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Homeoblock and DNA/Vivos Appliances. Moving teeth through the alveolar bone or true 3D skeletal expansion?
This is a question I'm yet to find a concrete answer on. Do these appliances truly provide 3D expansion or are they just moving teeth through bone? Ronald Ead's new video on AGGA has put my faith in these appliances into doubt, with him suggesting that AGGA provides no maxillary expansion and the gains made are just the teeth being aggressively pushed forward through the alveolar bone, providing the illusion of forward maxillary expansion and consequently damaging his top and bottom incisors. His scans have also all but confirmed this.
But is this the case for the Homeoblock and DNA appliances? From what I've seen online these appliances don't just move teeth through bone but are suseptible to doing so as they are teeth borne appliances. However, their sole purpose is mid face redevelopment. Both devices, from what I've seen, also use 3D scans to evidence bone growth and redevelopment in the mandible and maxilla. Are these scans truthful? Is this bone growth/redevelopment a consequence of the device itself or is it just a consequence of teeth moving through bone? These are questions I believe we all need answered for those of us who believe devices to be our only option to achieve growth while in adulthood.
I should also add that The Homeoblock and DNA devices, unlike AGGA, have been discussed, and favourbly so, by Mike + John Mew on their YouTube channel and also have a Facebook post dedicated to the DNA appliance.
Any anecdotes, experiences or clarification would be very welcome.
Teeth moving through the alveolar bone is usually accompanied with flaring out of the teeth, most likely to occur in tooth borne appliances. AGGA is especially bad because not only is it tooth borne, the forward pushing of the teeth, is anchored to the molars, preventing any real growth of the maxilla. Real forward expansion brings the whole maxilla/upper arch forward, not just 6 front teeth.
Imagine if you were to anchor lateral expansion of the molars on the premolars, where like in AGGA you get "expansion" of your molars while the premolars and front teeth don't expand at all, you get gaps like in AGGA, imagine how bad that would be. You "expanded" 10 mm let's say for the sake of argument (like in Ronald Ead's AGGA treatment), your intermolar width would be 10 mm wider technically, however the width between the premolars and canines haven't changed. If the teeth do not flare out I think it's likely skeletal expansion has occured, however, most people expand like 5 mm max with these appliances (DNA and Homeoblock) so the difference isn't really noticeable in the midface.
I'm also very interested in this question and would appreciate any insight into DNA, especially as it relates to AGGA and Schwartz expanders. Do we think DNA is just 3-way expander derivative that pushes on the alveolar ridge and teeth? I haven't ever looked into DNA but would like to learn more. All I know is that I've consulted with DNA patients who were underwhelmed with results and were considering MSE.
Also, what is the difference between DNA and RNA?
For anyone who hasn't seen my AGGA video here's a link: https://youtu.be/r9xJJgi67iQ
I would appreciate your insights.
@ronaldead Which issues did the DNA patients you consulted with have? The Schwarz appliance looks better IMO, since the DNA looks to put more pressure on teeth. When you used a 3-way expander and flared your teeth out, that wasn't a Schwarz appliance, was it?
Going though this key note lecture Dr. Singh has confirmed that through 3D imaging technology, the increased maxilary width is in fact from bone growth in the maxilla and not teeth moving through alveolar bone. Very encouraging.
Time stamp: 46:00
These appliances get a lot of exaggerated and gimmicky claims, most get 5 mm max of expansion and/or a change the shape of the arch from a V to more of U, which gives more space for the teeth and makes them straighter but doesn't do anything for actually expanding the midface. A similar sort of thing happens with RPE appliances where you get a big diastema but little to no change in IMW. I'd say skeletal expansion is achieved if the teeth don't flare and the whole arch widens/expands.
I'd encourage you to watch the lecture by Dr. Singh and see what you make of his claims. In the lecture he describes and evidences achievments similair to your ideas on skeletal expansion in which the arches have widened but the teeth have not flared. He goes into great detail in actually explaining as to why this is possible with the appliance and how its affect is disimilair to a Schwarz appliance or something similair.
Dr. Singh describes the device as most suited to those with mild to moderate cases of sleep apnea and it has been federally approved for such treatment. I think from this we can suggest that its efficacy is probably most useful for those looking for minimal/moderate expansion with little invasiveness. I think the exaggerated claims come moreso from the community than the practioners themselves as their claims, to me at least, seem mostly sensible and fairly moderate.
Perhaps actual bone expansion depends on how well the tongue is functioning. I think that mewing principles must be applied along with any appliance to reach genetic potential.
Random picture I came across when looking up VIVOS appliance...
Yeah I agree. The photo you linked is featured in the lecture I provided above which also includes 3D scans of her airway and photos of her palate. More cases like this can also be found in the lecture.