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MSE log

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AlexanderPerrier
(@alexanderperrier)
Active Member
Topic starter
 

Hello everyone,

I am going to be undergoing treatment with MSE and facemask starting next week. I want to chronicle my experience here as I turn the device and split/widen the palate. I am doing this primarily for health reasons, my nasal breathing is extremely poor despite previous surgical interventions. MSE provides significant widening of the nasal aperture and lateralization of the inferior nasal turbinates.

I will be using a 12mm expander under the supervision of an orthodontist in NY and will be expanding in conjunction with a facemask to try to gain some protraction as well. We will be moving the teeth around too, so hopefully there will be an aesthetic benefit of at least minor significance. 

My diagnosis is as follows:

.Bi-max retrusion

.Mid-facial deficiency

.Recessed jaw/chin

.Class 1 bite

.Upper and Lower crowding

.Posterior cross bite.

.Deep bite

.Deficient over-jet

.Narrow palate 31MM(!!!)

.Narrow dental arch

.Caries

As far as my mandible goes, we will be using a hyrax expander to match the bottom bite to the new width of the expanded palate. The teeth and diastema will be brought into alignment with Invisalign. Anyone have any tips for me as I proceed? Looking forward to sharing my progress with those who are interested here.

 
Posted : 06/06/2021 10:39 pm
Apollo and Apollo reacted
AlexanderPerrier
(@alexanderperrier)
Active Member
Topic starter
 

Some advice a highly knowledgable friend from another forum has had for me:

” I’ve never seen an adult male gain any results from MSE protraction, you are literally pulling from the tooth roots and from there the force goes into the alveolar bone and if you are lucky some goes to the actual skeletal complex.. for an adult male very rough.  If anything it’s going to be extremely minimal  and may not be worth the cost of jamming your forehead and mandible backwards.    As for the expansion if you are 25 or younger you probably can still get your split but your palate is so narrow hopefully you eeek out enough expansion with your 12 mm screw…. Also be careful about alveolar bending and thinning the bone supporting your Molars due to the forces from the molar bands.”

Can anyone comment on these suggestions? 

 
Posted : 06/06/2021 10:43 pm
Apollo
(@apollo)
Noble Member
 
Posted by: @alexanderperrier

Some advice a highly knowledgable friend from another forum has had for me:

” I’ve never seen an adult male gain any results from MSE protraction, you are literally pulling from the tooth roots and from there the force goes into the alveolar bone and if you are lucky some goes to the actual skeletal complex.. for an adult male very rough.  If anything it’s going to be extremely minimal  and may not be worth the cost of jamming your forehead and mandible backwards.    As for the expansion if you are 25 or younger you probably can still get your split but your palate is so narrow hopefully you eeek out enough expansion with your 12 mm screw…. Also be careful about alveolar bending and thinning the bone supporting your Molars due to the forces from the molar bands.”

Can anyone comment on these suggestions? 

I’m an adult male, significantly over age 25, and I think I’ve gotten at least a couple millimeters of forward change from MSE with reverse pull headgear. I still haven’t had follow-up imaging to measure. Varbrah said his orthodontist measured 3mm of skeletal advancement. It is a lot of effort for very minimal reward, but I’m going to continue for at least a few more months until my MSE comes out. There’s a thread about the tooth/bone anchorage of the MSE protraction hooks here ( https://the-great-work.org/community/main-forum/here-is-why-msefm-doesnt-and-wont-produce-much-forward-movement-in-adults/ ). Do you plan to have cortipuncture at the time of installation to help facilitate the suture split?

 
Posted : 06/06/2021 11:37 pm
AlexanderPerrier
(@alexanderperrier)
Active Member
Topic starter
 

@apollo

Great thread. Thank you for sharing that with me, I don’t know how I missed that one. I thought I’d read everything on here.

I read in Varbrah’s thread that he claimed 5mm. Did he come back and confirm 3mm? 

We do plan on corticopuncture given that I have some pretty sturdy bones. Is there a consensus on how much protraction/forward displacement can be achieved with MSE+FM?

We discussed using an Alt RAMEC protocol as well.

Have you experienced better sleep? Better quality of life? How much expansion did you achieve? 

 
Posted : 07/06/2021 4:09 am
Apollo
(@apollo)
Noble Member
 
Posted by: @alexanderperrier

@apollo

Great thread. Thank you for sharing that with me, I don’t know how I missed that one. I thought I’d read everything on here.

I read in Varbrah’s thread that he claimed 5mm. Did he come back and confirm 3mm? 

We do plan on corticopuncture given that I have some pretty sturdy bones. Is there a consensus on how much protraction/forward displacement can be achieved with MSE+FM?

We discussed using an Alt RAMEC protocol as well.

Have you experienced better sleep? Better quality of life? How much expansion did you achieve? 

I was also sure Varbrah had reported 5mm, but I quoted a post here ( https://the-great-work.org/community/main-forum/mse-asymmetry-and-protraction/#post-36565 ) where he disputed that figure and said it was actually 3-4mm. If you could point me to the original post where he claimed 5mm, I would feel better about my memory. Dr. Ting thinks even this is beyond what most adults could expect from reverse pull headgear with MSE. I tried several weeks alternating cycles of backward and forward turns after I completed my initial expansion and maybe it has helped prolong the window when my traction has had an effect. My sleep is still disrupted by the discomfort of the headgear, but my nasal breathing is significantly improved and my snoring has stopped. Hopefully I’ll feel better rested once the process is finished. I completed all of the turns on a 10mm MSE.

 
Posted : 07/06/2021 7:06 am
AlexanderPerrier
(@alexanderperrier)
Active Member
Topic starter
 

Hi guys something came up and I had to push back my install date. I just got the MSE installed three days ago. It’s a 12mm expander. I just ordered a Crane facemask. I had extensive corticotomy. I have a pretty thick palatal taurus and he really went to town on it. I could smell the bone burning from the friction with the drill.

On the drive home from getting the MSE installed and after turning twice, I felt immense pressure between my two front teeth. I am hopeful that this is an indicator I will have a successful split.

My orthodontist has me turning twice a day. After only six turns (!!) my nasal breathing is already slightly better. I don’t have a great explanation for that since I don’t see a diastema. I don’t think its placebo though.

Call me crazy but I am noticing some facial changes too, some improved tooth show when speaking and smiling and some swelling and edema around the paranasal area. Today marks 6 turns. 

The MSE device is a huge pain in the ass to keep clean, food gets caught in it easily. It also necessitates chewing and swallowing in an entirely different fashion which frankly makes life more difficult. I hope I will get used to it as time goes on.

Today I am able toI feel a depression in my palate at the suture line with my tongue. The depression is mostly at the posterior palate where the majority and most severe cortipuncture was performed on my palatal torus, there is no such depression at the anterior portion  behind the two front teeth, and still no diastema. I am thinking that the MSE is doing its job and I am partially split posteriorly but not anteriorly. I continue to feel enormous pressure between the two front teeth as well, and now there is some sort of force on my incisors too.

 

 
Posted : 10/07/2021 4:53 am
Apollo and Apollo reacted
AlexanderPerrier
(@alexanderperrier)
Active Member
Topic starter
 

Hello everyone. I’m pleased to share with you all that at 24 turns, I have a diastema. I am not sure if this is absolute conclusive proof that I have a suture split, as I still experience some considerable resistance and pressure when turning.

I have noticed a significant improvement in nasal breathing, sleep, and oddly enough in oral health. My teeth are easier to keep clean and my gums never bleed. I used to brush three times a day and floss after every meal and my teeth were still rapidly deteriorating. I speculate that the wounding forces brought about by the MSE appliance are bringing better blood flow to the area.

I have noticed extremely large physical changes in my face (to me). They are so extreme that my own face feels alien to me in my hands when shaving and washing. The zygos are more prominent and the upper arch is more broad.

I am honestly a little worried that if I don’t get any forward protraction to balance things out, my face will look TOO wide at the end of 12mms of expansion, but I will persist for the improved health benefits I am already getting a good taste of.

The first week with the MSE necessitated that I relearn how to swallow and chew, but now I barely even notice it is in my mouth.

I can feel that my body is under some considerable stress with the constant pressure being applied 24/7. I have increased and unprovoked feelings of general anxiety that I do not usually have.

 

 

 
Posted : 19/07/2021 8:12 pm
Apollo and Apollo reacted
Apollo
(@apollo)
Noble Member
 
Posted by: @alexanderperrier

I’m pleased to share with you all that at 24 turns, I have a diastema. I am not sure if this is absolute conclusive proof that I have a suture split, as I still experience some considerable resistance and pressure when turning.

You’ll continue to feel some resistance to turning even after the split because the surrounding structures continue to resist expansion. If you got an obvious gap between your central incisors that appeared suddenly, I think it’s safe to assume that your midpalatal suture successfully disarticulated.

 
Posted : 19/07/2021 9:32 pm
AlexanderPerrier
(@alexanderperrier)
Active Member
Topic starter
 

@apollo

Good to know! Thanks. Now I get to begin my journey with the crane headgear.

 
Posted : 20/07/2021 11:11 pm
AlexanderPerrier
(@alexanderperrier)
Active Member
Topic starter
 

Today I am feeling pain when I touch the areas of the frontozygomatic and zygomaticotemporal sutures. I did not even know where these sutures were and had to Google them. My entire face is swollen and my facial appearance is different because of this. 30 turns completed equates to 4mm of expansion but how much of that was absorbed by the molars I cannot say for certain. My frontal teeth now touch end to end which I guess would imply my jaw has been freed to move forward slightly by the broadening of the upper arch. 

My Dr. said to dial back to 1 turn per day since I have achieved a split. I am happy to do this as the pressure built up with two turns a day was enormous. 

I will begin pulling with the CRANE tonight at a force vector parallel to the occlusal plane. I am hopeful that the pain at the areas of the maxillary sutures will translate to good protraction gains.

This is an exciting adventure.

Dr. Ting suggests that for any adult male 2mms on average will be lost to teeth tipping right off the bat before achieving diastema. If that is true that would suggest I have only expanded 2mms. Is there any way to reclaim that 2mms?

 
Posted : 24/07/2021 2:50 am
AlexanderPerrier
(@alexanderperrier)
Active Member
Topic starter
 

Wore the crane facemask for 16 hours yesterday. I have found myself wondering if it would not be beneficial to turn the MSE screw while applying protraction forces.

The forward tension feels good. It seems to redistribute the lateral tension to the rest of the maxilla to create a better balance of force which is more comfortable. 

 
Posted : 24/07/2021 9:44 pm
Apollo and Apollo reacted
AlexanderPerrier
(@alexanderperrier)
Active Member
Topic starter
 

Today I hit 45 turns, half way to completing my 12mm MSE appliance.

Health changes have been drastic . My breathing is much improved. Acne problems that I have had since I was 13 have disappeared in a matter of days. This has lead me to believe that poor facial development is the cause of a vast majority of health conditions. My oral health has improved too, I am brushing the same amount and my gums don’t bleed as they used to.

Physical facial changes have been EXTREME and are happening so fast that it makes me nervous things will progress to an uncanny Valley without my being able to catch it. I have been wearing the Crane facemask for about 2 weeks now with extreme tension for 16 hours a day minimum. Some days longer. It is hard to say for certain but I believe my efforts at provoking protraction have been fruitful. However the crane headgear is an ENORMOUS stress on my body. The tension it places on the facial musculature plagues my energy reserves and causes constant anxiety. I can’t understate this. I hate that thing and I believe it is preventing me from feeling better. However obviously I want maximum therapeutic benefit while the sutures are malleable so I continue wearing it.

When the headgear is on I feel tension all throughout the zygos, nasal bones AND gums and teeth, the latter of which has me worried. Do you guys think this could be evidence I am pulling the teeth forward through the alveolar bone in a harmful fashion, or would this be an obvious sensation secondary to total maxillary displacement?

Regardless when I wear the mask overnight I wake up with my entire maxilla swollen and my face carrying significant edema which takes an hour to subside. Evidence of bone remodeling? I don’t know. 

Another 6mms of protraction is daunting to be frank given the magnitude and speed of these changes. Although positive it has been psychologically taxing. I will persist though to see what happens. My lisp has also become more pronounced as the diastema widens and the mse screw unwinds.

 
Posted : 07/08/2021 12:28 am
Apollo
(@apollo)
Noble Member
 

I’ve found the plastic pieces of the bow tend to crack at high tension. I’ve had to reinforce several parts. This thing is designed to be used by kids at light tension. I was clocking around 16 hours per day initially, but now I’m usually down around 12. I do believe that the hooks attached to the molar bands put at least some of the force into the teeth. Hopefully the soft metal arms translate some of the force to the TADs, but some of the changes will probably be dentoalveolar. I plan to keep using the bow until my MSE comes out even though it disrupts my sleep.

 
Posted : 08/08/2021 6:50 am
PerseusAkh
(@perseusakh)
New Member
 

Keep up the updates. Very interested in your case. I am personally getting the MSE in a month, so I will be looking to your experience as a reference for results to come.

 
Posted : 06/10/2021 4:33 am
GoTTi
(@gotti)
Estimable Member
 

It’s encouraging to see some positive results on here. I wasn’t planning on dropping anymore comments on this (or any other) forum (it’s become redundant) but now, i’m honestly intrigued. 

 

My only question to you is, how old are you?

 
Posted : 09/10/2021 5:04 am
GoTTi
(@gotti)
Estimable Member
 
Posted by: @apollo

I’ve found the plastic pieces of the bow tend to crack at high tension. I’ve had to reinforce several parts. This thing is designed to be used by kids at light tension. I was clocking around 16 hours per day initially, but now I’m usually down around 12. I do believe that the hooks attached to the molar bands put at least some of the force into the teeth. Hopefully the soft metal arms translate some of the force to the TADs, but some of the changes will probably be dentoalveolar. I plan to keep using the bow until my MSE comes out even though it disrupts my sleep.

Hey bud, i’m enjoying the exchanges. Do you happen to have any new health or aesthetic related benefits to share with us?

 
Posted : 09/10/2021 5:07 am
Apollo
(@apollo)
Noble Member
 
Posted by: @gotti

Hey bud, i’m enjoying the exchanges. Do you happen to have any new health or aesthetic related benefits to share with us?

I’m not sure what’s “new” to share. I’m still using my reverse-pull headgear and I think I’m still getting very minor advancement based on my bite changes. I’m finally to the point where my mandible doesn’t feel jammed backward when I bite down in maximal intercuspation. I’d still love to get my maxilla another millimeter or two more forward to allow room for normal overjet, remodeling of the mandibular condyles, uprighting of the incisors, and any relapse. I got a little more expansion of the already-wider right side of my arch. The bridge of my nose looks to be a little more symmetrical but still deviates slightly to the left. My maxillary cant is now almost parallel with my eyes, but my mandible still appears canted. My undereye and paranasal area seem to be a little less hollow, especially on my left (less developed) side, but I still have some dark circles under both eyes. My nasal breathing remains vastly improved from what it was before treatment, but I did notice some congestion in my narrower left nostril for the first time in months a couple nights ago and worried I might be having some relapse. I’ve stopped snoring, but my sleep quality still suffers from the discomfort of my headgear. I’m not sure what else to report. Let me know if you have specific questions. 

 
Posted : 09/10/2021 8:17 pm

THE GREAT WORK