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This is a public discussion forum. The owners, staff, and users of this website are not engaged in rendering professional services to the individual reader. Do not use the content of this website as an alternative to personal examination and advice from licenced healthcare providers. Do not begin, delay, or discontinue treatments and/or exercises without licenced medical supervision.

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

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Sam
 Sam
Active Member

Someone on the craniofacial action group said Dr. Timothy Bromage of NYU has done studies on AGGA and bone remodeling. I can’t find any research or studies on the internet. It would be very interesting to find them if anyone is interested in sleuthing them out.

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Posted : 20/07/2018 5:53 pm
rogerramjet
Eminent Member
Posted by: Sam

Someone on the craniofacial action group said Dr. Timothy Bromage of NYU has done studies on AGGA and bone remodeling. I can’t find any research or studies on the internet. It would be very interesting to find them if anyone is interested in sleuthing them out.

It looks like Bromage has presented with Gallela on growth guidance:

https://facialbeautyinstitute.org/ortho-success_schedule_course1.pdf

 

Would have ave been amazing to attend this. Looks like Bromage has a lot of kudos in his field, so great to hear he’s involved with Gallela’s/LVI’s work.

 

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Posted : 20/07/2018 6:25 pm
Sam
 Sam
Active Member

This is reassuring. Dr. Bromage is a professor and researcher at New York University dental school. NYU is a very notable school. The dental college is ranked 5th in the U.S.😀

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Posted : 20/07/2018 11:47 pm
minniesinatra
New Member
Posted by: jamesread
Posted by: minniesinatra

My practitioner is Anne Marie Cole. I think it might be the cost of living, yeah - I live in Brisbane, and she was the only dentist in my vicinity that provides this treatment (that I knew of). The next closest location was in Robina, which is like forty minutes away and I didn't end up going for a consultation there.

you're in best hands and certainly you get what you pay for. the fact that there are very few practitioners in your area makes the price on the upscale (in addition to the very high cost of living in Australia)

I agree! 🙂 She's been so amazing and there's already been a lot of physiological change - if anyone's in the Brisbane area, don't hesitate to go see her. I didn't understand the process so when I was quoted the price my parents had an aneurysm because they thought it was a scam haha.

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Posted : 21/07/2018 8:14 am
Apollo
Reputable Member
Posted by: rogerramjet

Does anybody know why the upload/attach tool is no longer working? I've tried unsuccessfully on two different browsers.

Anyway, I'm trying to post one of the pics from the FB group in which one of the practitioners shows an x-ray to disprove the notion that the FAGGA is causing tipping/flaring of teeth.

He says: 'Here is an image we took on a patient after AGGA when inserting ControlledArch braces. Ignore the hardware, but look at the measurements of the growth spaces. You will see they are almost identical between the top portion of the teeth and the root portion of the teeth. If it was just flaring that occurred, the length between the top portion of the teeth would be larger than the length between the root portion of the teeth. You can also see that there is bone filled into the growth space. Hope this helps!'

Posted by: Abdulrahman

I had the same problem several time few weeks ago and just stopped using upload since then. It sounds really exciting to see that x-ray.

@admin @progress could you please fix this issue so that we can upload images again?

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Posted : 21/07/2018 11:20 pm
Progress
Member Moderator

You can upload your image to imgur and then paste the image link to the reply window, which will then automatically convert the link to the corresponding image:

 

I sadly don't have the authority to fix any forum related errors.

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Posted : 22/07/2018 7:00 am
Apollo liked
TGW
 TGW
TGW Admin Admin

RE: Image Uploading

@abdulrahman

@rogerramjet

@Apollo

@Progress

Thank you for the notification. 

We've rolled back the forum software back to the original (simpler) single file attachment system for now. We'll get the newer upload system working and implement it again when it's ready!

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Posted : 22/07/2018 9:21 am
rogerramjet
Eminent Member
Posted by: TGW

RE: Image Uploading

@abdulrahman

@rogerramjet

@Apollo

@Progress

Thank you for the notification. 

We've rolled back the forum software back to the original (simpler) single file attachment system for now. We'll get the newer upload system working and implement it again when it's ready!

Awesome, thanks so much.

 

Here's the x-ray!

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Posted : 22/07/2018 7:40 pm
Apollo
Reputable Member
Posted by: rogerramjet

I'm trying to post one of the pics from the FB group in which one of the practitioners shows an x-ray to disprove the notion that the FAGGA is causing tipping/flaring of teeth.

He says: 'Here is an image we took on a patient after AGGA when inserting ControlledArch braces. Ignore the hardware, but look at the measurements of the growth spaces. You will see they are almost identical between the top portion of the teeth and the root portion of the teeth. If it was just flaring that occurred, the length between the top portion of the teeth would be larger than the length between the root portion of the teeth. You can also see that there is bone filled into the growth space. Hope this helps!'

Thanks for sharing! Since the roots taper, it makes sense that there would be a greater distance separating the teeth at that level, but I think this is pretty convincing that there is more than just dental tipping going on.

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Posted : 22/07/2018 8:31 pm
SUGR1
Active Member

Hi all, SUGR here.

Issue with my previous account so just using this for now. If you previously messaged me and didn't get a reply, please PM me here. 

I see a lot of comments on tipping of teeth etc. 
The teeth CAN tip with the AGGA but the majority of the work is achieved through bone remodelling. We want to limit tip for obvious reasons. The two most common reasons I have found for teeth tipping are: 

1. Debonding of the wire from the back of the upper front 6 teeth. This will certainly tip your teeth. Hence it is important to check at each review appointment the bonding. 

2. Continued poor postures. I find tongue thrusts are a huge problem with AGGA (personal patient experience). 
Naturally tongue thrust patients have tipped front teeth which often gives them an anterior open bite appearance. With the AGGA on and extra forces etc, tongue thrust seems to overload the balance even more. I find this so serious now that I refuse to treat with AGGA until the tongue problems are managed first. 

As a side, posture and nasal breathing are so important to successful AGGA treatment. 
If one continues to mouth breath, the mandibular remodeling will not happen and lower jaw will not grow forward with the upper jaw. 

Keep up the sharing of knowledge! 

ReplyQuote
Posted : 22/07/2018 10:59 pm
jamesread, seii, rogerramjet and 2 people liked
Abdulrahman
Reputable Member

Hello @sugr1

Welcome back. I was actually speaking with seii to contact you. Are you able now to check your personal messages on this new account?

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

ReplyQuote
Posted : 23/07/2018 12:55 am
SUGR1
Active Member

Yes, she informed me about your message. Let's connect directly. You can message me your questions and any records or photos you have. It will help me assess your situation. 

ReplyQuote
Posted : 23/07/2018 4:29 am
SUGR1
Active Member

With respect to the comments on studies etc I may be able to shed some light.

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. 

He was in fact the one who first promoted the concept of remodeling of the maxilla to create forward growth in all ages and has written prices describing it.

What they are doing now to truly prove this new growth is two fold. One with long term cbct post treatment. As some have already alluded to, a Cbct or during treatment often does not show much as bone minerals and remodeling process takes years. 

The second aspect they are exploring are in patients who are having the space created with Agga and choose to speed up the next phase of orthodontics by having an implant placed rather than space closure with orthodontics, they are taking bone cores as part of the implant osteotomies. Under histology studies they should be able to show that new bone is being formed etc. A lot of these bone cores are in fact being taken from patients in Melbourne Australia.  

What this space, as I am sure in coming years some very eye opening research will surface. It might be sooner than most think.

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. 

ReplyQuote
Posted : 23/07/2018 11:59 pm
jamesread, Apollo, rogerramjet and 1 people liked
rogerramjet
Eminent Member
Posted by: SUGR1

With respect to the comments on studies etc I may be able to shed some light.

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. 

He was in fact the one who first promoted the concept of remodeling of the maxilla to create forward growth in all ages and has written prices describing it.

What they are doing now to truly prove this new growth is two fold. One with long term cbct post treatment. As some have already alluded to, a Cbct or during treatment often does not show much as bone minerals and remodeling process takes years. 

The second aspect they are exploring are in patients who are having the space created with Agga and choose to speed up the next phase of orthodontics by having an implant placed rather than space closure with orthodontics, they are taking bone cores as part of the implant osteotomies. Under histology studies they should be able to show that new bone is being formed etc. A lot of these bone cores are in fact being taken from patients in Melbourne Australia.  

What this space, as I am sure in coming years some very eye opening research will surface. It might be sooner than most think.

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.

What's your view about implants vs. space closure with orthodontics?

ReplyQuote
Posted : 24/07/2018 2:17 am
Sam
 Sam
Active Member
Posted by: SUGR1

With respect to the comments on studies etc I may be able to shed some light.

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. 

He was in fact the one who first promoted the concept of remodeling of the maxilla to create forward growth in all ages and has written prices describing it.

What they are doing now to truly prove this new growth is two fold. One with long term cbct post treatment. As some have already alluded to, a Cbct or during treatment often does not show much as bone minerals and remodeling process takes years. 

The second aspect they are exploring are in patients who are having the space created with Agga and choose to speed up the next phase of orthodontics by having an implant placed rather than space closure with orthodontics, they are taking bone cores as part of the implant osteotomies. Under histology studies they should be able to show that new bone is being formed etc. A lot of these bone cores are in fact being taken from patients in Melbourne Australia.  

What this space, as I am sure in coming years some very eye opening research will surface. It might be sooner than most think.

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. 

Thanks for being such a great resource @SUGR1 . I am grateful for your expertise.

Regarding the studies by Dr Bromage, have they proven bone remodeling for the front 6 teeth to sit in? Every traditionally trained orthodontist is adamant that teeth are being pushed out of the bone. It has been pointed out on X-ray new bone growth in the new space behind canines, but can X-rays also reveal/prove new bone growth/remodeling in front of the incisors?

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Posted : 24/07/2018 9:55 am
SUGR1
Active Member

Yes, 3d xrays like cbct can show there is new bone in front of the front teeth. It however takes a while for the bone to mineralised to show up on a dental xray. This is because bone forms in steps, with matrix and then mineral content. Only when it is mineralised is it visible. Also dental xray including cbct are low dose so do not show accurately. A medical grade ct will probably show more details sooner but require a significant more radiation (maybe 100 fold). Also do not forget every medical CT increases your cancer risk by 1%!

Now consider this, with respect to argument of in and out of bone... 

Teeth not in bone, means it's in gums?

Couple of things happen if this is the case 

1. Tooth experience large recession 

2. Tooth becomes mobile 

3. Tooth loses blood supply and dies

4. Tooth becomes very sensitive

None of the above I have yet to experience after agga. 

I do a lot of Implants in my practice and take cbct to plan the surgery. I often see in patients without orthodontic or agga treatment have what appears as teeth NOT in bone... And then when I do my surgery I can directly visualise then teeth and bone  and you can clearly see a thin layer of bone on top of the teeth roots.

Put your finger on your gums just above the teeth in the front of yoyr mouth and you can feel the undulation of the tooth roots... The bone is thin and follows the root morphology very closely... But the roots are covered in bone... So you are not directly feeling your roots under your gums... I have had orthodontists claim that after agga they can feel the roots.... Well if that is their 'objective' test then in almost every person I know, I can feel their roots with or without treatment.

Now to be completely fair there are cases with agga where the teeth are pushed out of bone... I know this because colleague's have shared cases with me. This however always is caused by poor technique and management. Eg if the teeth begins to flare, you risk this. Or if the treatment was too fast etc. When managed properly i truly believe it does not happen.

As a final thought on this  

You show me an orthodontist who says they never pushed teeth out of bone with traditional techniques and I will show you a lying clinician. All traditional techniques have risk of this including the clear aligner treatment like invisalign. 

ReplyQuote
Posted : 24/07/2018 5:22 pm
Apollo
Reputable Member

Ronny Ead's most recent updates on his migrainehacks blog are pretty remarkable (  https://www.migrainehacks.com/  ). He achieved significant growth between appointments when the springs on his device weren't tightened out of caution for his flared incisors, and then even faster growth once they tightened the springs again. He offers a few theories about why this happened including residual momentum, a release of his lip tie, and changing his diet to include much more tough meat. The chewing must be at least partly responsible for the appearance of his masseters in his recent images. I also wonder if the exercises he did after his lip tie surgery helped. Head over to his blog to check out the latest posts, and maybe speculate about what could be responsible for his unexpected growth spurt.

ReplyQuote
Posted : 24/07/2018 5:31 pm
rogerramjet
Eminent Member
Posted by: Apollo

Ronny Ead's most recent updates on his migrainehacks blog are pretty remarkable (  https://www.migrainehacks.com/  ). He achieved significant growth between appointments when the springs on his device weren't tightened out of caution for his flared incisors, and then even faster growth once they tightened the springs again. He offers a few theories about why this happened including residual momentum, a release of his lip tie, and changing his diet to include much more tough meat. The chewing must be at least partly responsible for the appearance of his masseters in his recent images. I also wonder if the exercises he did after his lip tie surgery helped. Head over to his blog to check out the latest posts, and maybe speculate about what could be responsible for his unexpected growth spurt.

Those new masseters of his are something else!

ReplyQuote
Posted : 24/07/2018 6:41 pm
jamesread
Active Member

Not really sure if there is growth from Week 4 to Week 8, maybe 0.5-1mm? (Week 4 is when I started taking vitamins D and K, calcium and magnesium and also doing longer presses on the pad and slowly releasing my tongue from the pad. I've also been eating brocolli and carrots (less cooked) so I can chew harder.

If I am gaining at least 1mm per month, I hope I can have atleast 6mm of growth in 6 months? 😀

Is my growth really slow while others are really fast? Am I missing anything that I should be doing to promote more growth? 

Let's see how it goes.

ReplyQuote
Posted : 24/07/2018 11:06 pm
Apollo liked
SUGR1
Active Member

Ronny's blog is quite informative I find.

It also helps with this ideological argument of teeth are being pushed through bone...

They have not activated springs  yet it continues to develop forward. 

Just like any other part of the body, say weight lifting and muscle development, the progress of muscle development is not a linear function. Sometimes you feel you hit a 'plateau' and then suddenly you are adding 20kgs to your lifts. 

This also applies to bone and really any other part of the body that is in dynamic flux. 

The body remodels in 'cycles' and sometimes it may be in a slower cycle, and others in a more up regulated cycle. It is possible the AGGA creates a stimulus and his ongoing myofunctional habits are further adding to the stimulus of accelerated bone remodelling in a forward trajectory. So despite there being no activation, the up regulation is enduring for a period of time. 

In children between 6-9 I do a removable AGGA treatment. I always find at the end of the treatment I have achieved an 'X' amount of forward growth. but they are always told to keep wearing the plate without turning it for an additional 2-3 months as a retainer. At that review appointment I usually see significant increase in forward growth despite not turning of the appliance (in the vicinity of X+2mm).  

There are theories also that the bones are remodelling in sync with the cranio rhythm. This is why often AGGA patients are referred for cranio-sacral therapy/manipulations. The cerebral spinal fluid pumping around your skull applies forces which are hypothesised by many to be critical. In fact you can feel it if you are very still and in a quite space and place your hands around your skull. 
With AGGA treatment we are not just applying a force but also de-entrapping the interlocked upper/lower jaw with the occlusal pads. Possibly this release of the locking mechanism is allowing the cranio rhythms to unlock the torsion and strain which pre-existed.

SOme are familiar with the ALF concept. if you are able to hold an ALF wire you will find it has such minimal force. Yet the ALF has demonstrated time and time again it can create remarkable bony changes. The subscribers of ALF call this stimulation the peizo-electric stimulation of teeth and bone. 

What ever the term, it is important to understand body responds to very small forces! And often just be changing the imbalance you will see great results (eg with mewing). 

 

 

 

 

ReplyQuote
Posted : 24/07/2018 11:34 pm
jamesread, Sam, rogerramjet and 1 people liked
Dominik
Trusted Member

🙁 how do I get one of these!?

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Posted : 25/07/2018 1:26 am
seii
 seii
Active Member

depends what country you are in 🙂 

In America I guess you can try looking up Dr Steve Galella and his students of the Facial Beauty Institute/LVI. Dr Anne Maree Cole is lecturing on behalf of Galella this year in Australia as well as in the LVI community...  So pretty much a trained dentist you can find in your vicinity that you trust :))

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Posted : 26/07/2018 12:33 am
paradise
Eminent Member

Ronny's progression looks impressive. Could someone do an analysis on his changes?

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Posted : 27/07/2018 1:27 am
SUGR1
Active Member

I am sure a lot can be said about his changes. 

But for me the major one and most interesting/significant one which relate to health (as opposed to aesthetics) is the neck angle. 
It is now much straighter which will have a significant knock on effect on his symptoms relating to migraines etc and more importantly general health. 

I would hypothesis this change can be attributed to forward growth of the maxilla, allowing forward traction of the mandible. This opens up airway space and decompresses the TMJ. Allowing downward and backward rotation of the skull.  
WITHOUT forward growth of the maxilla, the simple correction of posture of the head would not be maintainable as in the absence of the mandible traction forward, simple downward and backward rotation will result in airways impingement and natural response of the body to re posture to decrease airways resistance (natural survival response). 

Radiography/x-ray would show much healthier vertebrae angles especially relating to the C1-c3. The Hyoid bone would also have improved its position. 

ReplyQuote
Posted : 29/07/2018 10:03 pm
paradise, jamesread, rogerramjet and 1 people liked
Apollo
Reputable Member
Posted by: SUGR1

I am sure a lot can be said about his changes. 

But for me the major one and most interesting/significant one which relate to health (as opposed to aesthetics) is the neck angle. 
It is now much straighter which will have a significant knock on effect on his symptoms relating to migraines etc and more importantly general health. 

I would hypothesis this change can be attributed to forward growth of the maxilla, allowing forward traction of the mandible. This opens up airway space and decompresses the TMJ. Allowing downward and backward rotation of the skull.  
WITHOUT forward growth of the maxilla, the simple correction of posture of the head would not be maintainable as in the absence of the mandible traction forward, simple downward and backward rotation will result in airways impingement and natural response of the body to re posture to decrease airways resistance (natural survival response). 

Radiography/x-ray would show much healthier vertebrae angles especially relating to the C1-c3. The Hyoid bone would also have improved its position. 

This is probably a chicken-or-egg scenario. Reading about the exercises Ronny does to improve his head posture, I suspect this dedication has improved his tongue posture and helped facilitate the forward growth of his maxilla, and that in turn his forward growth has made it easier to practice good head posture in a virtuous cycle. In other words, I'm not convinced that just any FAGGA patient would see the same degree of improvement in head posture from the same amount of forward growth without Ronny's attention to this issue because of his migraines.

ReplyQuote
Posted : 30/07/2018 12:46 am
rogerramjet
Eminent Member
Posted by: SUGR1

The second aspect they are exploring are in patients who are having the space created with Agga and choose to speed up the next phase of orthodontics by having an implant placed rather than space closure with orthodontics, they are taking bone cores as part of the implant osteotomies. Under histology studies they should be able to show that new bone is being formed etc. A lot of these bone cores are in fact being taken from patients in Melbourne Australia.  

What this space, as I am sure in coming years some very eye opening research will surface. It might be sooner than most think.

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. 

Do you know which practitioner(s) is doing the meta study?

ReplyQuote
Posted : 30/07/2018 12:59 am
jamesread
Active Member
Posted by: SUGR1

I would hypothesis this change can be attributed to forward growth of the maxilla... 

WITHOUT forward growth of the maxilla...

SUGR, are you referring to the Pre-Maxilla (Point A)? I was told that the Maxilla only grows in children and stops growing in adults. The Pre-Maxilla (Point A) does continue to grow (being a soft tissue I guess) at least for what I've been told.

Others say, with AGGA, the maxilla remodels in adults, does "remodel" mean "grow bone cells"(Osteoclast/Osteoblast)?

ReplyQuote
Posted : 31/07/2018 12:01 am
SUGR1
Active Member

@apollo - of course, everything is based on commitment to change and posture based. 

Giving a kid a myobrace doesn't result in change unless they wear it appropriately. Same as myofunctional therapy. AGGA is no different. You need to be committed to change and possibly to seeing other health professionals to help with correction of posture etc. However, without the AGGA Ronny would not have the type of forward growth he has, and hence would not have the airways development and then would not be able to adapt to a straighter posture. Like the TV Show "Dark" the beginning is the end and vice versa, but you need to introduce something to change the game. 

Insert an AGGA into a mouth breather and he/she continues to mouth breath... watch not much happen, even after 1 year. 

@Rogerramjet - not sure who will be publishing the study but the centre in Melbourne is by Ari Master 

@Jamesread - terminology is key here, grow vs remodelling. It depends on your definitions. Growing in the head tends to refer to sutures. Most sutures in adults are closed. Some research says maybe in some adults the pre-maxilla suture remains open hence can be manipulated. AGGA practitioners are working on remodelling. This was shown by Don Enlow who is famous in the orthodontic world but his work on remodelling tends to be ignored or misunderstood by a lot of the dental world. You can read up on Enlow's work. The maxilla and mandible are able to remodel and change their shapes due to the laying down of bone (osteoblasts) and destruction of bone (osteoclasts) by different cells. FOr a very simple introduction to this read : 
Guiding atypical facial growth back to normal. Part 1 Understanding facial growth; International Journal of Orthodontics; vol 22, no4. 2011. Free on google. 
Part 2 is also good insight. 

 

ReplyQuote
Posted : 31/07/2018 7:40 am
jamesread
Active Member
Posted by: SUGR1

@apollo - of course, everything is based on commitment to change and posture based. 

Giving a kid a myobrace doesn't result in change unless they wear it appropriately. Same as myofunctional therapy. AGGA is no different. You need to be committed to change and possibly to seeing other health professionals to help with correction of posture etc. However, without the AGGA Ronny would not have the type of forward growth he has, and hence would not have the airways development and then would not be able to adapt to a straighter posture. Like the TV Show "Dark" the beginning is the end and vice versa, but you need to introduce something to change the game. 

Insert an AGGA into a mouth breather and he/she continues to mouth breath... watch not much happen, even after 1 year. 

@Rogerramjet - not sure who will be publishing the study but the centre in Melbourne is by Ari Master 

@Jamesread - terminology is key here, grow vs remodelling. It depends on your definitions. Growing in the head tends to refer to sutures. Most sutures in adults are closed. Some research says maybe in some adults the pre-maxilla suture remains open hence can be manipulated. AGGA practitioners are working on remodelling. This was shown by Don Enlow who is famous in the orthodontic world but his work on remodelling tends to be ignored or misunderstood by a lot of the dental world. You can read up on Enlow's work. The maxilla and mandible are able to remodel and change their shapes due to the laying down of bone (osteoblasts) and destruction of bone (osteoclasts) by different cells. FOr a very simple introduction to this read : 
Guiding atypical facial growth back to normal. Part 1 Understanding facial growth; International Journal of Orthodontics; vol 22, no4. 2011. Free on google. 
Part 2 is also good insight. 

 

just to check if my understanding is correct..

grow - means new bone formations (there is significant increase in length just like a leg getting longer due to new bone formations growing from leg sutures) (?)

remodel - bones are broken apart (osteoclast) and then repaired (osteoblast) creating a different shape and the change in shape can be tremendous as if the bones had grown in lenght. no growth happens from sutures as sutures are already fused [except for Pre-Maxilla and Mid-palatal sutures which is left open according to studies ](?)

Thanks. I will be reading on Don Enlow's work.

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Posted : 31/07/2018 10:41 am
Rockyp33
Reputable Member

@paradise holy thats some insane results!

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Posted : 01/08/2018 3:42 am
Lee
 Lee
Eminent Member

SUGR, you don't think Ronny's neck losing its curve is worrisome?

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Posted : 04/08/2018 10:21 am
maubes
New Member

Where is available the FAGGA appliance and the required treatment (in  US, Europe)? I would like these kind of non-surgical treatments to be available outside that sphere and arrive to Latin America, there is potential market for many people who underwent conventional orthodontics and now have narrow facial dimensions, breath and TMJ problems.

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Posted : 04/08/2018 3:34 pm
materemi
New Member

Is there any LVI certified dentist in Canada who's using fagga?

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Posted : 05/08/2018 3:05 pm
Lee
 Lee
Eminent Member
Posted by: materemi

Is there any LVI certified dentist in Canada who's using fagga?

Look at the map:   https://www.lviglobal.com/listings/?searchtype=keywords&keywords=f02

ReplyQuote
Posted : 05/08/2018 3:59 pm
Lee
 Lee
Eminent Member
Posted by: maubes

Where is available the FAGGA appliance and the required treatment (in  US, Europe)? I would like these kind of non-surgical treatments to be available outside that sphere and arrive to Latin America, there is potential market for many people who underwent conventional orthodontics and now have narrow facial dimensions, breath and TMJ problems.

Look at the map:   https://www.lviglobal.com/listings/?searchtype=keywords&keywords=f02

ReplyQuote
Posted : 05/08/2018 4:00 pm
Lee
 Lee
Eminent Member
Posted by: maubes

Where is available the FAGGA appliance and the required treatment (in  US, Europe)? I would like these kind of non-surgical treatments to be available outside that sphere and arrive to Latin America, there is potential market for many people who underwent conventional orthodontics and now have narrow facial dimensions, breath and TMJ problems.

There is one in Germany too, not sure why he isn't showing on the map.

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Posted : 05/08/2018 4:01 pm
printfactory
Eminent Member

What´s the name of the one in Germany?

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Posted : 05/08/2018 9:40 pm
mandy
New Member

Dr. Susan Huxtable located in Toronto. she actually had undergone the procedure herself and so has her hygienist. She makes sure that to undergo procedures you are to learn correct tongue posture and swallow patterns.  I am waiting on a sleep study to come back and then I am going to see her so that she can file it for my insurance. Unfortunately, the sleep study was a waste of time since I couldn't sleep during said study but I'm still going through. She says to correct the tipping after the FAGGA is done she uses unligated braces to tip the teeth back.

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Posted : 05/08/2018 11:52 pm
Lee
 Lee
Eminent Member

The one in Germany:   https://www.lviglobal.com/listing/dr-charles-smith/

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Posted : 06/08/2018 7:55 pm
Lee
 Lee
Eminent Member

The one in Germany:   https://www.lviglobal.com/listing/dr-charles-smith/

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Posted : 06/08/2018 7:55 pm
seii
 seii
Active Member
Posted by: mandy

Dr. Susan Huxtable located in Toronto. she actually had undergone the procedure herself and so has her hygienist. She makes sure that to undergo procedures you are to learn correct tongue posture and swallow patterns.  I am waiting on a sleep study to come back and then I am going to see her so that she can file it for my insurance. Unfortunately, the sleep study was a waste of time since I couldn't sleep during said study but I'm still going through. She says to correct the tipping after the FAGGA is done she uses unligated braces to tip the teeth back.

You could try the home sleep study as well. It is not uncommon to repeat the sleep study to get a more accurate result.

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Posted : 07/08/2018 5:23 am
Apollo
Reputable Member

Without mentioning it by name, I think Dr. Mew makes an indirect reference to the FAGGA approach in his recent video responding to TGW forum questions (  https://youtu.be/jMb5OHy2z_s?t=30m18s ). @lagi asked, "what is your opinion on reverse extraction procedures for premolars on the upper jaw and lower jaw." Dr. Mew says, "The problem is, if your jaws have downswung and collapsed, trying to extend them in this direction here is not really the answer," as he holds his hands up to demonstrate forward growth at a downward angle, reminiscent of the argument @facehacking makes in this video (  https://www.youtube.com/watch?v=dJNKOZcZwiw&t= ) where he asserts "with a downward inclined maxilla, FAGGA will only make your face become longer." Dr. Mew goes on to say "To be honest, I'm not big on opening up spaces. I want to get an upswing in craniofacial form... and then don't open spaces. Why do you want to open spaces here? I want everything to move up and forward... en masse... Remember if you're going to create any space, to push the front forwards, you're going to push the back teeth backwards, and I don't think that's necessarily helpful. It's not going to get you anywhere, to make that space, and then you have to worry about what you're going to put in that space. If you put implants in the space, well then, you're going to really restrict your ability to gain further movement, because you're restricting, you're placing something in there that's fused to the bone. So my suggestion is: don't open spaces up, just work on your posture. Get everything moving up and forwards. Clearly, I would make a caveat there that if you want more tongue space, sometimes opening spaces can assist with that." I think the utility of the FAGGA system depends on the patient's preexisting maxillary pitch. Mine is pretty level, so moving it forward wouldn't cause much downward growth. As Dr. Mew seems to imply with his final caveat, even in some cases where vertical lengthening would result, the opening of the airway from the forward expansion might be worth the trade-off, and could maybe allow for upward remodeling to follow once the tongue has adequate space to posture without airway occlusion. I tend to agree with Dr. Mew about the restrictiveness of implants, and think that the controlled arch method to close the gap by bringing the posterior teeth forward is a better approach.

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Posted : 18/08/2018 6:24 pm
SUGR1
Active Member

I respect Dr Mew greatly but what he is saying about the downward and forward growth is not correct with the AGGA. The AGGA is all about up swing. The treatment completely changes the occlusal plane / curve of spee. 

The mandible rotates completely forward and Up with the pre maxilla being pushed forward and up to compensate. The molars then erupt to balance the posterior. 

With th removable AGGA I can show hundreds of cases in children where they have only one contact on the posterior molars and within 1month the mandible has rotated forward and up to allow completely occlusal adaptation. Of course in adults it is much slower but the mandible condole is a growth centre of the body and will remodel to stimulus at any age. 

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Posted : 18/08/2018 6:54 pm
Apollo
Reputable Member

Since he doesn't mention it by name, I'm just inferring Dr. Mew's comments relate to the AGGA in addition to other methods like the removable sagittal expanders used by Claimingpower to open up his extraction spaces. I can understand Dr. Mew's reasoning, but it is encouraging to hear from your clinical experience that his concerns don't apply to the AGGA in practice. Maybe if Dr. Mew saw a few adult AGGA cases in person he would come around.

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Posted : 18/08/2018 9:06 pm
Abdulrahman
Reputable Member
Posted by: Apollo

I can understand Dr. Mew's reasoning, but it is encouraging to hear from your clinical experience that his concerns don't apply to the AGGA in practice. Maybe if Dr. Mew saw a few adult AGGA cases in person he would come around.

I think one thing that clarified things to me so much and goes in contrary to this view is the role of the vertical growth indicator (VGI) in FAGGA treatment.

I didn't realize that it was the main measurement to determine the need for the treatment and that success was measured by how much it reduced.

It turns out FAGGA practitioners aim to reduce this number to the ideal 38mm. I just can't see the face continuing to expand forward and downward while this number reduces significantly.

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

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Posted : 19/08/2018 12:49 am
paradise
Eminent Member
Posted by: Abdulrahman
Posted by: Apollo

I can understand Dr. Mew's reasoning, but it is encouraging to hear from your clinical experience that his concerns don't apply to the AGGA in practice. Maybe if Dr. Mew saw a few adult AGGA cases in person he would come around.

I think one thing that clarified things to me so much and goes in contrary to this view is the role of the vertical growth indicator (VGI) in FAGGA treatment.

I didn't realize that it was the main measurement to determine the need for the treatment and that success was measured by how much it reduced.

It turns out FAGGA practitioners aim to reduce this number to the ideal 38mm. I just can't see the face continuing to expand forward and downward while this number reduces significantly.

When you refer to the vertical growth indicator (VGI), is this the same as the Mew Indicator Line?

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Posted : 20/08/2018 2:09 am
Apollo liked
Abdulrahman
Reputable Member
Posted by: paradise

When you refer to the vertical growth indicator (VGI), is this the same as the Mew Indicator Line?

Yes

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

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Posted : 20/08/2018 2:11 am
Apollo
Reputable Member

Here's an interesting post from the comments section of Ronny Ead's latest update (  https://ronaldead.com/new-blog-1/2018/8/21/40-weeks-with-agga-fastest-growth-yet ):

Posted by: RR

Boss pictures RE! Interesting to see your lower third developing heartily, particularly your masseurs.

I suspect some people will notice that your mid-face is not developing as quickly as the lower third is. To this I repeat a post one of the LVI practitioners made, which I can speak to, having seen my mid-face catch up post-AGGA:

'The process of remodeling of the face continues for many months even up to 2 years after a growth appliance is used. The midface has differing fields of apposition and resorption with different timelines. The nasal cavity; palate; floor of the orbits; cheek bones; bridge of the nose all undergo a long process of remodeling to rebalance the face after the Maxilla has been developed. There are multiple factors to look at when the diagnostic summary is completed. For example part of the equation is how much stimulation is needed for a retruded Mandible as the AGGA is highly stimulative to the Mandible. This anticipated response from the face thus influences the final calculations for growth. The so called static cranial reference points such as Nasion are not static but remodel with the rest of the face so much has to be taken into consideration with coming up with a recommended number to use for growth. It is not so much about a number as it is about the stimulation of the face to remodel, meaning more growth is not necessarily better. Understand that in controlled arch braces there is further remodeling stimulation by teeth stimulating the surrounding bone in the dentoalveolar complex and this is also factored into the formula. Don't fixate on the number, but trust the process and your dentist who has been trained in this.'

The other thing I would add to your discussion is about your mandible advancement. It's a question I get often from people either in, or thinking of undergoing treatment: "why hasn't/isn't my mandible keeping up?"

I suspect Ronny, you'll be like me where the advancement of the mandible isn't something that just happens in and of itself. To a large extent I find that the reason my mandible has advanced with the maxilla is that as the space opens up, I feel I actively engage with the process, and can project my mandible forwards and upwards with the new space as and when it develops. At first, this feels tight and uncomfortable in my muscles and near my ears, however, if I leave the mandible there repeatedly for some time, over time and with repetition it actually starts to want to shift to its new advanced location.

Then at my next consult I show my practitioner where my mandible readily wants to go and the molar pads are adjusted accordingly to suit.

I think this is an important observation to address about this treatment; sure, there is some passive role that the device plays, but really, the best outcomes are achieved by people engaging actively with the appliance, repeatedly and consistently in terms of posture, jaw positioning, tongue placement, etc.

Thanks for sharing your journey.

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Posted : 24/08/2018 3:07 pm
paradise
Eminent Member

Ronny Ead's 42 week update:  https://ronaldead.com/blog/42-weeks-with-agga-rapid-growth-continues

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Posted : 05/09/2018 11:23 pm
Beeautiful
New Member

Thanks for all yours discussion on AGGA

@sugr1 i’d like to ask if you have any medical experience with Asian treatment. 

If so, are there some remarkable differences between Asians and other races? Especially in the treatment result.

If not, do you think race can affect the outcome of treatment? 

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Posted : 11/09/2018 8:50 am
SUGR1
Active Member

Like all orthodontics and orthopaedic treatments you need to take into consideration ethnicity. 

We know that bimaxillary protrusion and class 3 are more common in Asian ethnicities.

Hence depending on your treatment goals it may mean if you starting with bimax protrusive, then Agga treatment will make your profile terrible despite it might be what is needed for health benefits.

 

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Posted : 11/09/2018 9:05 am
Abdulrahman
Reputable Member
Posted by: SUGR1

Like all orthodontics and orthopaedic treatments you need to take into consideration ethnicity. 

We know that bimaxillary protrusion and class 3 are more common in Asian ethnicities.

Hence depending on your treatment goals it may mean if you starting with bimax protrusive, then Agga treatment will make your profile terrible despite it might be what is needed for health benefits.

 

@sugr1 Why would a person with bimax protrusion need FAGGA treatment in the first place? Isn't their forward growth excessive or is it so only in a small area that does not help the airway?

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

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Posted : 11/09/2018 9:15 am
Beeautiful
New Member
Posted by: SUGR1

Like all orthodontics and orthopaedic treatments you need to take into consideration ethnicity. 

We know that bimaxillary protrusion and class 3 are more common in Asian ethnicities.

Hence depending on your treatment goals it may mean if you starting with bimax protrusive, then Agga treatment will make your profile terrible despite it might be what is needed for health benefits.

 

Thanks for your reply!

I got that the ethnicities and their own profiles should be considered when making a treatment plan.

Actually what i really want to ask is  the ethnicity have an effect on maxilla growing speed or remodeling a face. 

Are there any studies or medical experiences on this?

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Posted : 12/09/2018 2:40 pm
FutureModel
Trusted Member

How much upward and forward growth can one achieve? If you use the fagga long enough can you reach your "full genetic potential"? May you have the face of a model if you wear it long enough? Is a face like this possible if you keep wearing it? No matter how long it takes is this possible if you keep moving the maxilla up and forards via fagga?

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Posted : 16/09/2018 9:34 am
Abdulrahman
Reputable Member
Posted by: IThinkINeedLefort3

How much upward and forward growth can one achieve? If you use the fagga long enough can you reach your "full genetic potential"? May you have the face of a model if you wear it long enough? Is a face like this possible if you keep wearing it? No matter how long it takes is this possible if you keep moving the maxilla up and forards via fagga?

I like your questions 🙂 The short answer is no.

Now for the long answer.

Fagga is used to achieve forward (sagittal) growth in the maxilla to reach the patient's "genetic potential". This genetic potential is determine by several measurements including airway volume and the vertical indicator line to name a few. The goal is to have the patient develop enough space for all their teeth (including wisdom) and expand their airway. Also of importance is to allow for the mandible to swing forward to its optimal position.

Fagga focuses on the lower part of the maxilla to achieve this as that is where the stimulation from the device take place. Overtime other areas of the maxilla will follow until the face reaches a uniform expansion. This process takes years. 

When all done the patient will look like a better versions of themselves, but won't look drastically different. For example their lower jaw shape will become more visible, but their week chin will not transform into a stronger chin like the one you see on the model.

In fact, from an aesthetics perspective not all the changes this treatment offers can be expected to be an improvement. Just look at Ronald Ead's before, intermediate, and near final pictures. He started needing an improvement. 20 weeks later he improved allot. By the 42 week the effect is becoming "over". But overall his health has improved allot and his airway has become great. 

I hope you found this answer useful. I tired to answer it to my best knowledge and hope that SUGR will give his more advanced view.

 

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

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Posted : 16/09/2018 10:11 am
FutureModel
Trusted Member

Thanks for the reply. I understand that people won't look like a different person, but don't you think you'd have stellar bone structure if you do everything right? I think if you did everything right you could achieve model tier bone structure. Mike Mew made a video a while ago where he was replying to users on SH forum, some guy asked if he could achieve model teir bone structure with mewing and all that, Mike said yes. Mike also said that the chin can be modified with proper use https://www.youtube.com/watch?v=GmMKgXnyNH8

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Posted : 16/09/2018 1:02 pm
FutureModel
Trusted Member

I mean, there is no genes that make you ugly. So, why wouldn't proper oral posture and muscle use (mewing/fagga) not give you great bone development equal to a models face? I don't see how it couldn't because there is no genes that code for an ugly face or body. Except for maybe height and a few other things like eye color. Here is what Mike Mew had to say https://www.youtube.com/watch?v=PqUm7EaD1zo

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Posted : 16/09/2018 1:15 pm
Abdulrahman
Reputable Member

I think you are confusing esthetics with function. A well developed and functioning face will look better than the opposite but it won't necessarily be the most beautiful.

Some features that we find esthetic are purely cosmetic. Take for example the chin of that model, it's sticking out past the lips and looks good as a result, but it has no known function. It's mainly a cosmetic feature.

Think of it in terms of car parts. A car will need a bumper to cover internal parts and reduce drag. You can have a basic shape like the one seen on a basic Toyota that's made to function in the best way. On the other hand you can have a bumper like the one on a sporty Lexus that's made to look in the best way.

Both are bumpers that serve their main function well but one has a purely functional design while the other has some esthetic element added in. 

Regarding the sh forum video, it's been a while since I seen it, but I think Dr. Mew has changed his approach since then. I don't think he is making such bold claims anymore. Besides look at all his patients that he was able to treat from an early age until adulthood, did any of them develop model features? 

No, and those were treated by the master and over a good period of time in timing and length.

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

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Posted : 16/09/2018 10:12 pm
FutureModel
Trusted Member

Again thanks for the reply. Watch this video https://www.youtube.com/watch?v=GmMKgXnyNH8 Mike Mew talks about the chin and basically says that if you use your mouth properly you can have a nice chin

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Posted : 17/09/2018 8:49 am
Abdulrahman
Reputable Member

I watched this video before but I just re-watched it because you asked twice.

Dr. Mew mentioned several factors influencing the protrusion of the chin including the mandible rotation and the position of the lower teeth. Both points are correct with the first being valid in many cases while the second less so often.

The biggest factor however, which Dr. Mew briefly went over, is the natural or genetically determined shape of the bone. He referenced this when talking about the nerve that runs through the mandible.

Look at the two samples below and see the difference. Both mandibles are placed level so there is no issue with rotation. Also the teeth, while not identical in position, show no angulation problem.

Notice how much the pog point on the mandible on the left sticks out past the b point versus the one on the right? That's what makes the difference between a strong protruding chin and a weak one, at least that's the biggest factor.

Both mandible, from an anatomic stand point, are perfectly fine but one produces a more esthetic appearance.

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

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Posted : 17/09/2018 11:05 am
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