things end up at the end of that, yes ... I have considered surgery for the "upper third" of my upper airway as well - the nasal cavity.  

After all is said and done, I should hopefully have the most open airway possible (for me and my genetic ability) from my nostrils down to the bottom of my throat.

 

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Posted : 26/01/2021 10:11 am
Thomas22 liked
toomer
Estimable Member
Posted by: @thomas22

The fins on the DNA Appliance hold your jaw forward, but they also rotate it. 

By fins, do you mean the occlusal overlays between your posterior teeth?

How do you think they "rotate" it?  Obviously, "counter-clockwise rotation" of the maxilla (as you might depict it looking at a x-ray or ceph taken from your right side) is key for a lot of us considering this procedure - and a bit of a "holy grail" to hope to achieve.  I had always assumed that any rotation was coming from the "negative pressure" created between the appliance and the palate when you swallow ... as that's kind of what Belfor and Singh described in their patent.  But it would be interesting to ponder whether the occlusal overlay is contributing to that as well - and if so, how do you think so?

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Posted : 26/01/2021 10:14 am
Thomas22
Estimable Member

@toomer

 Yes

 This will take some visual thinking to imagine.

 I have a cross bite, my jaws are at an angle to each other, so if the fins are adjusted equally, only one fin will be in contact with the upper appliance at any time.

 What the provider does is adjust them unequally, until both fins are making simultaneous contact with the upper appliance. This in effect rotes the jaw into the correct alignment.

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Posted : 26/01/2021 10:36 am
toomer
Estimable Member

@thomas22 Ah, ok, you're talking about rotating the mandible.  I thought you were talking about the maxilla.

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Posted : 26/01/2021 2:40 pm
toomer
Estimable Member
Posted by: @thomas22
 
I have a diastema

Did you have it before you started treatment?

Most patients who see that, then note that it goes away after a little bit of time ... 

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Posted : 26/01/2021 3:30 pm
Thomas22
Estimable Member

@toomer

 When I was 12 my orthodontist glued my front teeth together, so they would look "good". When I started treatment with the DNA Appliance, my provider removed the glue.

 The diastema emerged about two months after that? It's possible it's the removal of the glue, the expander, or a combination of the two. No way to tell.

 It hasn't gotten any smaller though.

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Posted : 26/01/2021 6:31 pm
Thomas22
Estimable Member

My provider fixed my lower appliance, and I'm wearing it again for the first time since April 2020.

One thing that's odd.

It doesn't center your lower jaw, it pins one side in the correct location, where it should be, and it leaves a large lateral gap on the other side. 

Feast your eyes on my artistry.

The larger inverted U is my upper jaw, the smaller inverted U is the lower jaw.

The red squiggle is to emphasize the space between the two on the left side.

 

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Posted : 29/01/2021 3:18 pm
eternally12
Eminent Member

@thomas22

You have a similar problem to what I have by the looks of it, so when I try to put my teeth together there is a larger overhang on one side. I'm currently in CAB though (my request instead of using conventional braces after treatment) to try and align the top and bottom teeth. We are trying to artificially expand and tilt out the lower teeth to meet the upper teeth, but if that isn't able to make my bite meet on both sides then we may consider bringing in the over-expanded side slightly. But yes, my mandible also rotated slightly as a result of the treatment, and because the teeth on both sides don't touch perfectly yet it's difficult to decide exactly on the perfect position of the mandible at this stage for me.

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Posted : 30/01/2021 10:23 pm
mysterecessed
Active Member

Have you noticed any improvements in under eye support/facial sagging in general with the DNA appliance?

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Posted : 31/01/2021 8:06 pm
Thomas22
Estimable Member

@mysterecessed

No

I've only worn the upper appliance for six months total, and the bottom appliance three months. And that may be part of it.

But no. I don't see structural changes in my face.

My lower appliance has about 6mm of expansion, at maximum. I have to imagine there will be some changes at that point. I don't want to drift into wishful thinking, but the lower appliance also pulls the left side of mandible forward. My bones will have to remodel to accommodate that new position.

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Posted : 31/01/2021 10:03 pm
mysterecessed
Active Member

@thomas22

I see, why have you only worn the bottom appliance for 3 months? Did the orthodontist only realise you need it afterwards? Also did the orthodontist talk about facial changes/ palate changes/ straightened teeth or just improved airway?

I found a provider in my area and also another doctor that does MSE but haven't spoken to them yet, I'm not sure how many cases they've done successfully, though I'm expecting it to be pretty little. Other than a recessed jaw + maxilla, I definitely have an open bite and the right side of my teeth are lower than the left side and I also have a "middle tooth" like Tom Cruise though sadly I don't look like him lol, which seems like a huge issue though I have no TMJ issues, don't really know how to proceed from here. 

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Posted : 01/02/2021 6:55 am
Thomas22
Estimable Member

@mysterecessed

 The lower appliance stopped fitting after three months of treatment. It took a long time to get it replaced. Mostly due to issues on my end.

 They only talked about TMJ and Apnea.

 

 If I was you, I would call Dr. Belfor and see if he has any providers near you. 

  https://drtheodorebelfor.com

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Posted : 01/02/2021 3:15 pm
mysterecessed
Active Member

@thomas22

Cool, thanks for the link. Does calling him work for countries in South East Asia? I'll probably send a Facebook msg instead.

Weirdly I can't find the provider that claims to do DNA in my area on the Vivos site..

I'm surprised you're not seeing mandible expansion if the bottom appliance has increased by 6mm. Maybe you're not noticing it cause the movement is slow? Has it at least made more room for your teeth to move into place?

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Posted : 01/02/2021 6:36 pm
Thomas22
Estimable Member

@mysterecessed

 Vivos made me a new lower appliance which I have not expanded at all, yet.

 If it was fully expanded, it would expand 6mm.

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Posted : 01/02/2021 8:53 pm
mysterecessed
Active Member

@thomas22

Ah I see thanks.

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Posted : 01/02/2021 10:01 pm
Thomas22
Estimable Member

Despite what you read, the DNA Appliance does have a bite block on one side of the lower appliance.

Perhaps that's a factor.

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Posted : 02/02/2021 12:14 am
toomer
Estimable Member
Posted by: @thomas22

Despite what you read, the DNA Appliance does have a bite block on one side of the lower appliance.

Perhaps that's a factor.

I think in many/most cases a DNA would actually have occlusal overlay on both sides of the appliance.  This seems to be one area where Dr. Belfor and Dr. Singh's opinions varied significantly.  Belfor has been (and still is) very focused on facial symmetry and balance, so he believes you put the occlusal overlay on the deficient side of the patient's body to stimulate growth.  Singh has been very focused on the airway overall, so maybe he thinks having overlays on both sides gives more ability to improve the center of the body (airway).

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Posted : 02/02/2021 10:18 am
Thomas22
Estimable Member

@toomer

 The overlay isn’t flat on my appliance. It’s raised on one side to create a bite block. 

 I don't know if it's as effective as Homeoblock design, but that's why it's there.

 When the first took my impression, the Doctor took a hard look at me to decide which side of my face was less developed.

 

 I'm curious though, do they do this for all patients? Or just ones with markedly asymmetrical features?

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Posted : 02/02/2021 12:09 pm
toomer
Estimable Member

@thomas22 Most DNAs I've seen have occlusal coverage for the posterior teeth on both sides.  It might not be the same amount on both sides depending on the patient, but usually it's on both sides.

But dentists are given a wide amount of leeway in terms of what they choose to configure.  Heck, there is even an option to configure a DNA Appliance without any of the front springs if that would be necessary for some reason.  So maybe in your case your initial doc just felt it was best to really work on one side.

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Posted : 02/02/2021 12:31 pm
Thomas22
Estimable Member
Posted by: @toomer

 It might not be the same amount on both sides depending on the patient, but usually it's on both sides.

 The plastic shelf is perhaps 2mm to 3mm higher on the left side. 

 So when I bite down, the appliance is lopsided. Higher on the left, lower on the right.

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Posted : 02/02/2021 2:43 pm
eternally12
Eminent Member

@mysterecessed

Yes, I have noticed improvements in under eye support but more so when I smile. I still have smile lines but they're not as pronounced as before. I think this may also be because my mandible is more relaxed and centred than before, so my smile looks more balanced. My upper jaw also looks a bit fuller (which could be due to lateral expansion, whether that's teeth being moved through bone or the actual bone remodelling or both). I had a friend tell me my face looks "friendlier" after not seeing me for 3 - 4 months.

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Posted : 03/02/2021 2:23 am
mysterecessed
Active Member

@eternally12

So you've worn this appliance for 3-4 months and have these results already? That's great to hear. May I ask if you have both the upper and lower expander?

May I ask what problems you had in terms of health, teeth and facial assymetry at the start?

Also do you chew? Have you been working on anything else that might help facial assymetry since getting the DNA appliance?

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Posted : 03/02/2021 8:51 pm
Thomas22
Estimable Member

I’d forgotten how much a difference the lower appliance makes. 

When I woke up this morning, it felt like someone had replaced my spine with rebar. My posture was so much better. 

I’ve been wearing this lower for just a week and half. I assume the postural change has something to do with the way the appliance holds the jaw forward, and perhaps because my teeth are (sort of) in contact. 

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Posted : 04/02/2021 10:36 am
Thomas22
Estimable Member

The lower appliance also makes my face look more proportional, because of the way it moves my mandible forward. 

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Posted : 04/02/2021 10:38 am
eternally12
Eminent Member

@mysterecessed

I wore the actual appliance from late April until October last year. Since October I've been in braces to try and align my upper and lower teeth and expect to be in braces for approximately 12 months. I was concerned about losing expansion from braces so my provider and I decided to try controlled arch braces (CAB). I only had the upper appliance. I was diagnosed with mild sleep apnea and my provider determined I probably wouldn't need the lower appliance. He might be right. My breathing has improved substantially.

In way of asymmetry, my left side has more space for my tongue than the right side. But I think the symmetry has improved slightly thanks to the appliance and skilfully placed brackets (orthodontics). It's not perfect yet, however, and obviously achieving perfect symmetry is impossible.

I don't chew gum. But I do try to chew hard foods properly, even when my teeth are tender from the braces. Apples and crisp chips are my go-tos 😆 Keep in mind it's more difficult as the upper and lower molars don't touch how they should, so hard chewing is also a jaw workout.

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Posted : 06/02/2021 12:41 am
toomer
Estimable Member
Posted by: @eternally12

@mysterecessed

I wore the actual appliance from late April until October last year. Since October I've been in braces to try and align my upper and lower teeth and expect to be in braces for approximately 12 months. I was concerned about losing expansion from braces so my provider and I decided to try controlled arch braces (CAB). I only had the upper appliance. I was diagnosed with mild sleep apnea and my provider determined I probably wouldn't need the lower appliance. He might be right. My breathing has improved substantially.

In way of asymmetry, my left side has more space for my tongue than the right side. But I think the symmetry has improved slightly thanks to the appliance and skilfully placed brackets (orthodontics). It's not perfect yet, however, and obviously achieving perfect symmetry is impossible.

I don't chew gum. But I do try to chew hard foods properly, even when my teeth are tender from the braces. Apples and crisp chips are my go-tos 😆 Keep in mind it's more difficult as the upper and lower molars don't touch how they should, so hard chewing is also a jaw workout.

Great to hear your breathing got better.  Have you had a follow-up sleep test to determine whether or not your mild sleep apnea has been cured?

Was there an option to not do orthodontics afterward?  Did your provider feel your bite was stable enough that you could have done without if you were willing to live with the look?  Or were there still functional issues to address and he/she felt braces could do it well enough (and then you get the aesthetic benefits as well, obviously).

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Posted : 08/02/2021 7:30 pm
eternally12
Eminent Member

@toomer

There were still pre-existing functional issues to address from 3(!) rounds of prior braces. I was left with an open bite on my left side due to braces where the molars weren't hitting properly. Funnily enough, the right side actually need(s) more expansion than the left. Currently as a result of the expansion combined with poor orthodontic work prior, neither my lower or upper molars touch on each side. So, the orthodontics is simply to try and align the back teeth, keep the jaw in a stable position, and improve symmetry where possible. I've been wearing braces since October but the actual controlled arch component where most of the movement occurs isn't starting till next week! That's where we try to move teeth (including the molars) forward along the alveolar bone. I'm just hoping my roots can handle it as I've already had a lot of prior orthodontics. My provider said there's only one tooth in the lower jaw we need to watch, and we will be taking another x-ray halfway through braces treatment.

I haven't had a follow-up sleep test and to be honest it's probably better to wait until all the orthodontic work is done. This is because I've noticed even slight adjustment to the teeth positions due to braces can impact breathing. So I'd rather wait until everything is functionally where it's meant to be before doing it. But, my quality of sleep has improved and I'm not longer waking up short of breath multiple times in the middle of the night like I used to be - so that can only be a good sign.

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Posted : 09/02/2021 3:35 am
toomer
Estimable Member
Posted by: @eternally12

@toomer

But, my quality of sleep has improved and I'm not longer waking up short of breath multiple times in the middle of the night like I used to be - so that can only be a good sign.

That's a great sign.

Previously, would you also have to get up and pee during the middle of the night - and if so, has that diminished as well?  "Nocturnia" is reasonably well correlated with sleep apnea as well.  It was funny, because my getting up multiple nights in the week in the middle of the night to pee ... I had just assumed was becoming a "normal" thing as a part of getting older.  But once I got on CPAP, that went away in like a week.

Depending on what you want to figure out, there's a couple low-cost ways to do a sleep test - first, you can buy a single-use WatchPAT-1 from Amazon (assuming you are in the US) and put that on one night, and you'll get a full sleep study report within a few days.  They are supposedly reasonably accurate compared to a full in-lab PSG test, at least as far as OSA and UARS (can't detect for other things that need brain wave activity though, since there are no sensors on your head).

The other way is to buy a "logging" pulse oximeter, and then log the results all night and look at them in the morning.  I use the Wellue O2 ring, and it is super easy to use, and has a reasonably good iPhone app as well.

Congrats on getting back to some good sleeping!  Very jealous, hoping I can get there soon.

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Posted : 09/02/2021 10:16 am
eternally12
Eminent Member

@toomer

Some nights, yes. But I don't anymore. I do however usually have to pee first thing when I wake up in the morning, but that might just be because I do usually have a bit of water before bed. I will say, I currently have a TPA across the roof of my mouth which cuts into my tongue and does still occasionally make it difficult sometimes at night time, so once that is out things will be even better.

Thanks for those suggestions! I live in Australia so not sure how cheap it would be to ship any of that here. I'm happy to wait till my orthodontic treatment is finished because by then *hopefully* my jaw position will be stable and that's likely how I'm going to be breathing for the rest of my life. So at that point it would be more pertinent to do a sleep test.

Have you noticed many improvements thus far?

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Posted : 12/02/2021 10:46 pm
Thomas22
Estimable Member

I had asked my provider when I would be finished with expansion. They said I would eventually stop responding to the appliance. That at some point, expansion would become painful, and I would stop making any gains, no matter how much I wore it.

I wasn't entirely happy with that answer. But it is interesting.

I'm not sure how I square that with appliances like AGGA, which don't appear to follow that rule.

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Posted : 17/02/2021 10:20 pm
Thomas22
Estimable Member

In nine months of treatment, my IMW has gone from 38mm to 41mm. It doesn't appear like it's going to stop anytime soon either. I don't feel any resistance to expansion.

Eyeballing the appliance, I think it could easily expand up to 45mm.

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Posted : 17/02/2021 10:23 pm
Thomas22
Estimable Member

For the record, how much forward growth is the Y Appliance capable of?

Physically, I can expand my appliance by at least a one cm.

 

The provider did say that the body will stop responding to the stimulus of the appliance at some point. You'll hit a wall, and you won't be able to expand more.

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Posted : 22/02/2021 3:58 pm
eternally12
Eminent Member

My Y-plate stopped expanding at 5mm forward, and laterally 1cm. I do wish the forward plate could go further, but we're using CAB to correct inward tipping of the front teeth from previous orthodontics so hopefully that gives me the further "expansion" I would like to keep my lips looking a bit fuller and more normal.

I highly suggest anyone who needs to have orthodontics after using the DNA appliance to ask if their orthodontist can use CAB or a similar method that won't retract any teeth to lose the expansion gained.

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Posted : 23/02/2021 10:09 pm
aleksandr444200
Active Member
Posted by: @toomer

@aleksandr444200 Thanks for the update!

In regards to the teeth being a bit sore, make sure you keep to the proscribed wear time / turn schedule guidance!  One of the things Vivos trains their doctors to be careful about, is patients that slip into a "mostly just overnight" wear time ... so they only do 8-10 hours a day, but then still advance the screw on the same 5-7 day schedule (as if they were getting 14-16) because they still want to get done with their treatment on the same schedule.  That seems to increase the chances of problems happening.

You could also look into more in-and-out time during the day.  If you look over on @greyham's blog - he's got a link to a video recorded by Dr. Ben Miraglia who treats patients, and he said that the alternate cycling of in-and-out time is what really makes a difference in terms of bone growth and development.

As for the bottom appliance, I too don't understand the mechanics on that.  If you watch the Thomas Colquette Homeoblock video on YouTube (search for it with those 3 words) and go the to the point where he shows the time lapse photos ... it absolutely looks like the entire mandible is getting larger.  These were professionally done photos by an orthodontist colleague of his (Dr. Colquette is a restoration dentist) who did a full set of intra-oral photos ever 3 months over an 18-month timespan.  It's amazing to watch in its time lapsed view - you'd swear the jaw itself is getting bigger and the teeth are "just going along for the ride" (as Dr. Belfor and Dr. Singh have both said before).

 

Thanks Toomer, I checked out that timelapse video and it was fascinating.

I'm about 3 months into my DNA treatment now, still only using the upper. I mentioned to my provider about the lower last time we met (once a month) but he still wanted to see some more expansion from the upper.

The photos on the left are before treatment, and the right 3 months in.

One thing I've noticed is that the left side of my face (the right side looking straight on to me) the teeth drop down slightly lower, causing an asymmetry. Is there a way to fix this?

I'm also considering buying a facemask appliance, because I think I need some counter-clockwise rotation (my face is long probably thanks to the 6 extractions i've had - 4 wisdom teeth and 2 from behind the upper canines).

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Posted : 24/02/2021 6:22 am
toomer
Estimable Member
Posted by: @aleksandr444200

Thanks Toomer, I checked out that timelapse video and it was fascinating.

I'm about 3 months into my DNA treatment now, still only using the upper. I mentioned to my provider about the lower last time we met (once a month) but he still wanted to see some more expansion from the upper.

The photos on the left are before treatment, and the right 3 months in.

One thing I've noticed is that the left side of my face (the right side looking straight on to me) the teeth drop down slightly lower, causing an asymmetry. Is there a way to fix this?

I'm also considering buying a facemask appliance, because I think I need some counter-clockwise rotation (my face is long probably thanks to the 6 extractions i've had - 4 wisdom teeth and 2 from behind the upper canines).

I don't have my DNA yet, so I can't speak from experience.  One thing my provider did tell me (we're doing some other work before we start DNA) is that depending on what condition your TMJs are in, there could be some asymmetries.  He described the process as being somewhat "unpredictable" once you start triggering expansion and let the body decide what it should do.  I am pursuing DNA in order to try to beat sleep apnea, so as long as my eyeball doesn't end up down at my chin, I won't care as much about aesthetic impacts.

Overall, it looks like you've had good expansion of your upper arch already.  I also wonder, is it that your left side is sinking ... or is it going to where it actually should be, and maybe the right side will come down to join it in time?  You look like you did have your left side a bit lower pre-treatment, so I think you maybe already had some asymmetry there?

Here's another time lapse to look at - I made this one off of one of the more famous Vivos patient cases.  It's interesting to note a couple things here - for one, her left ear more or less stays in the same position in space, but her right ear is suddenly practically 1 centimeter (guessing) out to the right at the end ... implying her facial width is expanding.  At the same point in time, her nose was clearly deviated a little bit to her right, but you can see that re-centering as a result of the treatment.  And then the smile is getting wider, and it looks like the jaws are rotating counterclockwise too.

https://3dthis.com/share.htm?h=NTExMTc

So a whole lot of motion, in a lot of different directions.  I'd say give it time.

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Posted : 25/02/2021 10:29 am
aleksandr444200
Active Member

@toomer

Thats a great time lapse! And yep, I definitely had this asymmetry before - my dentist noticed the minor nasal deviation and mentioned it. But i've noticed its that whole side of the face - the teeth are lower, the eye is a bit lower with less under eye support too.

Yeah, hopefully as it widens further it'll even out.

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Posted : 26/02/2021 12:22 am
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