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Getting my Expander (MSE) installed shortly  

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DrMario
Eminent Member

Hi everyone!

I am excited to get my skeletal expansion installed soon. I was wondering if I can question box anyone who has any information or undergone skeletal expansion themselves (MARPE/MSE/SARPE...etc.) . Did any of the following occur?

 

1. Improved nasal breathing (less nasal breathing resistance, easier to achieve deeper breaths)
2. Physical changes to the nose (wider nose, bigger nostrils)
3. Increased width of zygos (more prominent cheekbones)
4. Increased distance between the eyes
5. Improved eyesight https://www.daniellopezdo.com/swallowing-incorrectly-can-affect-eyes/

6. Changes at all to the voice
7. Improvement in sleep quality

I think it would be great to share this kind of information to know how expansion prior to orthodontic treatment can benefit someone.

Thanks in advance ....

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Posted : 30/08/2019 9:07 am
darkindigo
Reputable Member

I talked with an oral and maxillofacial surgeon who didn't care for SARPE.  He said that the sides don't always push out evenly and sometimes one side will push up and out more than another.  I trust him.  He just prefers surgery...but not sure what kind.  It was tangential to the conversation we were having, but I do remember this distinctly.  Not sure the difference between MARPE and MSE and SARPE.  He was saying SARPE had this issue.

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Posted : 31/08/2019 1:40 pm
darkindigo
Reputable Member

Nasal space should open up...yes.

Distance between eyes will be more a factor or where things get pushed out.  Example...when the maxilla is broken...the face has many vectors for change.  Moving out more in the anterior region will affect the bridge of the nose more.   If you want that, Dr. Marianna Evans has some cool anterior tad-assisted expansion.  Just imagine that you're playing with legos and you're moving stuff around.  If you move apart the anterior region... you'll get associated facial changes.

Everything above makes sense regarding what you wrote... BUT!  There are risks.  For example... someone had MSE and because there was anterior open bite,...the top actually swung down and negatively impacted appearance.  From all I learned, I like to start with the outside and move in.

Ex.  Start with the borders... face height and chin... work to maxilla then teeth.  A stable maxilla is great to work against unless you have a long face.  If you have a long face or skeletal class 3, go see a surgeon.  People lump the maxilla with the chin often to save time.  But when your maxilla is all over the place (disarticulated)... it's harder to work off to put the lower jaw where you want!

My own observation
1) condyles
2) chin angle
3) chin/upper anterior
4) maxilla widening (if desired) followed with mandibular
5) final teeth placement

We don't start with the innards and let the outwardly appearance be however.  LET'S LOOK GOOD!  Let's figure the teeth out last.  They can intrude or extrude...adjust for tooth-size discrepancy...all that hard ortho stuff.  Doing the face placement is easy.  Doing it first makes sense.

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Posted : 31/08/2019 1:46 pm
Neigh and DrMario liked
DrMario
Eminent Member

@darkindigo

Thanks for your input! I appreciate you...

I should be a good candidate for this MSE transverse expansion because I never had any injuries, I already have a short mid-face with a class I bite. I'm at 33mm and he said he can get me around 10mm more. He also saw from my CBCT that my bone is very healthy. The modality of his treatment dictates working to expand the maxilla with the MSE and he plans for the TADs to stay in for 9 months for optimal retention. For the time being he is going to use bottom braces to match up the top arch and he told me the diastema should close on its own without braces to the top arch.

Thanks for highlighting about that possible issue with SARPE. 

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Posted : 01/09/2019 11:20 am
Azrael
Estimable Member

@drmario

Did you install the MSE? How is it going?

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Posted : 08/05/2020 4:08 pm