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Anxiety regarding MSE and sphenoid

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danksch
(@danksch)
Posts: 9
Topic starter
 

Hello everybody,

 

I am a 33-year-old male and just had my MSE installed yesterday with cortipuncture, which went fine.

Three weeks ago, I decided to support my orthodontic treatment via craniofacial therapy, and visited an osteopath a week ago. He told me that my sphenoid was twisted, and that it’s the underlying cause for my facial asymmetry. I always knew that my face was asymmetrical, but now I actually got to know more details, e.g. that one of my eyes protrudes more than the other (the retruded eye being on the flat side of my face), and that it is also the reason my teeth are more crowded on the right side. 

It all kind of made sense in the end – I was a difficult birth case (forceps delivery), and while I apparently did visit a specialist for those birth cases afterwards (checked that with my mum), this was apparently overlooked. 🙁 

On top of that, I then read this page about the MCB splint, where it is mentioned that MARPE/MSE treatment can further enhance this torsion. 

I’m really worried now that MSE will actually worsen my situation instead of improving it. Has anyone experience with this ? As in having a twisted sphenoid and undergoing MSE or something similar ? Or do you know if surgery could potentially fix it after MSE expansion ? I can’t seem find anything on the internet regarding that, unfortunately.
My ortho could not answer if this could happen, he said that we can monitor it via regular CBCTs and my ostheo should also keep an eye on it.

My osteopath said since the bones are fused, he can only do so much. He seemed very supportive about the idea of doing CFT along with my orthondtic treatment, but knows nothing of the MSE so far. I’ll visit him again tomorrow, and wont’t be surprised if he was not that happy about this barbaric thing in my mouth. 😉

My MSE plan is go to for 5mm expansion by the way, applying the slow protocol of 1-2 turns per day, only going for higher than one if I don’t feel any resistance at all while turning.

 

Thanks for reading, guys.

 
Posted : 08/07/2021 5:52 am
Apollo
(@apollo)
Posts: 1732
 

I discuss strategies to address MSE asymmetry including MCB splint therapy and osteopathy in this thread:

https://the-great-work.org/community/main-forum/mse-asymmetry-and-protraction/

 
Posted : 08/07/2021 3:11 pm
danksch
(@danksch)
Posts: 9
Topic starter
 

Thanks for the hint, I’ll check it out.

 
Posted : 09/07/2021 4:22 am
Max_111
(@max_111)
Posts: 17
 

I doubt it would make the underlying assymetry worse, but it could make it more pronounced. A good orthodontist should be able to balance it out though at the end of treatment.

Everyone has some form of assymetry too, so I wouldn’t worry too much. The main concern would be rebalancing your bite and jaw joint afterwards, and so you’d need an ortho that can do this. 

 
Posted : 09/07/2021 11:17 am
danksch
(@danksch)
Posts: 9
Topic starter
 

I’ve stopped turning for now and will get a second opinion from a holistic ortho before I continue with the MSE, because I’ve experienced more intense headaches during the last days, which confirms my impression that the pressure from the MSE is poison for my already existing cranial compressions (with only 1 turn per day)

The more I read about the craniomandibular system, the more I think I have to address my skull base asymmetry first. Expanding my maxilla while the base is distorted just makes no sense to me now; the torsion will still exist / potentially be worse afterwards with the current approach, which operates only from a dental point of view – if your cranial base is misaligned, you got bigger problems.

The ortho I’m seeing next week is specialized in CMD, and utilizes ALF / COPA.

I wish I knew this stuff earlier, years researching this stuff and you just never know enough it seems. Now I’m in a bad spot – continue turning and eventually getting the split, which further traps me into MSE treatment, which will most likely worsen my asymmetry, or stop turning and hope to find a good treatment alternative (ALF + splint therapy + NCR ?) to unwind my cranial strains first and foremost, while the cortipuncture window for suture split is running away ? Well, I could still get surgical assist, which might be necessary anyway for suture to split, since my ortho commented how hard my palate was while putting the screws in.

I’ve also realized how wearing the MSE and thus not being able to have proper tongue posture, has a negative impact on my posture and breathing. That’s what also makes ALF attractive to me, to have space for your tongue and carry the palate by yourself. What it probably cannot do though, is to give me the 5mm of palate expansion that I need. Anything that is not mostly skeletal is especially unfit for me, since some of my teeth (canines) already stand at the edge of my ridge, accompanied by big gum recession and exposed roots, so pushing teeth is a no-no. 

Something like this looks quite promising – while obviously not done on an adult in this example, the “brake” approach via an acrylic pad to force a one-sided expansion and unwind the torsion makes sense to me.

Well, I will be smarter next Wednesday and keep you guys updated.

 

 
Posted : 19/07/2021 2:31 pm
Apollo
(@apollo)
Posts: 1732
 

Obviously I don’t know the extent of your asymmetry. I started with my right side wider and canted lower. After my MSE expansion, my cant seems a little better, but my wider side did expand a little farther. The discrepancy in my bite isn’t as bad as what you see in JawHack’s before and after pictures. If I were you, I’d honestly move forward with your MSE treatment since you’ve already committed to having it screwed into your head, not to mention the payment. You could try some of the strategies like osteopathic manipulations, cross elastics, and/or splint therapy to minimize the asymmetry during the expansion and treat it afterward. I think you’re putting too much faith in the potential for strategies like ALF and NCR to actually correct your existing asymmetry. They are prolonged, expensive, and unproven. 

 
Posted : 19/07/2021 9:31 pm
danksch
(@danksch)
Posts: 9
Topic starter
 

My right side is interally rotated, my left side is externally rotated. From the eyebrow to the maxillary molars on the right side, everything is lower. I make contact first with my right molars when I bite (crossbite). My lower teeth also have this cant. 

I’m not sure if full face photos are allowed, if so I can post one. I know oneself tends to exaggerate when seeing his one photos, but the eye thing is the worst to me, especially in motion – when I look into the mirror and move my head in a up/down tilting manner, I can see how the right eye has more scleral show and kind of “moves faster” due to the depth discrepancy. Ever since my osteo noted this, I can’t stop thinking about it. It just makes me so mad that this wasn’t fixed when I was born, and now it seems I’m stuck with it.

Another thing that bothers me about the MSE is that it makes the maxilla rigid, and disrupts the flexion/extension movement of the skull during breathing, which probably hinders functionality of the pituitary gland amongst other things. Noone knows what this might mean mid-/longterm. Sure, you get it out eventually, but I saw Dennis Stroke mention it in one of his papers that this may not even be restored fully afterwards – this is just a claim obviously, but it’s one of those things that is unpredictable, and endocrine problems that you may get later down the road will probably be linked to other stuff before this connection deserves a consideration.

On the other hand, not doing anything and not fixing my bite will definitely give me problems, sooner than I may like. And you are also right when saying that I cannot be sure about what alternatives like ALF can actually achieve for me. MSE will give me expansion, one way or the other.

 
Posted : 20/07/2021 9:01 am
Apollo
(@apollo)
Posts: 1732
 
Posted by: @danksch

My right side is interally rotated, my left side is externally rotated. From the eyebrow to the maxillary molars on the right side, everything is lower. I make contact first with my right molars when I bite (crossbite). My lower teeth also have this cant. 

I’m not sure if full face photos are allowed, if so I can post one. I know oneself tends to exaggerate when seeing his one photos, but the eye thing is the worst to me, especially in motion – when I look into the mirror and move my head in a up/down tilting manner, I can see how the right eye has more scleral show and kind of “moves faster” due to the depth discrepancy. Ever since my osteo noted this, I can’t stop thinking about it. It just makes me so mad that this wasn’t fixed when I was born, and now it seems I’m stuck with it.

Another thing that bothers me about the MSE is that it makes the maxilla rigid, and disrupts the flexion/extension movement of the skull during breathing, which probably hinders functionality of the pituitary gland amongst other things. Noone knows what this might mean mid-/longterm. Sure, you get it out eventually, but I saw Dennis Stroke mention it in one of his papers that this may not even be restored fully afterwards – this is just a claim obviously, but it’s one of those things that is unpredictable, and endocrine problems that you may get later down the road will probably be linked to other stuff before this connection deserves a consideration.

On the other hand, not doing anything and not fixing my bite will definitely give me problems, sooner than I may like. And you are also right when saying that I cannot be sure about what alternatives like ALF can actually achieve for me. MSE will give me expansion, one way or the other.

I don’t think there’s any restriction on posting pictures of your face, but I wouldn’t be able to make any kind of objective assessment by looking at them. I’ve experienced the same concerns about my asymmetries and the long-term impact of splitting the midpalatal suture on cranial mobility, but ultimately I decided it was best to improve my nasal breathing and tongue space and hope that any torsion might unwind once the appliance comes out and I’m able to maintain better posture. My cant seems to have improved a little during MSE expansion, but the transverse discrepancy seems a little worse. MSE might or might not successfully split the suture for you, especially since you’ve delayed after your cortipuncture, but if it does, you’ll definitely get wider tongue space and nasal cavities. You might also get exacerbation of your asymmetries. So I guess it all depends on what matters to you.

 
Posted : 21/07/2021 1:26 pm
danksch
(@danksch)
Posts: 9
Topic starter
 

@apollo You’re correct that it’s a matter of what’s important for oneself. I have to accept that there is not the perfect solution for all of my concerns. But a possible future scenario of me being able to properly bite for the first time in my life, relieving my right TMJ and actually being able to breathe normally through my nose is quite a good one, so I just have to trust in the process for now.

I missed two days of screwing, and had the same concern, but my ortho said the peak window you get from cortipuncture holds for about 5 weeks and that I shouldn’t worry about the two missed days. Let’s hope for the best.

 
Posted : 21/07/2021 5:37 pm
Apollo and Apollo reacted
Apollo
(@apollo)
Posts: 1732
 
Posted by: @danksch

@apollo You’re correct that it’s a matter of what’s important for oneself. I have to accept that there is not the perfect solution for all of my concerns. But a possible future scenario of me being able to properly bite for the first time in my life, relieving my right TMJ and actually being able to breathe normally through my nose is quite a good one, so I just have to trust in the process for now.

I missed two days of screwing, and had the same concern, but my ortho said the peak window you get from cortipuncture holds for about 5 weeks and that I shouldn’t worry about the two missed days. Let’s hope for the best.

One factor that I’m not totally sure about is how the rate of expansion relates to asymmetry. It seems like the slower (1 turn per day) protocol should have less risk of exacerbating asymmetries. Dr. Moon says this gives the body more time to breakdown restrictions rather than mechanically breaking them, so it reduces the risk of failure, but also reduces the midface changes. It seems like this would result in a more even expansion, but I haven’t seen that stated explicitly. I suspect JawHacks might have gotten such an asymmetric expansion because of his rapid turn schedule.  

 
Posted : 21/07/2021 8:37 pm
Asymmetry
(@asymmetry)
Posts: 5
 

@danksch How is it going ? Did you find a way to correct your skull asymmetry ?

 
Posted : 13/01/2023 1:31 pm

THE GREAT WORK