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Fixed Anterior Growth Guidance Appliance (FAGGA) - Holy Grail? Gonial angle change, maxilla movement forwards and palate widening. Without surgery.  

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Le_Fort_or_Bust
(@le_fort_or_bust)
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I came across this:

http://thewholedentist.com/2016/03/07/my-2nd-post/

http://balanceepigeneticorthodontics.com/serices/growth-guidance-for-adults.html

http://www.robinatowndental.com/blog/article/jaw-expansion-without-surgery

This seems like a miracle appliance, so what is the catch?

If it moves the maxilla forward, does it mean the whole midface including the nose comes forward?

Or does it move only lower part of maxilla, since most pressure is inside the mouth? If it moves only lower part of maxilla, then won't this cause nose to change shape?

And what are the risks associated with this procedure? To me it seems it might replace Le Fort II in terms of effectiveness.

Does anyone have more experience with this? And what Mike Mew things of FAGGA aplliance?

 

30 yo, need to expand palate, move maxilla upward and forward, reduce gonial angle.

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Posted : 25/03/2018 2:12 pm
Apollo
(@apollo)
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Here is the previous thread about that appliance:  https://the-great-work.org/community/main-forum/thoughts-on-the-fagga-appliance/#

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Posted : 25/03/2018 3:08 pm
Miandra
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I'm starting this treatment this month hopefully! Will keep you guys updated.

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Posted : 25/03/2018 4:04 pm
Kraw109 liked
Miandra
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But as you can see on from this picture:

it does move the whole mid face. But it does NOT move the maxilla up and forwards, but only forwards.

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Posted : 25/03/2018 4:18 pm
Le_Fort_or_Bust
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Posted by: Miandra

I'm starting this treatment this month hopefully! Will keep you guys updated.

Keep us updated, which doctor are you having this treatment done with? At what speed do they expand? 1 mm a week? Do you have initial pics and will you post after pics (blanked eyes of course)?

it does move the whole mid face. But it does NOT move the maxilla up and forwards, but only forwards.

Moving maxilla forward and expanding sideways should also reduce gonial angle, right? Still, even if it does not move upwards, it is a tremendous improvement since you can get up to 12 mm of movement without surgery. 

 

The last picture is a morph though, the hair remains the same while face changes.

30 yo, need to expand palate, move maxilla upward and forward, reduce gonial angle.

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Posted : 25/03/2018 8:11 pm
Miandra
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Posted by: Le_Fort_or_Bust

 

Keep us updated, which doctor are you having this treatment done with? At what speed do they expand? 1 mm a week? Do you have initial pics and will you post after pics (blanked eyes of course)?

Will PM doctor name. I will provide you guys with properly taken pictures. 1mm a month is the rate of expansion in most cases, however there are some who can get more expansion. I actually provided a bit of wrong information on my last comment on the other thread, while the appliance let's you keep your tongue on the roof of the mouth, it does not let you keep your teeth together. They seem to put a flat splint on the lower jaw during the treatment in order to stop the lower jaw from locking into place.

Moving maxilla forward and expanding sideways should also reduce gonial angle, right? Still, even if it does not move upwards, it is a tremendous improvement since you can get up to 12 mm of movement without surgery. 

The last picture is a morph though, the hair remains the same while face changes.

It should yeah. However not everyone seems to get a big change in the gonial angle like the man on the picture you posted (For some reason). I saw one other picture from a dentist in Australia and he showed me a patient with big changes in the gonial angle like the one you posted above, while the other ones seems to only have minimal changes to the point where he did not document them.

I honestly don't know what the catch is. I ask myself this as well. While it's not the ideal changes you want (Facial upswing) it seems to help tremendously with asymmetry, and also improving the side profile for people with turkey gobblers. 

 

 

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Posted : 26/03/2018 1:09 am
Abdulrahman
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How does the lower arch keep up with such a massive expansion in the upper arch? Or is the appliance installed in the lower jaw also, though the pictures show the appliance installed on the upper arch only.

my story: http://www.aljabri.com/blog/my-story/

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Posted : 26/03/2018 6:03 am
Le_Fort_or_Bust
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Posted by: abdul

How does the lower arch keep up with such a massive expansion in the upper arch? Or is the appliance installed in the lower jaw also, though the pictures show the appliance installed on the upper arch only.

Yes, actually this is a legit question, how do lower teeth keep up with upper jaw expanding forward? How does lower jaw grow forward and fit the bite?

30 yo, need to expand palate, move maxilla upward and forward, reduce gonial angle.

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Posted : 26/03/2018 8:21 am
Meltcel
 Meltcel
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Posted by: Le_Fort_or_Bust
Posted by: abdul

How does the lower arch keep up with such a massive expansion in the upper arch? Or is the appliance installed in the lower jaw also, though the pictures show the appliance installed on the upper arch only.

Yes, actually this is a legit question, how do lower teeth keep up with upper jaw expanding forward? How does lower jaw grow forward and fit the bite?

Many possible mechanisms:

 

A)The teeth together would cause the lower arch to be pushed out from the forces of the upper jaw. This would essentially push out the mandible laterally, resulting in an increased mandible width. To demonstrate this, imagine you holding a model of a mandible and then push the teeth out. The bone movement would then follow 

 

B)the maxillary upswing would cause the mandible to swing upwards in order for the bite to make contact .

C)The outward and forward expansion of the maxilla gives the mandible more room to just forward . Picture a smaller U vowel sitting inside a larger U vowel. This enhanced space lets the mandible just forward naturally while kkeeping a closed bite 

D)Chewing would activate the masseters and in turn this increased muscle growth results in a longer ramus and wider mandible which naturally would "fit iitself " together with the maxilla through the pressures of the teeth coming together during chewing. These forces from the upper teeth against tthe lower teeth would theoretically cause pressure to be applied outwards on the lower teeth.

 

To be honest the last part of D seems the least likely. All of the others IMO would eexplain how the mandible is flexible to the movements of the maxilla.

 

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Posted : 26/03/2018 9:48 am
Meltcel
 Meltcel
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Posted by: Le_Fort_or_Bust
Posted by: abdul

How does the lower arch keep up with such a massive expansion in the upper arch? Or is the appliance installed in the lower jaw also, though the pictures show the appliance installed on the upper arch only.

Yes, actually this is a legit question, how do lower teeth keep up with upper jaw expanding forward? How does lower jaw grow forward and fit the bite?

Many possible mechanisms:

 

A)The teeth together would cause the lower arch to be pushed out from the forces of the upper jaw. This would essentially push out the mandible laterally, resulting in an increased mandible width. To demonstrate this, imagine you holding a model of a mandible and then push the teeth out. The bone movement would then follow 

 

B)the maxillary upswing would cause the mandible to swing upwards in order for the bite to make contact .

C)The outward and forward expansion of the maxilla gives the mandible more room to jut forward . Picture a smaller U vowel sitting inside a larger U vowel. This enhanced space lets the mandible jut forward naturally while kkeeping a closed bite 

D)Chewing would activate the masseters and in turn this increased muscle growth results in a longer ramus and wider mandible which naturally would "fit iitself " together with the maxilla through the pressures of the teeth coming together during chewing. These forces from the upper teeth against tthe lower teeth would theoretically cause pressure to be applied outwards on the lower teeth.

 

To be honest the last part of D seems the least likely. All of the others IMO would eexplain how the mandible is flexible to the movements of the maxilla.

 

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Posted : 26/03/2018 9:50 am
Apollo
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Posted by: Le_Fort_or_Bust
Posted by: abdul

How does the lower arch keep up with such a massive expansion in the upper arch? Or is the appliance installed in the lower jaw also, though the pictures show the appliance installed on the upper arch only.

Yes, actually this is a legit question, how do lower teeth keep up with upper jaw expanding forward? How does lower jaw grow forward and fit the bite?

For forward changes, the mandible is able to swing up to meet the maxilla in its more forward position. Just try protruding your mandible so that the lower incisors jut out beyond the upper incisors, and it will give you a feel for this potential. This is in contrast to the transverse expansion discussed in the other thread about the mandible keeping up with the maxilla.

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Posted : 26/03/2018 11:41 am
Abdulrahman
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Posted by: Apollo

For forward changes, the mandible is able to swing up to meet the maxilla in its more forward position. Just try protruding your mandible so that the lower incisors jut out beyond the upper incisors, and it will give you a feel for this potential. This is in contrast to the transverse expansion discussed in the other thread about the mandible keeping up with the maxilla.

Dr. Mew often alludes to this process in his description of Orthotropics.  He explains on his website: "This initial treatment creates a temporary malocclusion where the front teeth stick out and the upper jaw appears to be too wide."

http://www.orthodontichealth.co.uk/treatment/

This is of course for kids who are still growing (5-6 years old), but for adults it's different. There is no more growth to compensate for this difference; just limited remolding. Without significant stimulus, I doubt the lower arch can keep up with 12mm forward expansion.

my story: http://www.aljabri.com/blog/my-story/

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Posted : 26/03/2018 12:51 pm
Le_Fort_or_Bust
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Theoretically the compensation could come from teeth shifting. Move upper jaw forwards and tilt the upper teeth to the inside and tilt the lower teeth to the outside. This would partially compensate.

30 yo, need to expand palate, move maxilla upward and forward, reduce gonial angle.

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Posted : 27/03/2018 12:34 pm
Abdulrahman
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Posted by: Le_Fort_or_Bust

Theoretically the compensation could come from teeth shifting. Move upper jaw forwards and tilt the upper teeth to the inside and tilt the lower teeth to the outside. This would partially compensate.

Most people myself included are seeking Orthotropics not to move the teeth around but rather to expand the jaws including the lower. This will open up the airway, resolve tmj, and improve the facial profile.

my story: http://www.aljabri.com/blog/my-story/

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Posted : 27/03/2018 1:33 pm
Le_Fort_or_Bust
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Posted by: abdul
Posted by: Le_Fort_or_Bust

Theoretically the compensation could come from teeth shifting. Move upper jaw forwards and tilt the upper teeth to the inside and tilt the lower teeth to the outside. This would partially compensate.

Most people myself included are seeking Orthotropics not to move the teeth around but rather to expand the jaws including the lower. This will open up the airway, resolve tmj, and improve the facial profile.

I know, but you still have to have a proper bite and teeth have to align properly during bite. If the bite gets messed up, what then?

30 yo, need to expand palate, move maxilla upward and forward, reduce gonial angle.

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Posted : 27/03/2018 5:03 pm
Abdulrahman
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Posted by: Le_Fort_or_Bust

 

I know, but you still have to have a proper bite and teeth have to align properly during bite. If the bite gets messed up, what then?

You can use wires to torque the front teeth forward 1-2mm, but that would be closing the gap that otherwise could be closed with more proper methods such as fixing head posture and releasing tight flexor neck muscles that are holding back the lower jaw. Also when the tongue is postured correctly with backward pulling suction the lower jaw juts forward. I see none of this covered by those appliance promotional materiel. This makes me suspicious of their claims.

my story: http://www.aljabri.com/blog/my-story/

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Posted : 28/03/2018 11:04 am
Amber12
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I made a thread about this earlier, I'm glad someone is bringing it up again. I found some more AGGA pictures

 

 

 

  

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Posted : 31/03/2018 3:31 pm
Amber12
(@amber12)
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And this. I'm actually very very very impressed. These are both after 5mm of advancement and this looks like some legitimate forward growth of both jaws happening. I hope some more people here can give it a try, I can't afford it right now. 

On the bright side, it definitely seems to be doing the same thing as mewing. Same basic premise. Just faster results because it's a device. 

https://www.springfieldsmiledoctor.com/blog/2018/3/20/the-effect-of-airway-on-facial-growth

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Posted : 31/03/2018 3:35 pm
Apollo
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I've done a little more research about this device. It is also called the "controlled arch." I guess it is only "fixed" in the sense that it is bonded to the teeth, in contrast to the "removable anterior growth guidance appliance," which is used in young children. I wondered if there might be any temporary anchorage screws involved, but from what I can tell there aren't. There just seems to be orthodontic bands around the first molars and first bicuspids connected by a wire with a spring on the buccal or lingual side of the arch to an anterior wire that includes an acylic piece to distribute the force over a wider surface area.   

They open up a space between the canines and first bicuspids, and then bring the rest of the teeth forward in a stepwise fashion. It's unclear to me how they insure that the direction of movement is always forward rather than the reciprocal force pushing the rear teeth farther back. This is why I thought they might use temporary anchorage devices screwed into the bone. The initial separation is posterior to the premaxillary suture, so I think this anterior growth is based on bone remodeling rather than suture separation. Dr. Mew has stated on the BTM forum that he believes the premaxillary suture fuses (  http://breakthematrix.createaforum.com/therapies/could-you-please-give-advice-to-a-doctor-trying-to-perfect-maxillary-protraction/msg568/#msg568 ), and I agree that most of the pictures of adult skulls I have seen online don't have a visible premaxillary suture (whereas the midpalatal suture and the transverse palatine suture remain visible). 

Posted by: Mike Mew

The premaxilla is an interesting question, we could discuss it for days but in all the adult skulls that I've seen it is fused as it says in the text books.

I'm wondering if we can learn anything about how this device is successful to apply to mewing or self-treatment. It seems like the FAGGA first makes the arch bigger in an anterior direction and then shifts the teeth into the right position within the bigger arch. I don't think we have any way to accomplish that. Has anyone with a y-plate appliance used it to expand the front teeth forward? If so, how do you intend to close the gap that opens up? When we are pushing forward with our tongues or pulling forward with facepulling devices, it seems like we are trying to pull the whole arch forward rather than expand the size of the arch. Maybe we make the arch bigger by expanding laterally using the midpalatal suture and then the force of the tongue helps redirect some of that extra circumference forward?

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Posted : 31/03/2018 8:55 pm
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Abdulrahman
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Posted by: Apollo

 

One interesting note, the appliance in the picture you posted has the springs mechanism on the outside (buccal side) versus other pictures posted elsewhere where they are on the inside (lingual side). This would make a big difference with tongue posturing.

 

Posted by: Apollo

It's unclear to me how they insure that the direction of movement is always forward rather than the reciprocal force pushing the rear teeth farther back. This is why I thought they might use temporary anchorage devices screwed into the bone.

It could be because the 4 premolars and 2 molars root strength and bone structure is much higher than the 4 incisors and 2 canines, enabling the appliance to push the later group with no effect on the former group.

 

Posted by: Apollo

It seems like the FAGGA first makes the arch bigger in an anterior direction and then shifts the teeth into the right position within the bigger arch. I don't think we have any way to accomplish that. Has anyone with a y-plate appliance used it to expand the front teeth forward? If so, how do you intend to close the gap that opens up?

 I don't think its an accurate comparison because the FAGGA comes with braces to pull the teeth forward after expansion.

 

Posted by: Apollo

When we are pushing forward with our tongues or pulling forward with facepulling devices, it seems like we are trying to pull the whole arch forward rather than expand the size of the arch. Maybe we make the arch bigger by expanding laterally using the midpalatal suture and then the force of the tongue helps redirect some of that extra circumference forward?

Something that caught my attention while I was researching this appliance that goes inline with this is the following:

And that rather the miracle worker of forward growth is this Controlled Arch appliance, which pretty consistently gives some extremely rapid and huge growth. But at the expense of overpowering cranial motion, and therefore being a bit tough on the neurological system.  However he did say that since its nearly 100% bone remodeling that the results are stable.  

https://www.occlivion.com/controlled-arch-appliance-steve-galella/

Makes me wonder if this is as natural and effective as mewing.

my story: http://www.aljabri.com/blog/my-story/

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Posted : 31/03/2018 11:56 pm
Abdulrahman
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Posted by: Amber12

And this. I'm actually very very very impressed. These are both after 5mm of advancement and this looks like some legitimate forward growth of both jaws happening. I hope some more people here can give it a try, I can't afford it right now. 

On the bright side, it definitely seems to be doing the same thing as mewing. Same basic premise. Just faster results because it's a device. 

https://www.springfieldsmiledoctor.com/blog/2018/3/20/the-effect-of-airway-on-facial-growth

 

As shown below, I did a rough measurement and yes this is pretty impressive.

 

 

This patient actually really needed this advancement as both her upper and lower jaws were behind her nasion. Note though, both of her jaws were matching before treatment. I am still not sure how the lower jaw was advanced. The only mention I find of this is: 

In the meantime the lower braces will straighten the lower teeth. Once all the gaps are closed, the upper and lower teeth are coordinated to ensure optimal aesthetics and function.
http://thewholedentist.com/2016/03/07/my-2nd-post/

my story: http://www.aljabri.com/blog/my-story/

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Posted : 01/04/2018 5:25 am
krollic
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What sort of intermolar width do you have to have to be in need of such a product because proper oral posture isn't a feasibility? It's hard to picture the average person dropping 10 grand for such a device unless they didn't have an alternative.

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Posted : 01/04/2018 12:53 pm
Abdulrahman
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Posted by: krollic

What sort of intermolar width do you have to have to be in need of such a product because proper oral posture isn't a feasibility? It's hard to picture the average person dropping 10 grand for such a device unless they didn't have an alternative.

Inter-molar width is a measurement used for the arch transverse (width) expansion. This appliance is mainly used for sagital expansion (moving jaws and teeth forward). 

my story: http://www.aljabri.com/blog/my-story/

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Posted : 01/04/2018 1:52 pm
Apollo
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Posted by: abdul

Posted by: Apollo

It's unclear to me how they insure that the direction of movement is always forward rather than the reciprocal force pushing the rear teeth farther back. This is why I thought they might use temporary anchorage devices screwed into the bone.

It could be because the 4 premolars and 2 molars root strength and bone structure is much higher than the 4 incisors and 2 canines, enabling the appliance to push the later group with no effect on the former group.

Yeah, I guess it could be that whatever backward movement occurs is insignificant in comparison to the forward movement because of the anchorage of more and/or bigger roots.

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Posted : 01/04/2018 2:33 pm
krollic
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Oh, ok. Thanks for clearing that up. I still wonder though is; does this device does not achieve what is capable by mewing even with a shorter sagittal length?

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Posted : 01/04/2018 2:43 pm
Apollo
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I found this x-ray comparing the airway before and after treatment on the website for Dr. David Buck ( http://balanceepigeneticorthodontics.com/serices/growth-guidance-for-adults.html ). This is one of the three websites from the OP, and it seems like Dr. Buck regularly uses the FAGGA or "controlled arch" appliance. This image didn't note if the FAGGA appliance was used in this case, but I think its safe to assume that it was used based on the gap between the canines and bicuspids in the "after" radiograph. The arrows are directing our attention to the improved airway, I think this can be attributed to the tongue being able to sit farther forward in the palate, and the mandible being able to swing farther forward in occlusion. However, I am more interested in looking at how the shape of the maxilla has changed. First, note that the patient has an aquiline or "hooked" nose. This is unchanged in the "after" image. The zygomatic arch also appears to be in roughly the same position, although its anterior border is less distinct in the "after" image. Even the acanthion of the maxilla just below the nose doesn't appear significantly expanded forward, and it's hard to say if there is any change in the position of the bend where the palatine process of the maxilla turns down into the alveolar process. What is clear is that the roots of the incisors are both shifted forward in relation to the alveolar process and also tipped forward almost to the point of a class II malocclusion. It seems like this would cause a greater risk of root resorption than traditional braces, and there's not a significant change in the position of the rest of the maxilla, zygoma, or other facial bones. I also notice that during this in-between stage when the gap has been opened between the canines and bicuspids, but the posterior teeth haven't yet been shifted forward to fill the gap, it appears that the molars and bicuspids do move backward when the canines and incisors move forward (as I speculated earlier). Compare the position of the back teeth to the ramus. The rear second molar even looks a little tipped backward. I guess as they move the teeth forward one at a time to fill the gap this backward movement is reversed. The final occlusion should look better once they close the gap. All this is just to say that the results of this device do look promising, but I don't think it's a panacea for craniofacial dystrophy.

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Posted : 01/04/2018 4:03 pm
Allixa
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Bad news - and there's no way to say it gently, this device is a scam.

It pushes on the teeth only and not on the skull bones which causes bimaxillary protrusion. This means that the teeth get pushed away from the bone into a dangerous position. This is clear in the above x-ray. Look at his upper teeth. Look at how the front ones moved. Look at how the back ones moved. Look at how the maxilla itself didn't. All the proof you need is in that x-ray if you study it carefully.

Be very careful of before and after photos. It's very easy to fake results using camera angles, lighting, and head tilting. Make sure to check all supposed results photos very thoroughly. Check the nose bridge angle. Check the ear angle. Check where the camera is pointed at. 99 percent of these types of pictures are frauds. All of the ones posted in here are. And even if a person does get slight advancement using a device like this, if it happens just because of teeth movement then it's not true advancement and it doesn't matter or help at all. In fact it's bad for the teeth like apollo said.

The worst part is that by artificially moving your teeth forward with a device like this, you are taking away your potential to make real skull changes through mewing. Your tongue and jaw can only help move the skull up to their natural limit. If you artificially move the teeth forward to that limit then the tongue and jaw get taken out of the picture and can no longer help.

If you want more information on this topic feel free to go back through my old posts where I talk about orthotropics and the DNA appliance (3 separate threads).

That said, I encourage you to experiment with it if you are willing to take the risk. But make sure before you do that you really study up on just how ineffective these kinds of devices are. Pushing on teeth does not move skull bones. Least resistance - teeth always move first. The guy in the x-ray had his dentition ruined for no skull or airway gain at all. Anyone can get a larger airway by tilting their head upward and pushing their jaw forward a bit. Look at the top of his skull and the fact that his teeth aren't touching in the after photo for proof. These devices are a joke.

But like I said feel free to try it if you want, but make sure you are fully informed before you do.

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Posted : 01/04/2018 5:29 pm
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Abdulrahman
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Posted by: Apollo

I also notice that during this in-between stage when the gap has been opened between the canines and bicuspids, but the posterior teeth haven't yet been shifted forward to fill the gap, it appears that the molars and bicuspids do move backward when the canines and incisors move forward (as I speculated earlier). Compare the position of the back teeth to the ramus. The rear second molar even looks a little tipped backward. I guess as they move the teeth forward one at a time to fill the gap this backward movement is reversed.

I think that is why the effect of this appliance is referred to as rough on the teeth. Moving the back teeth further back and then pulling them forward while using the retained front teeth as anchor point is rough on all the teeth.

my story: http://www.aljabri.com/blog/my-story/

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Posted : 01/04/2018 11:47 pm
Abdulrahman
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Posted by: Allixa

Bad news - and there's no way to say it gently, this device is a scam.

I would not go as far as calling it a scam, but it certainly looks over glorified by marketing. Also, allot of important details are not covered, which is a valid source of suspicion. 

my story: http://www.aljabri.com/blog/my-story/

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Posted : 01/04/2018 11:50 pm
Meltcel
 Meltcel
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Shifting teeth only is why a lot of us don't support the idea of orthodontics. If maxillary upswing and expansion is the goal, merely moving teeth alone would make this a scam IMO

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Posted : 02/04/2018 1:12 pm
Apollo
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While I appreciate that people are agreeing with my skepticism, remember that I could only find x-rays for one case. I'm reserving judgement for now, but based on the evidence so far, it's not something I would want done on myself. Maybe we could find more evidence of skeletal movement if we examined more cases. The device does use that acrylic piece behind the incisive papilla in addition to the wire behind the incisors so I was hoping to see some anterior displacement of the alveolar process on the x-ray.

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Posted : 02/04/2018 4:19 pm
Amber12
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20 Weeks FAGGA. What do you guys think of this progress? 

I'm getting seriously irritated by the lack of lighting consistency for every before/after for every single thing that we ever discuss here. Even professional clinics are screwing up the lighting and making direct comparisons very difficult.

One change that definitely can't be lighting is the size/shape of his lips. And in the profile view he's getting that bulging masseter -> cheekbone line that well developed faces get. His head is rotate but he says that this is his new natural posture 

 

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Posted : 04/04/2018 8:48 am
Abdulrahman
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Yes the lighting difference is significant, soft and flat versus hard and directional. The later gives way more defined features, but I think as you pointed out there are some great improvements. Namely, the forward head posture reduction to neutral. Also, the masster muscles and the lips are much more pronounced. I think FAGGA is responsible for the lips part only. Most of the improvements are due to this man's hard work to fix his neck and strengthen his jaw muscles.   

Where did you find it by the way?

edit: I forgot to add one more change, he got a "tough" look on his face 😉 

my story: http://www.aljabri.com/blog/my-story/

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Posted : 04/04/2018 10:32 am
Meltcel
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In some cases lips seem to get thicker. What about in cases where they are too pouty? I hope that goes away. Lip fullness doesn't bother me but more so lip pout from the profile. I know it is possible to have a fully flat profile and full lips as I see it all too often in many men I know.

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Posted : 04/04/2018 12:27 pm
TGW
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Posted by: Apollo

 It seems like this would cause a greater risk of root resorption than traditional braces, and there's not a significant change in the position of the rest of the maxilla, zygoma, or other facial bones. I also notice that during this in-between stage when the gap has been opened between the canines and bicuspids, but the posterior teeth haven't yet been shifted forward to fill the gap, it appears that the molars and bicuspids do move backward when the canines and incisors move forward (as I speculated earlier). Compare the position of the back teeth to the ramus. The rear second molar even looks a little tipped backward. I guess as they move the teeth forward one at a time to fill the gap this backward movement is reversed. The final occlusion should look better once they close the gap. All this is just to say that the results of this device do look promising, but I don't think it's a panacea for craniofacial dystrophy.

Good observations. And interestingly it seems as if this is something that is actually part of the normal growth pattern. Here's an orthotropics picture:

Front teeth tip forwards, rear teeth seem to move back in relation to the lower jaw (but forward overall).

I dismissed the FAGGA initially but I've been researching it heavily recently. My doubts are decreasing, but the lack of X-rays, proper pictures, and other scans is discouraging. But I have found multiple practitioners claiming mid-face correction, cheekbone prominence etc from this device. I've sent out a few emails asking for before/afters and xrays, and I've booked a consultation with someone who does this near me, so that I can talk to them and understand what they think they're actually accomplishing. 

As the maxilla comes forward, it also rotates in the same way that the incisors are rotated here. This scan is mid-way through treatment, so we need to see what it looks like when the back teeth are brought forward. 

Something that bugs me is how long this device/technology has been on the market and how little it's used and how few before/afters are available. The ALF has the same issue. 

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Posted : 04/04/2018 1:02 pm
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I also found an article behind a paywall:

http://www.readingeagle.com/life/article/correcting-jaw-problems

Dr. David Schwartz said you can tell when a face is out of proportion.

The best example, he said, is comedian Jay Leno. His signature big chin actually comes from an upper jaw that never grew to its full size, Schwartz said.

On the other end of the spectrum are people who appear to have no chin because the lower jaw is trapped behind the upper jaw.

"Genetically we are all designed to grow a certain way," said Schwartz, owner of Schwartz Family Dental in Wyomissing. "But sometimes environmental factors prevent the body from reaching its potential. It happens a lot when it comes to facial growth and development."

For some people, the problems that start with the jaw may be more cosmetic, Schwartz said. But for others, those issues can lead to lingering symptoms, like chronic headaches, sleep apnea, facial pain and temporomandibular joint syndrome, or TMJ, he said. Others may have trouble speaking or eating.

For years, Schwartz has been on the lookout for a method to get the jaw to grow to the right size. For many patients, surgery has been the only option, he said.

Last year he found it in a device called an anterior growth guidance appliance, he said.

After receiving the required training, he's brought the appliance to his practice in Wyomissing, using it in about 12 patients so far.

"In four months of wearing this upper appliance, you see about 8 to 10 millimeters of new bone growth, which is about what a person needs," he said.

People can continue to grow bone in their jaw well into the life span, Schwartz said.

The tongue is supposed to stimulate a spot in the mouth that encourages the jawbone to grow. The process happens when breathing through your nose, Schwartz said.

But some environmental factors, such as poor air quality and seasonal allergies, can affect facial development over time, he said.

The creator of the device, Schwartz said, "actually was able to find a spot that, if stimulated, could get the upper jawbone to start growing again. It finishes the task it was assigned to do but for some reason couldn't."

He said that growth happens in a matter of months.

"The mid-face grows out," he said. "It's not just expansion in one area. It's three dimensions of growth."

Who it helps

Sarah Giorgio of Myerstown has always had problems with her teeth.

She's had teeth pulled and worn braces three times. One dentist wanted to do surgery that would have required her jaw to be wired shut for a stretch of time.

Those teeth problems have led to other health issues, such as debilitating migraines and jaw and neck pain.

Giorgio did not want to have an invasive surgery to fix her jaw placement. In June, she elected to have the appliance put in, and it's already showing some positive results, she said.

The appliance fits behind the front six teeth, and there's a piece applying pressure on the roof of Giorgio's mouth.

The device is moving her teeth forward, but it's also growing the bones in her jaw, she said.

There have been some adjustments that have come with having the appliance in place, but Giorgio is taking the long view.

"It's knowing this is a means to an end, that this will correct the problem that no one else could have been able to without surgery," she said.

She goes to Schwartz for monthly visits to check the progress and to make adjustments. The plan is to remove the appliance after a few more months of growth and then begin orthodontic work.

Giorgio, 38, said she hopes to have all the work behind her by her 40th birthday.

"A lot of times people have symptoms they don't realize are related at all to their mouth," she said. "All those muscles in your mouth are attached to your neck. If you pull your neck out of alignment, your whole body is out of alignment."

The right spot

Giorgio and about a dozen patients have received the appliance over the last six months or so, Schwartz said. The first crop of patients are getting ready to have them removed.

The time it takes for the jawbone to grow will vary from patient to patient, he said, but younger people tend to grow bone faster than older people.

Patients will need orthodontic work once the appliance is removed, but they are on a path to fix their underlying issue, he said. Schwartz would not say how much the appliance costs, but financing plans are available to spread the cost over a few years.

The appliance provides an alternative for some patients to avoid facial surgeries, he said.

"There's a lot of pain when your face is torn apart and put together," he said of surgery.

Schwartz said life is a lot easier when your jaw is the right size.

"When the bones are in the right spot, the smile is in the right spot, and everything is where it's supposed to be," he said.

Here's a practitioner describing what they can do:

https://www.konigdds.com/anterior-growth-guidance-appliance

Houston dentist Dr. Ronald Konig is pleased to offer both removable and fixed anterior growth guidance appliances for patients whose malocclusion or facial asymmetry may have previously required surgical intervention. With a growth guidance appliance, Dr. Konig can gently restructure the upper jaw and midface, helping eliminate breathing problems, severe TMJ, and irregular facial development.

  • Fixed (FAGGA) – the fixed anterior growth guidance appliance is best for adults who struggle with severe TMJ or sleep breathing problems (apnea). Unique among dental expanders, the FAGGA expands the upper jaw anteroposteriorly to create more tongue space, open airways, and improve TMJ issues. FAGGA treatment may also improve the appearance of the cheekbones, eyes, nose, and lower jaw

Another:

https://elitedentalgroup.org/services/controlled-arch/

ControlledArch® Treatment System offers Orthodontic solutions for patients of all ages and all aspirations. From purely cosmetic outcomes to comprehensive Orthodontics, ControlledArch has it covered. ControlledArch Treatment options are designed to work with and not against nature, by simply assisting or reminding the body of the natural genetic intention of your facial development.

We have incredible results. I am able to grow 6 to 8 mm without any problem. I working on one to grow 24mm, so far we have grown him 12mm. This saved him from orthognathic surgery for sure.
Controlled ortho is proceeded with facial growth guidance.
Heng Lim,DDS

 

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Posted : 04/04/2018 1:13 pm
Greensmoothies
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Estimable Member

Hmm.... so what I'd like to know is what is this magic spot on the palate that encourages jaw growth?

6-8mm forward growth without any problem from a device could be amazing.

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Posted : 04/04/2018 4:17 pm
Lee
 Lee
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www.migrainehacks.com is the guy above.

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Posted : 04/04/2018 8:28 pm
Abdulrahman
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Reputable Member
Posted by: Lee

www.migrainehacks.com is the guy above.

 

Thanks for sharing, that's a really nice blog. Going through it, especially the Q&A section, answered many questions about this appliance. I particularly liked his description of the FAGGA appliance where he compares it to traditional expanders:

 

Traditional palate expanders attempt to expand the maxilla by exerting forces on teeth. In this sense, they are "mechanical." They attempt to expand using brute force

....Treatment with the Anterior Growth Guidance Appliance is a physiological, not mechanical, process. It takes advantage of the body's natural ability to deposit bone in response to trauma, micro-trauma or soft tissue stimulus

.....Essentially, the AGGA plays the role of an ideally functioning tongue

......The Anterior Growth Guidance Appliance serves as an artificial tongue. It stimulates the soft tissue of the palate in the same way that an ideally functioning tongue does. Even for an adult, the body responds to this soft tissue stimulus by depositing bone throughout the face.

https://ww w.migrainehacks.com/new-blog-1/2018/1/31/the-best-adult-palate-expander

 

I also liked his answer to the question "How do you know FAGGA is creating bone and isn't just shifting teeth?" in the Q&A section:

One reason I don’t think wedging is occurring is because FAGGA hardly exerts any mechanical force. It does not have the power to shift teeth the way that, say, braces or acrylic appliances do. All it does is provide a very gentle, subtle stimulus through the oval-shaped plastic plate in the middle of my palate

The rear teeth would never shift backward if being pried against the front teeth. The rear teeth have much more robust root structure compared to the front.

 

He also explains how the lower jaw moves forward to match up with the upper expanded jaw in a similar way to Dr.Mew: 

According to Dr. Kundel the appliance "reshapes" the mandible by depositing bone at the back of the mandible and triggering bone resorption at its bottom.

This creates a more horizontal rather than vertical lower jaw which I believe there is evidence of in the GIF above.

....As mentioned above their whole purpose is to make occlusion possible while the mandible slides forward as it repositions itself in relation to the forward-growing maxilla. They will be removed prior to the braces phase of treatment.

 

 

my story: http://www.aljabri.com/blog/my-story/

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Posted : 05/04/2018 1:35 am
TGW
 TGW
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Part of my email: 

[...]

We have been discussing the possibilities of the FAGGA device with others looking to correct midface/maxillary issues. I was wondering if you could post/send more before/after Xrays using this device, especially ones where full treatment is completed. The main point of contention at the moment is whether the maxilla has actually moved or whether the devices are causing dental movement. The Xray posted on your website (airway space) depicts largely dental movement, but since the treatment does not seem to be complete in this Xray this may be inaccurate.

Any additional pictures and Xrays that you could post/provide would be immensely appreciated. Or, if you would like to discuss directly with the userbase, the website is here: the-great-work.org/community/main-forum

Thank you

Part of the response from Dr. Buck:

I think the quote, " If it is being done, it is probably possible" applies here. By unlocking the 3 dimensional remodeling capacity within known and accepted growth centers/sites in the jaws so clearly depicted by Dr. Enlow, we can literally, "grow a face". In response briefly to criticisms I noted on your site, no this appliance does not distalize teeth; does not flare teeth; it causes 3 dimensional bony remodeling in the entire Nasomaxillary complex, and is followed by a specialized form of orthodontics again developed by Dr. Galella called Controlled Arch orthodontics which allows for transverse final placement of the molars and protractive mechanics to bring all the teeth forward, effectively relocating the entire Maxilla as in a LeFort procedure, but better because of architectural changes in the nasal cavity and malar processes. Additionally the Mandible is fully remodeled forward by Ramus uprighting ( Dr. Enlow); Condylar remodeling and finally vertical drift ( Dr. Enlow). This stimulation is greatly enhanced by the presence of the growth appliance once activated. This effect is again much like a BSSO surgical advancement of the Mandible, again only better because the Condyles are allowed to physiologically remodel and heal not stay jammed back as in a surgical advancement procedure.

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Posted : 05/04/2018 8:28 pm
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I am not pasting the communication/email chain here: it seems unorthodox to paste an entire reply directed to me as if it were intended as a response to the community.

He did praise the community:

I see it is a very educated group of members. Are they mostly dentists? Or are they other professionals who are involved in structural and body work?

But did seem disappointed by the lack of faith in the philosophy behind the appliance, and in the work of Dr. Galella and Dr. Enlow:

I see a typical pattern of criticisms which is so common in any dental professional group. If a dentist does not understand something, the first response more often than not is to criticize it, of course without fully investigating it to be able to make educated assessments.

I think that we can understand this, as his brief visit to that specific thread may have given the impression that we are not approaching the ideas with the same philosophy - of stimulating natural and non-surgical growth in adults. I take that as my own fault for not communicating that we are, in fact, the largest community dedicated to naturally growing our skull/face/spine into its proper form by returning to posture and function.

Dr. Buck says that there are now many thousands of professionals who (although they may not be publically advertising it much) are switching to the philosophy of naturally growing the jaws to their proper size. Dr. Buck actually teaches the course on "epigenetic facial development utilizing orthodontic appliances" at the Las Vegas Institute. I've gone through their curriculum and tried to understand their philosophy through the papers/articles published, and it seems that this of the same vein as Orthotropics and the work of the Mew's. 

This isn't an endorsement post from me of these specific techniques/devices.  The community brings up the questions, I do my best to get answers from the top professionals in the field. 

---

Edit: I've received requests for updates on the Mew and Hornsby Q&As. Dr. Mew has recorded some answers and will cover others later. Upload date to be determined. He has become very busy lately, but still intends to get through the entire Q&A. Sarah Hornsby has received the questions and will post the video at some point in the future as well. I know this is vague, but I don't intend to bother them for updates when they've already communicated that they'll do it when they have time. 

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Posted : 05/04/2018 8:43 pm
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Lee
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Dr Buck often answers questions in an LVI facebook group. Yes it's in the same vein as orthotropics but they never talk about "mewing," rather proper tongue position and posture, myofunctional exercises, atlas position, the dangers of extraction ortho, and letting the body heal itself.

ETA: the fb group is strictly for LVI physiological dentistry. They don't allow for criticism of their treatment protocols or recommendations of non-LVI treatment. It's to join patients and dentists to discuss their treatment.

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Posted : 05/04/2018 9:05 pm
Abdulrahman
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Thanks for going through this effort. So far this procedure sounds great, but we just need more and better documented before and after cases. I think the team behind this appliance can do more in this regard.

By the way how is this appliance obtained, are there specific labs that make it?  

my story: http://www.aljabri.com/blog/my-story/

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Posted : 05/04/2018 11:35 pm
Lee
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The dentist has to be trained in it, either via LVI or from Galella's Facial Beauty Institute. Galella developed it 20 years ago and he teaches it around the world. I did see one lab in Indiana has an order form for it:  http://www.johnsdental.com/wp-content/uploads/2016/12/dr_galella_growth_rx_edited.pdf

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Posted : 06/04/2018 12:36 am
Abdulrahman
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Posted by: Lee

The dentist has to be trained in it, either via LVI or from Galella's Facial Beauty Institute. Galella developed it 20 years ago and he teaches it around the world. I did see one lab in Indiana has an order form for it:  http://www.johnsdental.com/wp-content/uploads/2016/12/dr_galella_growth_rx_edited.pdf

Thanks Lee. Are there any doctors certified in this method outside of the USA and Australia?

By the way, you know allot about the subject, did you undergo the treatment?

my story: http://www.aljabri.com/blog/my-story/

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Posted : 06/04/2018 1:17 am
Lee
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I'm trying to start it asap. I know a handful of people who recently began it or have spacers in now to prep for it.

The only locator I know of is at the LVI website. There are a few dentists who just took the first AGGA course in January, they are in Germany, London and Ireland. They still have two more courses to take to be fully versed in the process from start to finish, but they can begin it now on patients if patients don't mind being guinea pigs.

I know there are more who learned it from Galella who could be anywhere in the world, but there is no locator as of yet for them.

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Posted : 06/04/2018 1:48 am
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I'm still skeptical of this device/appliance, but I am willing to have an open mind about it because I realize that it represents a potential new breakthrough for what we are trying to achieve.

I can't see how pushing on the teeth would create real skull growth, and I'd like to see some hard proof because the images in the other thread were not very convincing, especially the xray. My wish is that anyone who is looking at this device will be skeptical of the claims presented,  will question things deeply, and will not trust without verification.

I wouldn't have a clean conscience unless I made this post. I promise that this is the last time I will bring this issue up, and I wish good luck to whoever moves forward with the treatment.

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Posted : 06/04/2018 1:55 am
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Posted by: Lee

I'm trying to start it asap. I know a handful of people who recently began it or have spacers in now to prep for it.

The only locator I know of is at the LVI website. There are a few dentists who just took the first AGGA course in January, they are in Germany, London and Ireland. They still have two more courses to take to be fully versed in the process from start to finish, but they can begin it now on patients if patients don't mind being guinea pigs.

I know there are more who learned it from Galella who could be anywhere in the world, but there is no locator as of yet for them.

Can you share their contact details if you know them?

I guess one way to figure out who is certified is to contact Dr. Galella directly with that question or even Dr. Buck for that matter.

Best wishes with your treatment. Please keep us updated.

my story: http://www.aljabri.com/blog/my-story/

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Posted : 06/04/2018 2:33 am
Abdulrahman
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Posted by: Allixa

I'm still skeptical of this device/appliance, but I am willing to have an open mind about it because I realize that it represents a potential new breakthrough for what we are trying to achieve.

I can't see how pushing on the teeth would create real skull growth, and I'd like to see some hard proof because the images in the other thread were not very convincing, especially the xray. My wish is that anyone who is looking at this device will be skeptical of the claims presented,  will question things deeply, and will not trust without verification.

I wouldn't have a clean conscience unless I made this post. I promise that this is the last time I will bring this issue up, and I wish good luck to whoever moves forward with the treatment.

It doesn't, the little acrylic pad that rests on hard palate around the incisive papilla stimulates remolding much like the tongue does but in a more pronounced extent, as it's constantly in contact. At least that is what they claim. Check my last post on the other thread if you like to know more:

https://the-great-work.org/community/main-forum/fixed-anterior-growth-guidance-appliance-fagga-holy-grail-gonial-angle-change-maxilla-movement-forwards-and-palate-widening-without-surgery/paged/2/#post-1970

my story: http://www.aljabri.com/blog/my-story/

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Posted : 06/04/2018 2:37 am
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Lee
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Posted by: abdul
Posted by: Lee

I'm trying to start it asap. I know a handful of people who recently began it or have spacers in now to prep for it.

The only locator I know of is at the LVI website. There are a few dentists who just took the first AGGA course in January, they are in Germany, London and Ireland. They still have two more courses to take to be fully versed in the process from start to finish, but they can begin it now on patients if patients don't mind being guinea pigs.

I know there are more who learned it from Galella who could be anywhere in the world, but there is no locator as of yet for them.

Can you share their contact details if you know them?

I guess one way to figure out who is certified is to contact Dr. Galella directly with that question or even Dr. Buck for that matter.

Best wishes with your treatment. Please keep us updated.

Buck would just tell you to go to the LVI website. Galella could tell you if he'd ever respond and take the time to look through his records 🙂

David Cook:
London Holistic Dental Centre
Suite 340-41 Wimpole Street
London W1G 8AB

t: +442074875221
www.londonholisticdental.com

DR. JOHN HAUGHEY

Chatham St. Dental Care
4 Chatham StreetDublin 2, 

Dublin D14
www.chathamstdentalcare.ie
 

Dr Charles Smith:
Progressive Practice for Family and Aesthetic Dentistry
Röemerstrasse 7
Heidelberg 69115
t: 011-49-6221-651-6090
www.heidelbergdentistry.com

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Posted : 06/04/2018 2:55 am
Abdulrahman
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lol, you gave me the short answer.

Thanks for the contacts, I will reach out to them after I complete my current transverse expansion in few months. I like to also follow people on the forum who are undergoing the treatment. In the mean time maybe I can find someone closer to me in the ME region. I would not me surprised if someone in Dubai is already certified for this but not listed anywhere. Are you part of the privet Facebook group you were referring to earlier?

my story: http://www.aljabri.com/blog/my-story/

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Posted : 06/04/2018 3:04 am
Jorge
 Jorge
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Be sure to check out this guys blog he has been using the FAGGA for 20 weeks and has posted pictures of his progress.  https://www.migrainehacks.com/new-blog-1/2018/3/15/anterior-growth-guidance-appliance-faqs

 

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Posted : 06/04/2018 4:57 am
Allixa
(@allixa)
Estimable Member
Posted by: abdul
Posted by: Allixa

I'm still skeptical of this device/appliance, but I am willing to have an open mind about it because I realize that it represents a potential new breakthrough for what we are trying to achieve.

I can't see how pushing on the teeth would create real skull growth, and I'd like to see some hard proof because the images in the other thread were not very convincing, especially the xray. My wish is that anyone who is looking at this device will be skeptical of the claims presented,  will question things deeply, and will not trust without verification.

I wouldn't have a clean conscience unless I made this post. I promise that this is the last time I will bring this issue up, and I wish good luck to whoever moves forward with the treatment.

It doesn't, the little acrylic pad that rests on hard palate around the incisive papilla stimulates remolding much like the tongue does but in a more pronounced extent, as it's constantly in contact. At least that is what they claim. Check my last post on the other thread if you like to know more:

https://the-great-work.org/community/main-forum/fixed-anterior-growth-guidance-appliance-fagga-holy-grail-gonial-angle-change-maxilla-movement-forwards-and-palate-widening-without-surgery/paged/2/#post-1970

Yeah I read that post. But the xray posted in that same thread shows a different result than what they claim would happen.

I've marked in blue what happened to the upper teeth after treatment. You can see that they have become flared both forwards and backwards, with no change in actual skull shape - in other words no skull growth at all like they claim happens.

I've marked in red proof that they took the before and after photos from different head postures for some reason.

Next is the idea that the FAGGA stimulates growth somehow. I'd need to see proof, it's a very interesting claim but really stimulating growth just seems like fancy words for 'applies pressure'.

I've marked in red where I believe the force vectors are on the left picture. I was wrong to say that it just pushes on teeth for the front. It looks like it pushes on the palate as well, especially if it uses the acrylic piece like the picture on the right. But still we have to keep basic physics in mind - for every action there is an equal and opposite reaction. Pushing forward on the palate/teeth will push backwards onto whatever is bracing the force which in this case is the back teeth. This explains the x-ray above and how the back teeth got tipped backwards.

Now on the right-hand photo I've marked in red where there is a huge area of missing potential for force. This area in red is where I feel good force/pressure when I mew with my tongue, not just on the spot where the acrylic is.

My suspicions are that this device simply flares the front teeth outwards with zero actual skull growth, and that all the talk of stimulation and genetics are just marketing. I do have an open mind about it though but really want to see some actual evidence and proof for their claims.

My greatest fear is that this is basically Maxilla Method 2.0 and that it's going to lead us down another wild goose chase.

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Posted : 06/04/2018 6:25 am
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Abdulrahman
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I see all the the things you are highlighting and they make sense but do you see them in the pictures posted by Ronny Ead on his blog? I posted the pictures below for you.

Also comparing this to the maxilla method is far fetched because that was a scam by one guy who no one knew and who hardly posted any evidence. This appliance is promoted on the websites of like 10 to 20 orthodontists with locations and phone numbers. 

before treatment

 

20 weeks into treatment

my story: http://www.aljabri.com/blog/my-story/

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Posted : 06/04/2018 7:27 am
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Thor91
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https://pdfs.semanticscholar.org/5abe/48bcd923d2f8eca9285d1a847213fa2a79ce.pdf

I think this is an article about Growth Guidance Appliances in childs.

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Posted : 06/04/2018 8:24 am
Sam
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I have been lurking here for a couple of months. I have gone on a consultation for this appliance. I am still hesitant to begin this procedure. Some of the FAGGA photos are very impressive, however, I see no photos of the finished dental product. I am curious to see how the bite and teeth look after completion. A big concern I have is root absorption and gum erosion. I am also annoyed by the photos that do not mimic lighting and position. I think that if these practitioners want to drum up business, they would plaster the good results all over the internet. I understand patient privacy concerns but there are ways to conceal identity and still show results. Some questions I have are:

How many successful cases have there been? What are the main concerns/dangers of moving teeth in this manner? (If practitioner says none, big red flag.) I would Like to know exactly why traditionally trained orthodontists/surgeons feel this does not work.  What happens to the bite when the molar build ups are removed, does a posterior open bite remain? molar extrusion is not a guarantee with braces. How difficult is it to correct the malocclusion created? Is it always successful? There are many more as well.

I have another consultation with a FAGGA practitioner next week where I hope to have my concerns answered. If anyone has any questions they feel are important to this conversation, please let me know, and I will try to ask them if I feel they are pertinent. I am hoping the photos that are published are true results, but I still have some dental safety concerns. I would really like to speak with someone who has had this procedure done to completion. It seems that this is a fairly new way to use this device, and I am not sure I want to be the guinea pig.

 

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Posted : 06/04/2018 1:46 pm
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Posted by: Allixa
Posted by: abdul
Posted by: Allixa

 

 

Yeah I read that post. But the xray posted in that same thread shows a different result than what they claim would happen.

 

 

Look at the skin under his chin. His head posture doesn't seem to have moved much, but he's gone from turkeyneck to normalneck. I really wish I had some sort of photo editing/measuring ability, but I'm going to have to send out a request to the forum: Can anyone measure distances from an arbitrary point on his cranium to the tip of his chin, front of his maxilla, his back molars.. basically all over the craniofacial complex?

Because that would mean forward growth. I can't eyeball the two images properly and I don't know how to edit it myself.

Or if someone could do the overlay GIFs for this case?

 

EDIT: I tried it myself with an online tool. I measured from that bony spike at the back of the cranium, to the tip of the chin (bone only for both). Also from the top vertebrae to the tip of the chin. Both of these measurements are higher, the lower jaw has definitely come forward. I measured to the back molars as well, and they don't seem to have measurably gone backwards at all. Which makes it possible that they appear further back as a result of the maxilla having remodelled forward in comparison while they are stuck in place. 

I couldn't get this to repeat for any other point on the maxilla/face, some are the same and some even seem less. Staring at the image for a long time, I'm basically reached the conclusion that this persons head is either tilted away/towards the X ray machine or is entirely closer or farther from the machine in both pictures. I think this is accidental, it's just very hard to get the same Xray twice (since you can't just keep taking them). 

So it looks like the lower jaw has definitely come forward, and since the appliance is on the upper jaw this must mean that the upper jaw/maxilla has also remodelled forward to have caused this change in the lower jaw. Right? Maybe I'm wrong. 

Measurements from the very back of the cranium to the tip of the chin would only have increased if the lower jaw came forward. The appliance only applies pressure to the upper jaw, so we must attribute this to changes in the upper jaw (?). The tilting/rotation of this persons head between X-rays makes it impossible to measure properly the changes in distance between the back of the cranium and parts of the maxilla. 

If anyone has other theories I'd like to hear them. This is the best I could think of

If someone could line up the spike on the back of the cranium in both images, and the top vertebrae, and do that before/after GIF fade it would answer a lot of questions about what happened to the maxilla and jaws. 

 

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Posted : 06/04/2018 6:53 pm
Apollo
(@apollo)
Reputable Member
Posted by: abdul
Posted by: Lee

www.migrainehacks.com is the guy above.

Thanks for sharing, that's a really nice blog. Going through it, especially the Q&A section, answered many questions about this appliance.

Another section of the Q/A addresses the utility of comparing before and after x-rays, with comments from Dr. John Mew:

Did you take x-rays (such as a lateral cephalogram) prior to treatment? Will you take new images upon the completion of treatment and compare the two to see if change to your underlying bone structure has occurred? 

I had a cone beam x-ray done with Dr. Kundel before treatment began. Another will be taken after. I will definitely make these available later on.

But I think Dr. John Mew makes a fair point when he argues that these x-rays may not be so useful in determining whether or not bone growth has occured. 

In a message to me he warned that “in my experience X-rays are misleading as the bones remodel making the 'landmarks' unreliable so they disguise what actually happens.” 

He later added that “it worries me that so many clinicians consider that X-rays will give them an idea of what is happening inside the skull [throughout the process of facial redevelopment]. When the inter-cranial bones move they also remodel and so the landmarks move too. This of course means that we don't really know what happens.” 

This might explain some of the lack of discernible skeletal changes in Dr. Buck's X-rays. However, I tried some image manipulation to see if we could find any sign of anterior expansion of the maxilla. I took the before and after x-rays and created their negatives so that the whites were black and the blacks were white. I then colorized the "before" image yellow and the "after" image blue, overlayed a transparency of the "after" image on top of the "before," and rotated the before image to align with the after. It doesn't really show much that we didn't already observe in the side by side. Overlap of the two colors appears green. The blue and yellow palatal and alveolar processes of the maxilla seem to totally overlap, but the blue incisors angle forward. The yellow "before" zygoma is visible farther forward than the blue "after." The blue mandible is able to sit farther forward, but I don't see much sign that anything besides the teeth moved in the maxilla.

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Posted : 06/04/2018 8:23 pm
Apollo
(@apollo)
Reputable Member

Here's another before and after comparison:  https://www.lviglobal.com/wp-content/uploads/2017/06/ProbablyPossible.pdf

Maybe there's some change to the shape of the alveolar process?

 

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Posted : 06/04/2018 8:52 pm
Gifferthegifgiver
(@gifferthegifgiver)
New Member

I've been lurking but I think I'm pretty good with these so I'll jump in with a before/after GIF. I think that they're a lot better at seeing what has changed and grown than two static images on top of eachother.

I've locked the back of the cranium/occiput in place and centered everything around the middle of the skull. When you fade in/out it's almost like watching what grew and moved in real time.

The spine straightens up and decompresses, the lower jaw moves away from the cranium (like you said)

And I think it shows very clearly the entire midface developing up and forward, along with the cranium bones moving in relation to the craniofacial complex. Look at the soft tissue and bones while keeping in mind that the occiput bone (rear back of the skull) is pretty much fixed in place in this GIF. 

You can see how the area under the chin goes from that turkey neck to becoming forward. The nose and lips and everything is also moved up and forward. 

After doing this comparison I genuinely think that it looks like the entire craniofacial area of the skull has expanded not only outwards, but also rotated counter-clockwise. 

https://the-great-work.org/wp-content/uploads/wpforo/default_attachments/1523063165-TheGreatWork.webm   

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Posted : 06/04/2018 9:06 pm
Makmama liked
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As you undergo correction in the near future, please consider keeping records for your own sake and for others. Pictures of dental impressions, scans, medical reports reports can be very helpful even with all personally identifying information blocked out.

Your input could help many, many people

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