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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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entelechy
Trusted Member

@theadonisking

if you cannot feel your tongue going up it is because it doesn't have space to go up in the right place of the palate.    Imagine a 6 foot man lying cramped on the ground in a 4 X 4 foot space.  When he tries to stands up, he will be able to touch his head on the ceiling (the tip of the palate) but he will not be able to both touch his head on the ceiling and press the  length of  his back  up to the butt on the the ceiling (the rest of the palate) because there literally is no space to do so.    Trying to the best of his ability, he will press his head on the ceilng and curl up his neck and upper back to it, with the butt hanging down unable to touch that last part of the ceiling (the soft palate).    This is a visual image of what a x mm long tongue can do in an x minus 10 mm length space.   

This description might be hard to imagine.  The best would be to see and ENT and ask them to look at a CT scan to see if your tongue is hanging low at the back of your mouth.  This would mean it is cramped for space and is doing the best you can.    You would need to expand the maxilla the extra millimeters to get more space for the tongue in order to allow it the space to rest comfortably  and rise up with no problem to the palate.     

 

A sign of the tongue not being able to be up on the soft palate is OAS, UARS or snoring.   It can also mean neck tension and shoulder tension, as if the tongue is not able to rest on the palate, and give  muscular support, the skull is less supported, and this compromises the skull-neck relationship, which strains the neck muscles.   Moreover, if the tongue is back low in the throat, blocking the airway, then the tendency is for people to tilt their chins up and keep head forward  to open the airway to be able to breathe.    This 'forward head posture' is typical, for example, of people with premolar extractions, whose maxilla and mandila and very retruded.  It will in the longrun cause neck strain and bad spinal posture overall, as the head is very heavy and must be supported by the tongue and the neck muscles, to keep alignment.

I may not be explaining this all correctly---I am not a doctor.   This is a compilation of what I learned from the 60 plus doctors I consulted for my own condition (ENTs and physical therapists specialized in swallowing were the best in explaining this to me).  

I did a year of rehabilitation of physical therapy for "swallowing", which terminated with the therapist saying there is no use in going further until I get the expansion as there is no way I could swallow any better than I was. 

A real swallow means the tongue rises all the way back to the soft palate and THEN you swallow.  Rather than pressing up to the top of the roof, and then using your throat muscles (which is what I do).

Have you consulted with an ENT or had a laser exam to check the position of your tongue when you swallow?   Easy exam:  laser goes down the nose and  you see on the screen exactly where your tongue is.   Where I live, this exam is available in the ENT office, and costs an additonal $30 to the consult.

 

 

 

 

 

 

 

 

 

 

entelechy

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Posted : 02/10/2019 5:33 am
James
Eminent Member
Posted by: @entelechy

@james

Hello James,

Thanks for taking the time to give such a precise response.     A couple questions--

--what are the risks of MSE?    I have asked several doctors and they said "none" except that it does not work.  And yet I can't help thinking that playing around with breaking sutures in the skull might have its risk (especially as one cannot control which sutures split).    I checked online in research articles and could find no consequences.   Could I ask what you think they may be?

I don't know because I am not an expert, but I've heard of multiple other people refer to risks, including my osteopath. She has seen a MARPE case where the patient ended up with neurological problems and 70lbs weight gain. I asked her what had gone wrong, but she didn't know because it happened prior to the patient starting with her. Of course, this is likely not a representative, because osteopaths are more likely to see failed cases.

--with the greater tongue space with FAGGA.   I also needed that because I have a very retruded maxilla as well:  and accomplished 3 mm with arch-braces.  These 3 mm made for a great improvement (although still not enough).      Can I ask if you what I do?  Now that my tongue has space to actually be more on the palate, I use it minute-by-minute to press against the first molars to do my own expansion.  It seems to work as day by day I feel more comfortable (of course the flexible titannium arch wires help).    But it is certainly not palate but teeth I am trying to move.   My imw is only 28.5  so any push is helpful.

28.5mm is very small. I definitely would not be able to do good tongue-posture at that width.

--can I ask how uncomfortable FAGGA is and whether it takes up tongue space or makes it difficult to talk?    I see your concern is braces, which is not mine as I don't find braces so uncomfortable (albeit yes will be nicer without).  But these palate expanders frighten me.  Doesn't it feel like your mouth is cramped with some bulky object that makes the lack of mouth space even worse?

FAGGA does not take up a lot of space, but the tongue pad does cause a mild lisp. The discomfort is very minor.

My concern is not with having braces, my concern is having braces twice. I am currently in braces for Controlled Arch. It's uncomfortable, but I can see the results developing. What I am not excited about would be needing a second round of braces if I did MSE, because that would be a long treatment time in braces. Aesthetically, my upper arch will look good enough after Controlled Arch, because my starting width wasn't awful and I had very little upper crowding pre-treatment. So it would be annoying to have to do MSE for nasal breathing, which is why I'm doing septoplasty and turbinate reduction to try and fix my nose another way.

However, everyone's situation is different. For a patient with large sagittal and transverse deficiency, it might not be resolved in a single appliance, and doing multiple treatments might be necessary depending on the patient's goals. This is what Ronald Ead is doing, and this is what the other dentist I mentioned does by using AGGA followed by a Hyrax expander (he is in Australia).

ReplyQuote
Posted : 02/10/2019 7:43 pm
Lian
 Lian
Active Member

@minniesinatra

Hi! So great to hear that you are happy with your progress! Would you mind sharing a little bit more? How long was your treatment? What were the changes you noticed in your function and aesthetics? Any undesirable changes? Thank you so much! 

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Posted : 08/10/2019 5:21 am
April
New Member
Posted by: @james

 

However, everyone's situation is different. For a patient with large sagittal and transverse deficiency, it might not be resolved in a single appliance, and doing multiple treatments might be necessary depending on the patient's goals. This is what Ronald Ead is doing, and this is what the other orthodontist I mentioned does by using AGGA followed by a Hyrax expander (he is in Australia).

Hi James,

Are you able to tell me the name of the Aus orthodontist?

I'm a premolar extraction case. I'm seeing AMC in about a month's time for a consult, but would like to know of other orthos too. Thanks.

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Posted : 09/10/2019 10:00 am
entelechy
Trusted Member

@april

Hello April,   I met with Dr. Derek Mahony (in Sydney Australia) who is an orthodontist who does reversal for premolar extractions with FAGGA.   Very kind man.   You might want to contact him.

I too am a victim of premolar extractions, and am now working on advocacy to get help for victims.    Might I please ask you to take this survey on extraction consequences and pass it on to anyone you know who has had them?   It is important to get data on how many people have suffered from this standard orthodontic procedure, in order to make it "public", rather than a "secret" in the dental world.       I believe all our costs for reversal procedures must be reimbursed, and the orthodontic community be held to task to research treatment that effectively restores people's health and aesthetics, without jaw surger

Here is the survey.  Please do pass on -- Facebook and anywhere.

https://forms.gle/E77UZK4BnqaaCDvY6

I will note that I was lucky enough to be unaware of any of the symptoms when I was young.      However, the face 'collapses' for many premolar victims in their forties, and then the physical health consequences can become unbearable.     If you happen to be young and have any concerns now, I most urge you to do reversal now, no matter what it costs, or how much time it takes, to be saved from future horrific consequences (as happened in my case, and others I have spoken to). 

entelechy

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Posted : 09/10/2019 4:48 pm
entelechy
Trusted Member

ps.  I am still curious why someone would do AGGA first, and then Hyrax.  Also:  does anyone know the difference between HYRAX and MSE or MARPE?  

entelechy

ReplyQuote
Posted : 09/10/2019 4:51 pm
paradise
Eminent Member
Posted by: @entelechy

@april

Hello April,   I met with Dr. Derek Mahony (in Sydney Australia) who is an orthodontist who does reversal for premolar extractions with FAGGA.   Very kind man.   You might want to contact him.

I too am a victim of premolar extractions, and am now working on advocacy to get help for victims.    Might I please ask you to take this survey on extraction consequences and pass it on to anyone you know who has had them?   It is important to get data on how many people have suffered from this standard orthodontic procedure, in order to make it "public", rather than a "secret" in the dental world.       I believe all our costs for reversal procedures must be reimbursed, and the orthodontic community be held to task to research treatment that effectively restores people's health and aesthetics, without jaw surger

Here is the survey.  Please do pass on -- Facebook and anywhere.

https://forms.gle/E77UZK4BnqaaCDvY6

I will note that I was lucky enough to be unaware of any of the symptoms when I was young.      However, the face 'collapses' for many premolar victims in their forties, and then the physical health consequences can become unbearable.     If you happen to be young and have any concerns now, I most urge you to do reversal now, no matter what it costs, or how much time it takes, to be saved from future horrific consequences (as happened in my case, and others I have spoken to). 

@entelechy, thank you for sharing. Interesting that Dr. Mahony also uses FAGGA. Does he do anything to reverse the extractions at the lower jaw as well? Also, does he use implants to close the FAGGA gaps, or use Controlled Arch to bring the back molars forward?

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Posted : 09/10/2019 4:57 pm
entelechy
Trusted Member

@paradise

He told me he believes the spaces should be replaced by implants:  he did not think pulling forward from the molars was a good idea as one loses space and we need all the space we can get in our reduced palates.  However perhaps each case is different.    I would be curious to learn more about the debate between whether implants or moving forward from the molars:   I have heard plus and minus for both methods.  Might anyone be up on this debate?

As for lower jaw:   my impression is that you always have to try to open the 2 spaces on the bottom, to have the jaws match. However it is more difficult as the bone is more solid in the lower jaw.   I myself have been expanding top and bottom just with braces.   In 8 months, I have gained  about 5 mm expansion on the top and 3 on the bottom.  So it is true that the top moves  easier than the bottom (this also because of the tongue) but it seems possible to open the bottom teeth as well.    I believe it depends on the person  

entelechy

ReplyQuote
Posted : 09/10/2019 5:21 pm
paradise
Eminent Member

@entelechy

What did he mean that pulling molars forward would lose space? In theory the Controlled Arch should keep the front teeth in place while the back teeth are pulled forward?

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Posted : 09/10/2019 6:35 pm
entelechy
Trusted Member

yes, I see your objection.  I really didn't quite understand what he meant;  it was something about gaining all this space with expansion, only to close it which he seemed to suggest would necessarily narrow the arch again.  I am not sure.  I think this is a question that needs to be answered by someone more knowledgeable.  I would really like to know the answer.

 

Anyone able to answer this?

 

entelechy

ReplyQuote
Posted : 09/10/2019 6:42 pm
Robbie343
Trusted Member

Hello new to the forum here.

 32 yr old male. I have a 5 mm deep bite and I am starting AGGA in 20 days. Anybody on here have experience with treating a deep bite using this appliance. Ortho said they will move my maxilla 5 to 8 mm forward resulting in 10 to 16 mm in lower mandible advancement. My mandible is compressed but I have no pain. Also to note my neck posture has drastically changed for the worse over the course of a year due to an injury making me less active which definitely made the mandible compress further imo.

I got a frenectomy, am working with a myofunctional therapist and an osteopath. 

No premolar extractions, teeth are straight, bottom front 6 have spaces. Deep bite is the only problem

I see a wealth of knowledge on here and look forward to following this forum. I wasn't sure if I should start a thread with my questions or revived this one.

p.s Has anyone seen any skin benefits post AGGA treatment of any other appliance or even just mewing? Since my neck and jaw position has changed my skin has become ultra sensitive and dull over the course of one year. Any facial muscular changes? My myofunctional therapist has me doing some cheek lip and jaw exercises ( I am using the same one Ronny Ead used, she's in my area)

Thanks!

Rob

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Posted : 02/11/2019 8:23 pm
davewheeler87
Active Member

Update ..... I am out of AGGA I got 7 mms of forward growth. Everything went great. Mandible came forward.... Breathing and swallowing is better. I have a nice jaw line.... Its hard to say if it has improved my sleeping because there is so much [Rude Language or Insults are not tolerated] in my mouth its hard to tell. The molar pads are easily the worst part of all of this. I hate them they are so uncomfortable and they make me clench at night. I haven't been in CAB long but I can already notice massive changes.... I also think my nasal breathing has improved since being in CAB.. 10-12 months to go and I will finally be finished with this process for good!!! I look forward to posting before and afters in here so y'all can judge lol.

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Posted : 04/11/2019 9:10 pm
theadonisking
Active Member

i had a consult with an LVI dentist for AGGA, but she says i will only know the type of chin i can get after the cone beam scan to see the chin shape.

i dont want this result (see below), i know its from a non-LVI dentist (dr Kundel) so probably not optimal but still looks like he has no chin, what do you guys think ?

my profile for reference:

 

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Posted : 09/11/2019 4:51 pm
entelechy
Trusted Member

why would you think FAGGA would affect the chin --if it work on the maxilla?   Sure the mandible will come forward, but an extremely recessed chin as in the photo, no matter how much the mandible came forward, is still going to be recessed.   

entelechy

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Posted : 09/11/2019 5:23 pm
theadonisking
Active Member

well cause my mandible is trapped by the recessed maxilla, and when i advance my mandible forward i have a "chin", i think its also related to my mandibular incisors which are proclined so chin is more absent too.

i just hope i'll have more chin than the guy in the after pic, seems like his incisors are proclined based on the lower lip also

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Posted : 09/11/2019 5:49 pm
entelechy
Trusted Member

would need to see a photo to even guess.     My mandible is also trapped by my maxilla but the chin is not so  drooping as this man in the photo.   I think it depends on how your chin is now.  If when you advance your mandible, it looks fine, this would be indicative.  Yiou might also consider genioplasticity if you really are concerned with the aesthetics, although that has a huge risk of nerve loss (in chin sensation).    For me, the health issues are most important.  Did you have extractions?

 

 

entelechy

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Posted : 09/11/2019 5:53 pm
entelechy
Trusted Member

oh--that is you in the photo?   your chin is certainly not as bad as the man with the beard.   Hard to say what will happen once you advance your maxilla, but could be fine enough.    And then just focus on health issues.  Most impt!

 

entelechy

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Posted : 09/11/2019 5:56 pm
theadonisking
Active Member

it's me in the picture lol, i can take one with the mandible fully forward to give you an idea of what i mean.

The drooping is fat due to the face recession lol, when i bring my mandible forward it doesnt "droop" anymore.

I would prefer a chin implant over a genioplasty for sure after AGGA, i'll see the dentist told me most of the changes appear during CA braces phase

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Posted : 09/11/2019 5:57 pm
theadonisking
Active Member
Posted by: @entelechy

oh--that is you in the photo?   your chin is certainly not as bad as the man with the beard.   Hard to say what will happen once you advance your maxilla, but could be fine enough.    And then just focus on health issues.  Most impt!

 

i'm the one with the beard lol i said see my profile for reference, the before/after are pictures are from a patient of Dr, Kundel who is not LVI, they are on his website

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Posted : 09/11/2019 5:58 pm
theadonisking
Active Member
Posted by: @theadonisking
Posted by: @entelechy

oh--that is you in the photo?   your chin is certainly not as bad as the man with the beard.   Hard to say what will happen once you advance your maxilla, but could be fine enough.    And then just focus on health issues.  Most impt!

 

i'm the one with the beard lol i said see my profile for reference, the before/after are pictures are from a patient of Dr, Kundel who is not LVI, they are on his website

like the before after is a before / after of AGGA, so that's what i mean by i hope i'll have a better result than that, i dont see much difference in his chin.

ReplyQuote
Posted : 09/11/2019 5:59 pm
theadonisking
Active Member
Posted by: @entelechy

oh--that is you in the photo?   your chin is certainly not as bad as the man with the beard.   Hard to say what will happen once you advance your maxilla, but could be fine enough.    And then just focus on health issues.  Most impt!

 

lol like i mentioned, i'm the one with the beard, the other guy in the after has already done AGGA, i took it on Dr Kundel's website. I was hoping to get a better result than him since his chin didn't advance much.

ReplyQuote
Posted : 09/11/2019 6:10 pm
entelechy
Trusted Member

I think his chin did advance---not so much, but substantially.   What are your structural issues?   no extractions?   reduced maxilla for  what reason?

 

 

entelechy

ReplyQuote
Posted : 09/11/2019 6:24 pm
theadonisking
Active Member
Posted by: @entelechy

I think his chin did advance---not so much, but substantially.   What are your structural issues?   no extractions?   reduced maxilla for  what reason?

 

 

i had wisdom teeth extracted only, had braces as a teenager.

Mouthbreathing from youth, nose was blocked due to allergies most of the time, low tongue posture.

I have a class II, steep palate and lack of anterior tongue space which means i can't mew, IMW is decent at around 38mm.

My main issue is sleep, i want to be able to nose breathe at night and avoid having sleep apnea in the future, thats the main reason i want to do AGGA and also reduce clenching and overuse of teeth.

Neck posture is not forward but tilted up so my shoulders/thoracic spine have a lot of tightness, i can't fully flex or internally rotate my shoulders.

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Posted : 09/11/2019 6:35 pm
entelechy
Trusted Member

@theadonisking

Hi--I have some  similar issues: narrow palate, and chin tilted up, neck issues.   I am looking into SFOT instead of FAGGA and MSE for palate expansion. 

entelechy

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Posted : 10/11/2019 3:17 am
Colbiew
New Member

@abdulrahman

I can answer this because I had this exact question... I need upper and lower expansion as I have a narrow palate. You cannot expand the upper without expanding the lower so the devices you get to keep your bite aligned are upper and lower expanders. The FAGGA is fixed and only gives lateral growth, it will not drop palate. A DNA like device does both horizontal (widening) and lateral (frontal face forward growth). Because I need frontal and horizontal growth I am getting the dna like device. I will share pictures once I get them. 

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Posted : 21/11/2019 10:05 pm
theadonisking
Active Member
Posted by: @colbiew

@abdulrahman

I can answer this because I had this exact question... I need upper and lower expansion as I have a narrow palate. You cannot expand the upper without expanding the lower so the devices you get to keep your bite aligned are upper and lower expanders. The FAGGA is fixed and only gives lateral growth, it will not drop palate. A DNA like device does both horizontal (widening) and lateral (frontal face forward growth). Because I need frontal and horizontal growth I am getting the dna like device. I will share pictures once I get them. 

Controlled arch braces after AGGA give widening of the arch up to 5 mm and will help with vaulted palate from what my dentist told me

ReplyQuote
Posted : 22/11/2019 2:44 pm
adam-gary
New Member

I would also consider the DNA appliance. The DNA is much easier to tolerate since it is removable. Also the DNA is much better at lateral growth as well as anterior growth. Most people who have facial development issues have height of the bite issues (aka vertical dimension) and TMJ issues. The DNA has a plastic bite plane like a night guard where these bite issues can be worked out. The DNA is also a "functional device" or a device that can assist in bringing the lower jaw forward. The AGGA does not have a bite plane. Here are a few links that are helpful: https://marylandholisticdentist.com/agga-appliance-vs-dna/

https://marylandholisticdentist.com/dna-appliance

 

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Posted : 23/11/2019 8:47 pm
theadonisking
Active Member
Posted by: @adam-gary

I would also consider the DNA appliance. The DNA is much easier to tolerate since it is removable. Also the DNA is much better at lateral growth as well as anterior growth. Most people who have facial development issues have height of the bite issues (aka vertical dimension) and TMJ issues. The DNA has a plastic bite plane like a night guard where these bite issues can be worked out. The DNA is also a "functional device" or a device that can assist in bringing the lower jaw forward. The AGGA does not have a bite plane. Here are a few links that are helpful: https://marylandholisticdentist.com/agga-appliance-vs-dna/

https://marylandholisticdentist.com/dna-appliance

 

But with AGGA and LVI everything is tested to ensure optimal physiologic bite, which is not the case with all DNA practitioners

ReplyQuote
Posted : 30/11/2019 11:37 pm
hugo
 hugo
New Member

Hey, I would be really grateful if someone could give me some advice/point me in the right direction. I've read so much about maxillas and teeth and surgery in the past few weeks, but I just keep getting more confused. 

I'm 21 and have a mild underbite. I went to see a dentist recently and he said he would be able to move my lower teeth back 2 - 3 mm to correct it. However, it's not quite that mild so my lower lip would still be noticeably in front of my upper lip. He also pointed out that my upper dental arch was too narrow, so he would widen it using a palatal expander. The other option was jaw surgery, which he thought would be overkill but was still willing to refer me for.

After reading about all these expanding appliances like FAGGA, I was thinking that expanding my maxilla and largely leaving my lower teeth alone could be the ideal solution ? Would using FAGGA and then a lateral expanding device fix my underbite? I'm confused because people's mandibles also seem to move forward in the before/after photos. Obviously I don't want to expand my mandible ... right? If it's relevant, I also have a mildly recessed chin. It's almost good because it balances out the underbite and so I look normal at first glance.

(also, could people recommend some sort of beginner thing? there are so many acronyms and everyone disagrees with each other...)

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Posted : 02/12/2019 8:22 am
Faggapatient
New Member

Hi everyone, Fagga patient here. I had it on from April of 2019 -  October 2019.  Saw a dentist out in LA (FBI-trained I believe) 8mm of growth on both sides. I decided to use it for my sleep apnea and hoped it would help with my narrow/recessed jaw. I started with a slight overbite (upper teeth ahead of my lower), but it was nothing crazy or noticeable unless you were looking. Only orthodontists point this out my overbite. Also, I never had an orthodontist as a kid, only thing I had on my teeth were cavity fillings lol. I've just always had poor oral posture, mouth breathing, etc.

Starting Anatomy: Skinny/Athletic build, restricted/narrow airway with not recessed mandible so not much of a side profile, forward head posture, mouth breather, obstructed 

Here are my thoughts -

Perceived Positives:

-As soon as the bite pads were put on and my lower jaw could slide forward I noticed a release in debilitating neck strain and back strain

-Correct posture is much easier to hold

- Mandible sliding forward brings my lower jaw/masseters (I guess) further out and so my face does look a little wider just from that 

-Profile has improved

Perceived Negatives:

- Overbite is now very apparent

-Face looks longer...but now I have more of a chin so there's a trade off. I already had a long/narrow face and I'm not too self conscious about it but I know people aren't happy to see that.

-I don't understand how the mandible stays forward and can naturally rest forward and do all its function while in a forward. I can hold forward but it wants to slowly fall back as soon as I lose conscious effort. Perhaps a lot of retraining needs to be done to get rid of 26 years of bad posture. My sense is unlikely. When I sleep, my jaw 100% falls back.

I think something like this is better for someone with an underbet (mandible is ahead of the maxilla). Any thoughts? Anyone with a starting overbite, recessed mandible, forward neck posture, mouth breather, high vauled/narrow palate that thinks the AGGA helped them?

ReplyQuote
Posted : 03/12/2019 2:09 pm
theadonisking
Active Member
Posted by: @faggapatient

Hi everyone, Fagga patient here. I had it on from April of 2019 -  October 2019.  Saw a dentist out in LA (FBI-trained I believe) 8mm of growth on both sides. I decided to use it for my sleep apnea and hoped it would help with my narrow/recessed jaw. I started with a slight overbite (upper teeth ahead of my lower), but it was nothing crazy or noticeable unless you were looking. Only orthodontists point this out my overbite. Also, I never had an orthodontist as a kid, only thing I had on my teeth were cavity fillings lol. I've just always had poor oral posture, mouth breathing, etc.

Starting Anatomy: Skinny/Athletic build, restricted/narrow airway with not recessed mandible so not much of a side profile, forward head posture, mouth breather, obstructed 

Here are my thoughts -

Perceived Positives:

-As soon as the bite pads were put on and my lower jaw could slide forward I noticed a release in debilitating neck strain and back strain

-Correct posture is much easier to hold

- Mandible sliding forward brings my lower jaw/masseters (I guess) further out and so my face does look a little wider just from that 

-Profile has improved

Perceived Negatives:

- Overbite is now very apparent

-Face looks longer...but now I have more of a chin so there's a trade off. I already had a long/narrow face and I'm not too self conscious about it but I know people aren't happy to see that.

-I don't understand how the mandible stays forward and can naturally rest forward and do all its function while in a forward. I can hold forward but it wants to slowly fall back as soon as I lose conscious effort. Perhaps a lot of retraining needs to be done to get rid of 26 years of bad posture. My sense is unlikely. When I sleep, my jaw 100% falls back.

I think something like this is better for someone with an underbet (mandible is ahead of the maxilla). Any thoughts? Anyone with a starting overbite, recessed mandible, forward neck posture, mouth breather, high vauled/narrow palate that thinks the AGGA helped them?

If you're still in the bite pads its normal that face looks longer, are you in CAB now ?

With CAB your bite will be perfected and mandible will stay with maxilla, but at night you will need the micro2 appliance to keep the mandible from falling down.

Are you able to mew or you lack tongue space ? Myself due to my vaulted palate i cant really mew or suction hold, i think i also lack forward space.

I had a consult for AGGA (you can see my side profile on this page) and will probably start next year, seems to be the best option for recessed maxilla/mandible so far with the most detailed protocol and testing

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Posted : 04/12/2019 1:37 pm
rogerramjet
Eminent Member
Posted by: @rogerramjet
Posted by: SUGR1

...

Timothy Bromage is part of the Facial Beauty Institute Faculty and is spearheading studies on the effect of Agga. There are no published studies because the data collection is ongoing. 

...

The core people and brain trust  behind this are holding an international symposium on this early next year (2019) in Sydney where there are claims of some big reveals. 

I'm all about this; thanks for sharing. Please keep us updated with any inside info you have.

...

Just swinging by here to see if anyone has managed to get their hands on this meta study that was supposed to be spearheaded by Bromage?

(@SUGR1)?

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Posted : 09/12/2019 12:47 am
orthojourney2020
New Member

@garrett

Hi! I am looking for a myofunctional therapist.

I am considering Kathy Winslow. Can you please share your experience with her and did you found that she helped you solve your issues, if so how ? 

Any help would be greatly appreciated.
Thank you

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Posted : 16/12/2019 12:18 pm
Char
 Char
Active Member

@blah

I think the Fagga is a faulty appliance.  Messed up daughter’s face and jaw. Go with a surgeon every time. 

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Posted : 15/02/2020 7:33 pm
Robbie343
Trusted Member

@char

i have heard multiple stories from patients as well confirming it to be a joke. I have recently been diagnosed with OSA and visited two surgeons, one being quite famous in sleep surgery for the jaw and both have said along the lines of “I wouldn’t do that if I were you” in regards to AGGA.  

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Posted : 15/02/2020 9:39 pm
entelechy
Trusted Member
Posted by: @robbie343

@char

i have heard multiple stories from patients as well confirming it to be a joke. I have recently been diagnosed with OSA and visited two surgeons, one being quite famous in sleep surgery for the jaw and both have said along the lines of “I wouldn’t do that if I were you” in regards to AGGA.  

A warning:  take with a grain of salt advice from doctors in different medical disciplines: i.e. what a surgeon says about an orthodontic procedure.    The field of medicine is highly compartamentalized.     Surgeons told me I could only fix my problem wiht surgery---and said MSE was crazy.  MSE people told me that FAGGA was crazy.  FAGGA people told me that surgery, mse and arch wires are crazy.    

And my osteopath thinks ALL of the above is crazy---and people should just try to maniupulate their bones to grow in the right way....

 

Surgeons to me are the worst though: chop and that's it.

However, among surgeons, a sleep expert surgeon is prob the best, as knows soft tissue issues.

entelechy

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Posted : 16/02/2020 6:23 am
Robbie343
Trusted Member

@entelechy

Oh I agree with you wholeheartedly. That’s why I still don’t have anything in my mouth lol. So many opinions can’t decide, I’ve also consulted about MSE and EASE.

But I gotta lean towards this particular sleep surgeons opinion in regards to AGGA curing OSA at least in my case. It was more like “that appliance won’t help you” 

What road have you ended up going down if you don’t mind me asking? 

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Posted : 17/02/2020 9:12 pm
entelechy
Trusted Member
Posted by: @robbie343

@entelechy

Oh I agree with you wholeheartedly. That’s why I still don’t have anything in my mouth lol. So many opinions can’t decide, I’ve also consulted about MSE and EASE.

But I gotta lean towards this particular sleep surgeons opinion in regards to AGGA curing OSA at least in my case. It was more like “that appliance won’t help you” 

What road have you ended up going down if you don’t mind me asking? 

Hi--I have had MSE in for one month.   The suture split, the width of my top arch has expanded so far a couple mm.    One worry is that it expands ALL your face.  Your cheekbones, etc.   Aesthetically, it's wonderful--I look younger, and my face is fuller.

 

BUT it is also terrifying because I wonder if the zigmats will expand into my tmj.   Plus now there is no occlusion:   first the top teeth overlap the bottom slightly, and the facemask HAS expanded out my top jaw a millimeter.  All promising, best thing I could have done, but still a nightmare occluson issue.

I do not know what EASE is. What is it?

The next challenge is the "length".     Some say FAGGA can do it. I am also looking into SFOT:  bone transplant and corticotomy, so I can expand 3 mm further than I could otherwise (total of 6 maybe?)

MSE for me is a good replacement for surgical SARPE, if it doesn't screw up my TMJ!

 

entelechy

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Posted : 17/02/2020 9:57 pm
Robbie343
Trusted Member

@entelechy

EASE is very similar to MSE but used by Dr Kasey Li at Stanford. You can check his website for more information. 

Were you class 1 occlusion going into MSE? 

I already have TMJ so skeletal expansion might not be my route. 

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Posted : 18/02/2020 12:16 am
Thomas22
Trusted Member
Posted by: @theadonisking
Posted by: @adam-gary

I would also consider the DNA appliance. The DNA is much easier to tolerate since it is removable. Also the DNA is much better at lateral growth as well as anterior growth. Most people who have facial development issues have height of the bite issues (aka vertical dimension) and TMJ issues. The DNA has a plastic bite plane like a night guard where these bite issues can be worked out. The DNA is also a "functional device" or a device that can assist in bringing the lower jaw forward. The AGGA does not have a bite plane. Here are a few links that are helpful: https://marylandholisticdentist.com/agga-appliance-vs-dna/

https://marylandholisticdentist.com/dna-appliance

 

But with AGGA and LVI everything is tested to ensure optimal physiologic bite, which is not the case with all DNA practitioners

I have a DNA Appliance.

I do a monthly take home sleep test. If I continue to show signs of apnea, I advance the device 1mm. The doctor also spoke about using speech patterns to determine the correct jaw position. I don't know what that means, he did note that I had trouble with S sounds due the position of my jaw.

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Posted : 18/02/2020 10:17 pm
toomer
Eminent Member
Posted by: @lee

One thing to note is if you have tmj issues and do agga through an LVI dentist, they move the jaw forward first with a lower orthtic then do agga. I'm in my orthotic now and it gave me an underbite so I can't wait for agga.

Hey @Lee - I'm just digging through all the pages of this AGGA thread here ... and came across your post from a while back.

I just started with a TMJ doc and I've got an orthotic bite-splint I need to wear for the next 3-5 months in order to "let my jaw come to its natural resting place".  

Unfortunately, 1 month in ... I can already see that this is going to be an underbite.  My lower jaw seems to be sliding forward, and my lower and upper teeth now touch directly on the tips when I close.  Not fun.  But the TMD symptoms were killing me.

So this is so frustrating to me to try to figure out how it's all going to end ... but it seems like you may have gone through this as well?  Lower orthotic leading to an underbite, and then AGGA to get you the maxilla growth needed to overcome that?

I'm also considering a DNA Appliance (the TMJ doc I'm seeing is actually a DNA provider) but obviously one can't come to this forum without worrying about "tipping/pushing teeth" from any appliance ... 

 

 

 

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Posted : 20/02/2020 6:45 pm
toomer
Eminent Member
Posted by: @robbie343

i have heard multiple stories from patients as well confirming it to be a joke. I have recently been diagnosed with OSA and visited two surgeons, one being quite famous in sleep surgery for the jaw and both have said along the lines of “I wouldn’t do that if I were you” in regards to AGGA.  

What did you end up going with?

I have severe OSA, and now TMJ issues ... so I am seriously pondering that I should just go and get the complete jaw surgery, get everything right ... and then just deal with weeks of liquid diet/soft foods.

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Posted : 20/02/2020 7:40 pm
Lee
 Lee
Eminent Member
Posted by: @toomer
Posted by: @lee

One thing to note is if you have tmj issues and do agga through an LVI dentist, they move the jaw forward first with a lower orthtic then do agga. I'm in my orthotic now and it gave me an underbite so I can't wait for agga.

Hey @Lee - I'm just digging through all the pages of this AGGA thread here ... and came across your post from a while back.

I just started with a TMJ doc and I've got an orthotic bite-splint I need to wear for the next 3-5 months in order to "let my jaw come to its natural resting place".  

Unfortunately, 1 month in ... I can already see that this is going to be an underbite.  My lower jaw seems to be sliding forward, and my lower and upper teeth now touch directly on the tips when I close.  Not fun.  But the TMD symptoms were killing me.

So this is so frustrating to me to try to figure out how it's all going to end ... but it seems like you may have gone through this as well?  Lower orthotic leading to an underbite, and then AGGA to get you the maxilla growth needed to overcome that?

I'm also considering a DNA Appliance (the TMJ doc I'm seeing is actually a DNA provider) but obviously one can't come to this forum without worrying about "tipping/pushing teeth" from any appliance ... 

 

 

 

Yes, I did. I'm in cab now. My mandible is very comfortable and my front teeth are is overjet now, still have plenty far to go.

 

I didn't have osa. I hear DNA is good for that. Does your dentist think dna will take care of the underbite ok? 

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Posted : 20/02/2020 7:53 pm
toomer
Eminent Member
Posted by: @thomas22 I have a DNA Appliance.

I do a monthly take home sleep test. If I continue to show signs of apnea, I advance the device 1mm. The doctor also spoke about using speech patterns to determine the correct jaw position. I don't know what that means, he did note that I had trouble with S sounds due the position of my jaw.

I am working with a TMJ/sleep specialist that is a DNA provider.  Would love to know more about your process so far - how long have you had it, have you had any measurable decrease in AHI, do you think your breathing is better, did you have any TMJ before you started, etc.?

I have severe OSA with an in-lab measured AHI of 41, been on CPAP about 18 months ... thought that was going to be the rest of my life unless I wanted MMA surgery, until I started learning about all of this stuff a little while back.

 

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Posted : 20/02/2020 7:54 pm
toomer
Eminent Member
Posted by: @lee
Yes, I did. I'm in cab now. My mandible is very comfortable and my front teeth are is overjet now, still have plenty far to go.

I didn't have osa. I hear DNA is good for that. Does your dentist think dna will take care of the underbite ok? 

Glad it sounds like it's working for you.

I'm working with a specialist in my area that has been focusing on TMJ for many years, and it seems like he was one of the early adopters of the DNA program because I can find archive.org versions of his webpage going back to 2014 when it was being marketed under BioModeling Solutions (apparently Dr. Singh's company before he presumably sold to Vivos).  So I'm hoping that once he's happy with where my mandible finally comes to rest with the bite splint ... that we can start to consider the DNA more seriously.  

Unfortunately, he takes a very conservative approach to everything (which is actually not bad) which means he doesn't really want to speculate too far into the future, I guess so I don't get my hopes up.  So I have to come here to try to find answers 🙂 And of course, what I find here is all the comments about pushing/tilting teeth through bone for pretty much any appliance ... so it's all a bit scary.

 

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Posted : 20/02/2020 8:07 pm
Robbie343
Trusted Member

@toomer

I haven’t decided yet. I was planning on doing AGGA but changed my mind I just don’t think it will help with my breathing given my maxilla has rotated CW, it can’t fix that to my knowledge. I’ve heard from others that it didn’t help theirs but who knows everyone’s different. My TMJ is compressed so it could help with that, but I have an overbite and I worry it could make it worse. I’ve also heard of it moving teeth out of the bone from members of this forum.

I am considering ALF with Dr. Bronson. He’s quite busy and I am still trying to get a consultation. He usually puts on lower molar build ups which allow the mandible to slide forward thus decompressing the TMJ. It also claims to relieve neck pain and improve posture when used alongside an osteopath which I really need. 

And I gotta say I’m going to give mewing a shot alongside with it. I had a pretty bad face melt happen within the past couple years that’s when my sleep quality declined. I had good skeletal development and posture a few years ago and have some hope that I can reverse it to a degree. I’ve increased my IMW 2mm and my Mew indicator line 1mm since October. I’m confident I got it down. I did myofunctional therapy which helped me reverse my bad habits. 

If those don’t pan out then I would go the surgical route myself (last resort). It would definitely increase airway and most likely aesthetics, but has risks. Not breathing well and crappy sleep definitely suck and I’ll do whatever I can to fix it. I’m scheduled for a sleep study in a week. 

I live near Stanford and plan on getting a consult with Dr. Stanley Liu as well. He does DOME and and MMA. 

I recommend as many different consultations as you’re able to do. 

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Posted : 20/02/2020 8:11 pm
toomer
Eminent Member

@robbie343

Sounds like we are on similar journeys.  I hope you find the best treatment!

The TMJ doc I'm working with right now is a DNA provider, so I assume that will be his default recommendation once we finish the TMJ bite splint part of this process and my mandible has dropped down to its ideal resting position.  What's a bit unsettling so far is that I had a class I malocclusion (according to him) on my first exam, so we've put the bite splint in ... and now 1 month in my upper and lower incisors are practically touching tip-to-tip, so I think my malocclusion class is now actually worse.  So yes, my jaw does seem to be moving ... but not in the way I expected.  That's why I'm back on here studying up.

Interesting that you call it a "face melt" because I kind of think that's what has happened to me - but slowly, over many many years (perhaps decades) ... putting me in the position I'm in today.  It's not like I look in the mirror and am annoyed by my face/jaw ... I still think I'm a handsome chap 🙂 ... but my lower face definitely seems a bit different than it was many years ago.  And if that is creating/contributing to my OSA ... then it's even more frustrating, and something I will do almost anything to fix.

DOME seems interesting, and certainly seems to avoid a lot of the "it's pushing teeth!" concerns.  And to be honest, I would do it in a heartbeat - even though the 10mm diastema between your front incisors would be annoying to live with for the 9-12 months it takes to close back up via braces.  I think the best part of DOME is that you're basically done with the expansion in about 30-45 days, so you should accrue all of the benefits (increased airway) in a really short amount of time.  That seems really appealing, the thought of potentially being off of my CPAP in less than 2 months.

However, DOME seems targeted at lateral width deficiencies ... and given how my bite now seems to be lining up, I may have more of a front-to-back kind of issue going on (hence, reading through this entire AGGA thread).

I posted another thread here a couple days ago on the DOME timeline.  One of the most recent reports from Stanford, they documented about 75 patients that had DOME - you should read the link before you go meet with them (if you haven't already).  They alluded to the fact that a handful had MMA after DOME ... but didn't provide any additional details about them, which was disappointing.  I was really curious to see if a DOME+MMA combo over a 2-year period would effectively cure the patient's AHI (mine was 41 in my sleep lab test).

You said "If those don’t pan out then I would go the surgical route myself (last resort). It would definitely increase airway and most likely aesthetics, but has risks." -- what are the risks?  I mean, it's a hugely disruptive procedure ... weeks (if not months) of blended food ... yeah, it's extreme.  But I wouldn't have necessarily used the word "risk" to describe that ... which makes me wonder if there are other things I've missed?  I'll admit, I've not studied MMA a ton yet, but my assumption is that it's been getting done for decades (people end up with broken faces for lots of reasons) so I would have assumed it has relatively known and predictable long-term outcomes (unlike something like a Vivos DNA).  

Curious to get your thoughts ... I have to admit, the thought of having 3 months of my life absolutely positively suck ... but then to have the rest of my life be potentially OSA and TMJ free ... it's tempting.

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Posted : 21/02/2020 10:00 am
Robbie343
Trusted Member

@toomer

The recovery of surgery is brutal and the liquid diet would suck, but thats something that just comes with it. As far as risks go I have just read about permanent nerve damage and possible botched surgeries, but if it goes well than ya it'll be life changing. Just depends on how bad your condition is. Main thing is find the best surgeon you can find and make sure they do the surgery quite often. If you have your pre X-rays you can post them here. Theres a lot of knowledge on this forum and people can add some info since it also sounds like you were not sure what your bite looked liked as far as what class occlusion you were. Im definitely not an expert but the more research you do you come to learn, that was my case.

Stick around this forum and keep researching, this place helped me a lot in finding out what was going on with me.

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Posted : 21/02/2020 2:31 pm
toomer
Eminent Member

@robbie343

In the initial report with my TMJ doc, he noted it as a "class I" malocclusion in his report.  What I had noticed at the time of that appointment, was that the tips of my lower incisors would make contact at about the middle-back of my upper incisors as I closed my bite.  

My bite wasn't always like that, I know at one point in my life it was more or less perfect.  But I don't know at what point things changed.

I have a TMJ bite splint in now, and will have that for the next 3-5 months according to my doc.  We adjust it every couple weeks by shaving a bit down on one side or the other to make sure my molars are all making contact on both sides.  This is supposed to let my lower jaw come to its "natural resting place" over time.  And hopefully that will clear up a good portion of my TMJ issues at that point.

Unfortunately, what this seems to be leading to is that when I take the splint out to eat my lower and upper incisors are now almost completely touching tip-to-tip.  So if I have studied things correctly, I believe that means I have now gone from a class I malocclusion, to a class III.  And that seems to be one of the harder ones to fix, hence why I spend so much time here.  Simply put, it sounds like my maxilla has shrunk over the years (probably due to mouth-breathing while sleeping for the past 20 years, due to nasal congestion).

Despite being a brutal process to go through, I may just have to consider MMA in order to make sure I get fixed.

As for the nerve damage, yeah that seems to be the #1 thing they list as a possible negative outcome but overall, it seems like most surgeries are relatively un-eventful.  I did find some interesting NIH documentation on the topic of negative outcomes seen over a sampling of MMA procedures: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039051/

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Posted : 21/02/2020 4:17 pm
Robbie343
Trusted Member

@toomer

Maybe once you are done with splint therapy he will push your top teeth forward with orthodontics or another device to achieve proper occlusion?  

Mouth breathing at night will have that effect on the face, jaws as well as TMJ maybe. I never mouth breathed at night but I did through 2019 and it seemed to serious cause some recession to my face or at least speed up what was already slowly developing. I also have had a deep bite which can reek havoc on facial structure over time as well. I strengthened my tongue and face muscles via myofunctional therapy and I no longer mouth breath. Keep your tongue up and and breath through your nose the best you can, that’s a basic principle on these forums and ortho tropics. Is your posture bad? 

Ive been told I need surgery, but I’m still considering less invasive options. 

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Posted : 21/02/2020 5:17 pm
toomer
Eminent Member

@robbie343

Yeah, I noted with my provider during my last visit that clearly things were moving ... but that the current status actually seemed a bit worse.  I had gone from my lower incisors sorta touching my uppers during the bite, to now almost tip-to-tip.  I told the doc that I was of course going to just trust that it's "part of the process" ... but that I really wanted to know what - if anything - would be our approach if we reach the end and I still have teeth touching tip-to-tip (or worse, a full underbite).

I like my doc so far ... in that he takes a very conservative approach.  Unfortunately, that also seems to translate into him being conservative about speculating what the next steps in our process will be.  He doesn't have the best "bedside manner" in that department.  He did say that a DNA Appliance would be one strategy we'd look at, or potentially traditional orthodontics ... but that we couldn't really build a plan until we got to that point and had some final data and images to work with.

And then, of course, he had to close it up with "...and sometimes, there isn't anything that can be done" which of course sent my anxiety through the roof, and me back onto the boards here.

Fortunately, the bite splint is helping significantly with proper tongue posture.  With this giant piece of acrylic across my entire lower arch, there's nowhere else for my tongue to really go but up and to the roof of my mouth!  So hopefully 4-6 months of this will train my brain.  I have also switched my CPAP from a full face-mask, to a nasal mask ... and I tape my mouth shut in the evening.  So I am pretty much fully nasal breathing all day long these days ... and hoping that 6 straight months of that will wire my brain to stay that way.  But if my maxilla has truly shrunk over a couple decades due to nightly mouth breathing, that doesn't seem like something that will readily reverse itself if I'm now breathing properly.

We'll see how it goes.  Good luck with the Stanford folks!

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Posted : 21/02/2020 6:26 pm
Robbie343
Trusted Member

@toomer

There’s conservative dentists and explorative ones too. Both good in their own ways. I think there’s always something that can be done. 

The tongue up and mouth breathing might not reverse it but it should stop it from getting worse at least. Mouth breathing and bad posture over a period of one year change me for the worse so it’s good you stopped. 

Good luck to you too. 

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Posted : 21/02/2020 7:56 pm
Disregard
New Member
Posted by: @char

I currently have my daughter in this. I did it because she had vertical growth.  I was hoping for counterclockwise growth. Iinstead the gumline and teeth moved down and she looks more toothy  and a little more gummy  increase in Mew measurement  

It is impressive to see the gaps from the growth. However in the process she has a longer face. The Agga moves along the same downward trajectory.  I am so upset.  Is this something that will change in the braces phase?  

Now I see it so plain and simple on her ceph that this would happen. With all the analysis by the facial beauty institute why didnt they let me know about this?

Since I see Dr Buck on here i am really hoping for an answer. Or some tip for her dr. 

So you have her ceph, can you please consider posting it? It's kind of weird how you mention all of this downward growth when now we know that the fagga does not encourage forward growth anywhere else but the lower third and premaxilla. I noticed that you mentioned that her mew measurements increased. How is this possible when almost every single case that I have seen have experienced a decrease in this, including Ronald? 

 

With all of that being said, I'd love to see her ceph. Maybe she was affected differently since she's still growing... Who knows. Just please post something lol. Not to be rude, but come on. By making these claims, please understand that you are driving away some people that may need and qualify for this treatment. Like for exa mple, class 2 or 3 individuals 

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Posted : 22/02/2020 1:25 am
Disregard
New Member
Posted by: @faggapatient

Hi everyone, Fagga patient here. I had it on from April of 2019 -  October 2019.  Saw a dentist out in LA (FBI-trained I believe) 8mm of growth on both sides. I decided to use it for my sleep apnea and hoped it would help with my narrow/recessed jaw. I started with a slight overbite (upper teeth ahead of my lower), but it was nothing crazy or noticeable unless you were looking. Only orthodontists point this out my overbite. Also, I never had an orthodontist as a kid, only thing I had on my teeth were cavity fillings lol. I've just always had poor oral posture, mouth breathing, etc.

Starting Anatomy: Skinny/Athletic build, restricted/narrow airway with not recessed mandible so not much of a side profile, forward head posture, mouth breather, obstructed 

Here are my thoughts -

Perceived Positives:

-As soon as the bite pads were put on and my lower jaw could slide forward I noticed a release in debilitating neck strain and back strain

-Correct posture is much easier to hold

- Mandible sliding forward brings my lower jaw/masseters (I guess) further out and so my face does look a little wider just from that 

-Profile has improved

Perceived Negatives:

- Overbite is now very apparent

-Face looks longer...but now I have more of a chin so there's a trade off. I already had a long/narrow face and I'm not too self conscious about it but I know people aren't happy to see that.

-I don't understand how the mandible stays forward and can naturally rest forward and do all its function while in a forward. I can hold forward but it wants to slowly fall back as soon as I lose conscious effort. Perhaps a lot of retraining needs to be done to get rid of 26 years of bad posture. My sense is unlikely. When I sleep, my jaw 100% falls back.

I think something like this is better for someone with an underbet (mandible is ahead of the maxilla). Any thoughts? Anyone with a starting overbite, recessed mandible, forward neck posture, mouth breather, high vauled/narrow palate that thinks the AGGA helped them?

The FAGGA usually isn't allowed to be used unless your atlas is taken care of. With you having forward neck posture, your atlas is out of place. This should have been mitigated beforehand.

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Posted : 22/02/2020 1:55 am
Disregard
New Member
Posted by: @char

@blah

I think the Fagga is a faulty appliance.  Messed up daughter’s face and jaw. Go with a surgeon every time. 

A surgeon lol ok

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Posted : 22/02/2020 1:58 am
Disregard
New Member
Posted by: @robbie343

@entelechy

Oh I agree with you wholeheartedly. That’s why I still don’t have anything in my mouth lol. So many opinions can’t decide, I’ve also consulted about MSE and EASE.

But I gotta lean towards this particular sleep surgeons opinion in regards to AGGA curing OSA at least in my case. It was more like “that appliance won’t help you” 

What road have you ended up going down if you don’t mind me asking? 

It's not meant for sleep apnea, I agree with that. However, your osa could improve if it caused by a set back mandible

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Posted : 22/02/2020 2:02 am
entelechy
Trusted Member

@toomer

risks of upper jaw surgery:

--permanent numbness in upper gums

--permanent slight loss of sensitivity in facial skin

--nasal sinus issues (and need for subsequent nasal surgery)

--may need physical therapy to learn how to talk again 

--may exacerbate tinnitus or TMD

--relapse

--intolerance to the metal plates:  will feel cold and hot weather severely.    Will need plates taken out if so:   second major surgery to take them out.

risks of lower jaw surgery:

-- loss of sensation in lower or both lips  (chances of it being permanent are 80% if over 40)

- loss of sensation in chin (80% chance if you have genioplasticity)

--permanent burning nerve damage:  lips feel like they are burning, or teeth "send shooting nerve pain" when you close.  If this happens:  nothing you can do about it.  Permament.

this summarizes the 20 odd medical articles I read about consequences

There is a 20% chance of "some" consequence happening.    Double that if you are over 40.

Full recovery for double jaw surgery is about a year.     Upper jaw surgery much less.   Upper jaw surgery is much better (in my opinion) than lower.   Less risk of nerve damage and you can keep your lip sensation (which people HATE losing).   

 

 

 

 

entelechy

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Posted : 22/02/2020 9:35 pm
Robbie343
Trusted Member

@entelechy

a friend of mines mother had lower jaw advancement surgery to correct an overbite and all her feeling came back. She was in her early 50s too so she was a lucky one, but ya all those are legit risks I’ve read as well. 

 

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Posted : 25/02/2020 1:26 am
Sergio-OMS
Eminent Member
Posted by: @entelechy

@toomer

risks of upper jaw surgery:

--permanent numbness in upper gums

--permanent slight loss of sensitivity in facial skin

--nasal sinus issues (and need for subsequent nasal surgery)

--may need physical therapy to learn how to talk again 

--may exacerbate tinnitus or TMD

--relapse

--intolerance to the metal plates:  will feel cold and hot weather severely.    Will need plates taken out if so:   second major surgery to take them out.

risks of lower jaw surgery:

-- loss of sensation in lower or both lips  (chances of it being permanent are 80% if over 40)

- loss of sensation in chin (80% chance if you have genioplasticity)

--permanent burning nerve damage:  lips feel like they are burning, or teeth "send shooting nerve pain" when you close.  If this happens:  nothing you can do about it.  Permament.

this summarizes the 20 odd medical articles I read about consequences

There is a 20% chance of "some" consequence happening.    Double that if you are over 40.

Full recovery for double jaw surgery is about a year.     Upper jaw surgery much less.   Upper jaw surgery is much better (in my opinion) than lower.   Less risk of nerve damage and you can keep your lip sensation (which people HATE losing).   

 

 

 

 

Agreed, in general. But big overbite treatment is surgical. Camouflage orthodontics doesn't work. Postural and bad habits correction and all that stuff is important and works at early ages as long as there is not a small mandible.

Have you heard of IMDO?

 

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Posted : 25/02/2020 4:22 am
Neigh
Active Member

Found a decent gallery all from the same doctor in Missouri

Here are 9 examples

 

None of them are very impressive.

This one was though

https://www.springfieldsmiledoctor.com/blog/2018/4/30/facial-growth-orthodontics-with-daniel

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Posted : 16/04/2020 12:06 am
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