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How to Encourage the Mandibular Arch to Keep Up with Expansion of the Maxillary Arch  

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Apollo
(@apollo)
Reputable Member

In class 1 (normal) occlusion, the mesial slope of the upper canine should coincide with the distal slope of the lower canine. In other words, the cusps of the upper canines should line up with the contacts between the lower canines and first bicuspid and the cusps of the lower canines should line up with the contacts between the upper lateral incisors and upper canines.

 

Since I have expanded my maxillary arch by 2-1/2mm so far, moving the upper canines laterally, the cusps of the lower canines are now more than a milimeter closer to the midline than the contacts between my upper canines and lateral incisors. In other words the distal slopes of my lower canines aren't touching the mesial slopes of my upper canines.

When I was first investigating getting a palate expander, I debated also ordering an expander for my mandibular arch. I read that this wasn't necessary or even advisable because the mandible doesn't have a suture to separate, and the lower arch should automatically expand to fit the upper arch. Chewing exercises are the only way I know to encourage the lower arch to keep up. As I understand it, the lower teeth will shift to maintain occlusion. However, I've been pretty diligent about chewing for a couple hours every day, and so far the crowding of my lower incisors hasn't changed. I've also read some unsubstantiated claims that the expansion of the lower arch is dependent on growth factor/hormonal control, but I don't know where this information comes from or how it could be used to improve mandibular expansion.

Quote
Posted : 25/03/2018 4:05 pm
Progress
(@progress)
Member Moderator

Chewing isn't that effective for shifting teeth permanently, as that would defeat the utility of teeth. After reading some things @allixa and @sclera (or @silver , cant remember) discussed earlier, I think playing around with something like this could be a potential solution.

In latter lower teeth are not supported against the weight of the upper teeth + lips, which may lead to inward tipping or lack of improvements. In former example the teeth are within a vacuum created by jaws, lips and tongue. Being surrounded by these forces the teeth should fall to straight arches, because they have nowhere else to go. 

 

In any case, it should make a real difference whether the posterior tongue is folded in order to make room for anterior tongue, or anterior tongue for posterior tongue.

 

ReplyQuote
Posted : 25/03/2018 4:36 pm
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Progress
(@progress)
Member Moderator

You could take this kind of folding further by placing the tip under your lower teeth against the interior of mandible/chin.

 

 

In the end important is not pushing the tongue up, but pushing it away from spine. When the tongue moves, it drags the spine with it. This is the anatomically important aspect of tongue posture. In recessed skull the lacking upward space could perhaps be surrogated with by simulating additional forward space in previously demonstrated manner. You can probably prove this yourself by trying to push your tongue far away from your mandible and noticing how your core wakes up to assist this movement.

 

 

ReplyQuote
Posted : 25/03/2018 5:18 pm
Apollo liked
Allixa
(@allixa)
Estimable Member

I was always under the impression that chewing was all that was needed to help the bottom teeth keep up with the upper teeth while a person was expanding, and all of the accounts that I have read so far seem to back this up. But I do believe that you have been diligent with your chewing (what gum btw?), so we have to look for another solution.

edit: look at my post below

 

ReplyQuote
Posted : 25/03/2018 6:40 pm
Apollo liked
Progress
(@progress)
Member Moderator

 

If talking about molars, yes I agree. Molars are jagged in a way that locks them together. For lower front teeth there is nothing that could pull them along with the expanding upper front teeth, so acquired crowding there could be difficult to fix. My earlier posts tried to offer a solution to this. Perhaps Mew's Tongue Chewing is intended to achieve something similar.

ReplyQuote
Posted : 25/03/2018 6:55 pm
Allixa
(@allixa)
Estimable Member

@progress

That's a good point. With that in mind I can't think of a real way to get lateral forces onto the bottom canines. It doesn't even look like something that the tongue could pull off. Check the picture I'm posting below.

@apollo

Do you remember the expansion study we looked at earlier? It seems to show the exact thing you are talking about (left canine in the picture from our pov):

The expander they used for this case didn't even touch the canines, just the premolars and molars.

Based on what progress said I'm not sure that all the chewing in the world could resolve something like this. It looks like the entire front portion of the lower jaw needs to become more lateral in order for the canine cusps to line back up. Do you guys think it's possible to achieve this with anything OTHER than an expander? It looks tough.

I'm pretty sure that just like progress said, the whole growth hormone connection that other posters have talked about would only help for the back teeth because of how they interlock.

ReplyQuote
Posted : 25/03/2018 10:49 pm
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Apollo
(@apollo)
Reputable Member
Posted by: Progress

In the end important is not pushing the tongue up, but pushing it away from spine. When the tongue moves, it drags the spine with it. This is the anatomically important aspect of tongue posture. 

 Thank you @progress, for the creative suggestions and the diagrams to help me understand! I've never really thought about tongue posture as dragging the cervical vertebrae into alignment. When I bring the tip of my tongue down to the level of my mandibular incisors or lower, while keeping my posterior tongue against the roof of my mouth, it does give a stretching sensation at the top of my neck below my occiput. I could see how the tongue pressure could tip the lower incisors forward. However, I'm not sure that it would do much to shift the canines laterally, which I think is the right way to reduce the crowding. I'm also concerned that I don't feel much forward force on my maxilla without the tip of my tongue down in that position.

Posted by: Allixa
 
Do you feel like your bite is about to get messed up due to the mismatch? Are you getting any soreness at all in your bottom teeth (indication of movement)?

My occlusion still feels relatively normal, and I'm not too worried yet. I just thought I would put this out there as a topic that could be helpful for anyone using an expander. I wonder if @admin has observed his mandibular arch expanding along with his maxillary arch. I've mentioned before how the intermolar width of my lower arch is wider than my upper arch except that the bottom molars are tipped inward so that the cusps of the top teeth sit outside the cusps of the bottom teeth without any crossbite. As I have expanded the upper arch, I expected the bottom molars and bicuspids to start tilting upright more than they have. This in turn might make space for the canines to shift laterally and then the incisors to space out. I suspect as I get farther along with expanding the upper arch the force of occlusion with all of my chewing exercises will begin to have that effect. I probably just haven't expanded far enough to throw off the occlusion and provoke the changes. At least that's my theory. My mandibular teeth haven't had any significant tooth-movement pain, but my maxillary teeth haven't had much either. Sometimes I feel it when I first start my chewing exercises, or begin to eat a meal, but once I've been chewing for a couple minutes it subsides.

Posted by: Allixa

I do believe that you have been diligent with your chewing (what gum btw?)

I'm on my third box of that same brand of mastic you mentioned last week (  https://the-great-work.org/community/main-forum/where-to-order-mike-mew-chewies-for-jaw-chewing-training/#post-1372 ). I've always found it to be very suitable for my purposes.

Posted by: Allixa

The first question to ask is whether you believe your teeth are remaining together at night? If they aren't then perhaps the bottom teeth aren't getting the expansive forces they need to start moving.

I've been practicing mouth taping for the past few weeks. Before then I suspect that my mouth was sometimes opening during sleep. Since then, it's still possible that the teeth might separate, but I feel like there is a better tendency to keep the teeth together when I can't breath through my mouth. That being said, the wires between my teeth from the expander don't allow the teeth to totally occlude even when they are touching. 

Posted by: Allixa

The second thing that comes to mind for me is nutrition and supplementation. I know we briefly talked about it earlier but I never asked you in detail what your diet is like, what you eat like, and if you are taking any supplements to help out with your expansion process. Do you mind sharing? The reason I keep bringing this stuff up is because I know it's true and I know it helps. Just like with OMC and Rotary Chewing (which I brought up in my first ever post on this forum, you can check) I know that nutrition should be considered one of the pillars of proper mewing.

I mentioned some of these details in my nutrition thread. I eat a lot of vegetables, meats, fruits, healthy fats, prebiotics, and fermented foods, while minimizing grains, added sugars, artificial sweeteners, and processed foods. I often allow some grains for one of my two meals per day, especially recently because my work schedule has forced me to eat at restaurants more frequently. I mentioned my rational for supplements in this thread (  https://the-great-work.org/community/main-forum/de-ossify-skull-sutures-or-unfuse-the-skull/#post-748 ) about bone mineral balance. I'm taking a multivitamin, magnesium, D3, K2, and fish oil. I'm only using dietary sources and the multivitamin for my vitamin A (which encourages osteoclastic activity to balance the osteoblastic activity of the D3), but also has the potential for side effects from excess. I have debated cutting out the multivitamin and D3 and replacing them with dietary sources and a high-vitamin fermented cod liver oil but it is expensive. I think my dietary calcium intake is adequate because I consume a fair amount of fermented dairy. If I remember correctly, the link you provided in my nutrition thread to the perfect health diet had recommendations for supplements, so I should go back and read through those again.

I have my old clear aligner bottom retainer from after my braces came off in high school. It covers everything between the bottom two first bicuspids, but not the second bicuspids or molars. It wouldn't be a good idea to try and force my teeth into it now because one of the central incisors is especially crowded back out of alignment. If I begin to get some expansion on the bottom and that incisor gets closer to realigning, I could try using that retainer for a while to speed up the process.

ReplyQuote
Posted : 25/03/2018 11:00 pm
Apollo
(@apollo)
Reputable Member
Posted by: Allixa

@progress

That's a good point. With that in mind I can't think of a real way to get lateral forces onto the bottom canines. It doesn't even look like something that the tongue could pull off. Check the picture I'm posting below.

@apollo

Do you remember the expansion study we looked at earlier? It seems to show the exact thing you are talking about (left canine in the picture from our pov):

The expander they used for this case didn't even touch the canines, just the premolars and molars.

Based on what progress said I'm not sure that all the chewing in the world could resolve something like this. It looks like the entire front portion of the lower jaw needs to become more lateral in order for the canine cusps to line back up. Do you guys think it's possible to achieve this with anything OTHER than an expander? It looks tough.

I'm pretty sure that just like progress said, the whole growth hormone connection that other posters have talked about would only help for the back teeth because of how they interlock.

This is similar to what I am seeing in my mouth, except mine is maybe slightly more obvious. A little gap of black space is visible between the mesial slope of my upper canines and the distal slope of my lower canines, and the tips of my lower canines line up about a millimeter from the distal edge of my upper lateral incisors. Maybe there is just a lag period since the lower jaw doesn't have the suture to allow for expansion, so it takes longer for the bottom teeth. I remember CP writing that he had to turn the screw on his bottom expander slower than the screw on his top expander. So maybe given time the bottom teeth will catch up after we finish expansion on top.

ReplyQuote
Posted : 25/03/2018 11:14 pm
Greensmoothies
(@greensmoothies)
Estimable Member

Thanks for starting this topic, wondering what to do for myself. Is having a ~2mm midline deviation make me a good candidate for getting a lower palate expander as well when I do get an upper palate expander from bracesshop? I've been mewing 5 years, started with folded tongue. The deviated midline has been gradually coming on to my current situation. I've not always been diligent with chewing over the years or with supplementing. Also only started OMCing recently. My bite still feels ok and I had braces. I have some crowding in the front along the mandibular arch which I think could be helped with a lower palate expander as well but hoped to get some thoughts. 

ReplyQuote
Posted : 26/03/2018 12:53 am
Abdulrahman
(@abdulrahman)
Reputable Member

Just a general comment, chewing gum does not help in expanding the lower arch specifically, it mainly helps in uprighting the teeth. As far as I understand the teeth cusps, or their misalignment to be precise, forces the arches to change teeth position to meet each other where they should. This of course does not always work as in the case of a cross bite for example.

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

ReplyQuote
Posted : 26/03/2018 12:40 pm
Apollo
(@apollo)
Reputable Member
Posted by: abdul

Just a general comment, chewing gum does not help in expanding the lower arch specifically, it mainly helps in uprighting the teeth. As far as I understand the teeth cusps, or their misalignment to be precise, forces the arches to change teeth position to meet each other where they should. This of course does not always work as in the case of a cross bite for example.

As I understand it, chewing works by the process mentioned in the quote from Dr. Mew's website that you posted in the other thread about the FAGGA system:

This initial treatment creates a temporary malocclusion where the front teeth stick out and the upper jaw appears to be too wide. This will alarm uninformed dentists and orthodontists. It is however a normal part of this treatment and will be corrected during the second phase. The second phase of treatment aims to teach a patient correct jaw posture and improve facial muscle tone. Over time, with good compliance, this correct posture will become the patient’s default resting position. This correct positioning will in turn allow natural alignment of the teeth and affect the craniofacial structure.

So the expander is pushing and holding the upper teeth out of alignment. The lower teeth shift from the force of chewing to reestablish the homeostasis of occlusion. What I mentioned above is that (in addition to enough chewing) I suspect the upper teeth have to be far enough out of the old occlusion to prompt the lower teeth to shift. It's not clear to me how this would yield any skeletal expansion/bone remodeling. However, the alveolar ridge of my mandible started out wider than the alveolar ridge of my maxilla, so if I can get the lower molars to tip upright it might be enough to match my upper expansion.

ReplyQuote
Posted : 26/03/2018 4:48 pm
Apollo
(@apollo)
Reputable Member
Posted by: Greensmoothies

Thanks for starting this topic, wondering what to do for myself. Is having a ~2mm midline deviation make me a good candidate for getting a lower palate expander as well when I do get an upper palate expander from bracesshop? I've been mewing 5 years, started with folded tongue. The deviated midline has been gradually coming on to my current situation. I've not always been diligent with chewing over the years or with supplementing. Also only started OMCing recently. My bite still feels ok and I had braces. I have some crowding in the front along the mandibular arch which I think could be helped with a lower palate expander as well but hoped to get some thoughts. 

I still believe what I have read that a lower expander is unnecessary and potentially inadvisable because there is no mandibular suture to separate. However, I'm open to having my mind changed. I believe it would require advancing the screw much slower on the bottom than the top, and would probably cause more teeth tipping and dental movements rather than skeletal movements. In my case this could have been useful to rectify the inward tilt of my lower molars, but once they were upright, expanding any farther might increase the risk for root resorption or other side effects. CP claims that he had some bone remodeling from using a lower expander.

 

Here is the claimingpower article about expanding the mandible:

https://claimingpower.wordpress.com/2013/08/23/progress-report-on-palate-expansion-is-it-possible-to-expand-the-mandible/

ReplyQuote
Posted : 26/03/2018 5:03 pm
Greensmoothies
(@greensmoothies)
Estimable Member
Posted by: Apollo
Posted by: Greensmoothies

Thanks for starting this topic, wondering what to do for myself. Is having a ~2mm midline deviation make me a good candidate for getting a lower palate expander as well when I do get an upper palate expander from bracesshop? I've been mewing 5 years, started with folded tongue. The deviated midline has been gradually coming on to my current situation. I've not always been diligent with chewing over the years or with supplementing. Also only started OMCing recently. My bite still feels ok and I had braces. I have some crowding in the front along the mandibular arch which I think could be helped with a lower palate expander as well but hoped to get some thoughts. 

I still believe what I have read that a lower expander is unnecessary and potentially inadvisable because there is no mandibular suture to separate. However, I'm open to having my mind changed. I believe it would require advancing the screw much slower on the bottom than the top, and would probably cause more teeth tipping and dental movements rather than skeletal movements. In my case this could have been useful to rectify the inward tilt of my lower molars, but once they were upright, expanding any farther might increase the risk for root resorption or other side effects. CP claims that he had some bone remodeling from using a lower expander.

 

Here is the claimingpower article about expanding the mandible:

https://claimingpower.wordpress.com/2013/08/23/progress-report-on-palate-expansion-is-it-possible-to-expand-the-mandible/

Thanks for your post! I guess it's possible to get some bone remodelling this way. My concern is teeth tipping when using a lower palate expander as well. Wondering if use of a myobrace might help with this issue... CP wrote more about this here. Even if it might not help in this area, I found it difficult to keep up with doing all my Mewing-related activities when pregnant, so a myobrace could help me with preventing stagnation of progress, and there are some other effects I believe I could obtain from use of a myobrace that I can't seem to achieve otherwise (chiefly, getting Roman arch-shaped arches). I'm not totally sure, but I'm thinking of trying it out.

ReplyQuote
Posted : 26/03/2018 9:15 pm
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Allixa
(@allixa)
Estimable Member

@apollo, I originally edited my first post because I realized that the expansion of the lower teeth is probably not something that chewing alone can solve, but since you quoted it I don't mind going back to some of those ideas even if i'm not sure they'll help.

My occlusion still feels relatively normal, and I'm not too worried yet. I just thought I would put this out there as a topic that could be helpful for anyone using an expander. I wonder if @admin has observed his mandibular arch expanding along with his maxillary arch. I've mentioned before how the intermolar width of my lower arch is wider than my upper arch except that the bottom molars are tipped inward so that the cusps of the top teeth sit outside the cusps of the bottom teeth without any crossbite. As I have expanded the upper arch, I expected the bottom molars and bicuspids to start tilting upright more than they have. This in turn might make space for the canines to shift laterally and then the incisors to space out. I suspect as I get farther along with expanding the upper arch the force of occlusion with all of my chewing exercises will begin to have that effect. I probably just haven't expanded far enough to throw off the occlusion and provoke the changes. At least that's my theory. My mandibular teeth haven't had any significant tooth-movement pain, but my maxillary teeth haven't had much either. Sometimes I feel it when I first start my chewing exercises, or begin to eat a meal, but once I've been chewing for a couple minutes it subsides.

The upper teeth shouldn't get the movement soreness as much as the lowers since most of the movement happens at the suture. I've read others reporting the same thing a few times. You're right, you might just need to expand more to see changes of the bottom teeth, and also the new rotary chewing technique you are doing may need more time to kick in as well.

The way rotary chewing puts forces onto the bottom teeth may help expansion of the jaw as well.. but I don't know if that will translate to wider canines... that's on a completely different area of the jawbone. Not sure how to widen that area..

I'm on my third box of that same brand of mastic you mentioned last week (  https://the-great-work.org/community/main-forum/where-to-order-mike-mew-chewies-for-jaw-chewing-training/#post-1372 ). I've always found it to be very suitable for my purposes.

Yeah that's definitely a very tough gum.. if anything would get teeth moving it would be that one.

 

I've been practicing mouth taping for the past few weeks. Before then I suspect that my mouth was sometimes opening during sleep. Since then, it's still possible that the teeth might separate, but I feel like there is a better tendency to keep the teeth together when I can't breath through my mouth. That being said, the wires between my teeth from the expander don't allow the teeth to totally occlude even when they are touching. 

I noticed that about the wires as well. I actually had to cut off the labial bow on mine right away due to the way my occlusion works, but all of the chewing you do should keep nighttime separation from being an issue.

 

I mentioned some of these details in my nutrition thread. I eat a lot of vegetables, meats, fruits, healthy fats, prebiotics, and fermented foods, while minimizing grains, added sugars, artificial sweeteners, and processed foods. I often allow some grains for one of my two meals per day, especially recently because my work schedule has forced me to eat at restaurants more frequently. I mentioned my rational for supplements in this thread (  https://the-great-work.org/community/main-forum/de-ossify-skull-sutures-or-unfuse-the-skull/#post-748 ) about bone mineral balance. I'm taking a multivitamin, magnesium, D3, K2, and fish oil. I'm only using dietary sources and the multivitamin for my vitamin A (which encourages osteoclastic activity to balance the osteoblastic activity of the D3), but also has the potential for side effects from excess. I have debated cutting out the multivitamin and D3 and replacing them with dietary sources and a high-vitamin fermented cod liver oil but it is expensive. I think my dietary calcium intake is adequate because I consume a fair amount of fermented dairy. If I remember correctly, the link you provided in my nutrition thread to the perfect health diet had recommendations for supplements, so I should go back and read through those again.

 It actually sounds like you are hitting all the bases. Your diet and supplements both sound great. Just make sure to keep your calories as high as you can so that your body has energy to make the bone changes. I'd say maybe 70% of the battle is metabolism and the other 30% is nutrients and supplements... probably.

I have my old clear aligner bottom retainer from after my braces came off in high school. It covers everything between the bottom two first bicuspids, but not the second bicuspids or molars. It wouldn't be a good idea to try and force my teeth into it now because one of the central incisors is especially crowded back out of alignment. If I begin to get some expansion on the bottom and that incisor gets closer to realigning, I could try using that retainer for a while to speed up the process.

Interesting idea.. if you can get it to fit at some point it might definitely help.

ReplyQuote
Posted : 27/03/2018 1:33 am
Apollo liked
Allixa
(@allixa)
Estimable Member
Posted by: Apollo
Posted by: Allixa

@progress

That's a good point. With that in mind I can't think of a real way to get lateral forces onto the bottom canines. It doesn't even look like something that the tongue could pull off. Check the picture I'm posting below.

@apollo

Do you remember the expansion study we looked at earlier? It seems to show the exact thing you are talking about (left canine in the picture from our pov):

The expander they used for this case didn't even touch the canines, just the premolars and molars.

Based on what progress said I'm not sure that all the chewing in the world could resolve something like this. It looks like the entire front portion of the lower jaw needs to become more lateral in order for the canine cusps to line back up. Do you guys think it's possible to achieve this with anything OTHER than an expander? It looks tough.

I'm pretty sure that just like progress said, the whole growth hormone connection that other posters have talked about would only help for the back teeth because of how they interlock.

This is similar to what I am seeing in my mouth, except mine is maybe slightly more obvious. A little gap of black space is visible between the mesial slope of my upper canines and the distal slope of my lower canines, and the tips of my lower canines line up about a millimeter from the distal edge of my upper lateral incisors. Maybe there is just a lag period since the lower jaw doesn't have the suture to allow for expansion, so it takes longer for the bottom teeth. I remember CP writing that he had to turn the screw on his bottom expander slower than the screw on his top expander. So maybe given time the bottom teeth will catch up after we finish expansion on top.

I expect the bottom teeth to do tilting and tipping and maybe some jaw expansion but I just can't see how the canine area would widen. The study we looked at earlier has pictures from 10 years after the expansion was done just as a follow up and he still has the same relationship where the canines don't really touch anymore. The only way I can think to expand the actual canine area is to focus on doing a lot of rotary chewing right on the premolar near the canine... the rotary chewing should place expansive forces on the lower jaw..

 

Here's CP's before and after. Wider jaw but canine area is the same:

ReplyQuote
Posted : 27/03/2018 1:35 am
Apollo liked
Abdulrahman
(@abdulrahman)
Reputable Member
Posted by: Apollo

 

As I understand it, chewing works by the process mentioned in the quote from Dr. Mew's website that you posted in the other thread about the FAGGA system:

This initial treatment creates a temporary malocclusion where the front teeth stick out and the upper jaw appears to be too wide. This will alarm uninformed dentists and orthodontists. It is however a normal part of this treatment and will be corrected during the second phase. The second phase of treatment aims to teach a patient correct jaw posture and improve facial muscle tone. Over time, with good compliance, this correct posture will become the patient’s default resting position. This correct positioning will in turn allow natural alignment of the teeth and affect the craniofacial structure.

So the expander is pushing and holding the upper teeth out of alignment. The lower teeth shift from the force of chewing to reestablish the homeostasis of occlusion. What I mentioned above is that (in addition to enough chewing) I suspect the upper teeth have to be far enough out of the old occlusion to prompt the lower teeth to shift. It's not clear to me how this would yield any skeletal expansion/bone remodeling. However, the alveolar ridge of my mandible started out wider than the alveolar ridge of my maxilla, so if I can get the lower molars to tip upright it might be enough to match my upper expansion.

Chewing strengthens the mastication muscles and keeps the lower jaw closed against the upper. This in turn forces both arches to try to establish proper contact between the upper and lower cusps. Since the upper arch is supported with an appliance the lower jaw has to compensate for most of the movement. In young children, this is possible because they are still growing. That's why Dr. Mew always advices parents to start treating their children around 5-6 years old before growth stops at around 12 years old. In adults expansion is limited. Short of mild dental movement, there is only remolding to compensate and it happens very slowly.

I would summarize this as:

  • appliance expands and holds upper arch
  • chewing strengthens mastication muscles
  • closing mouth forces teeth to proper occlusion

 

There are of course other steps in the whole process.

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

ReplyQuote
Posted : 27/03/2018 3:06 am
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Apollo
(@apollo)
Reputable Member

I really appreciate everyone's contributions! 

Posted by: Greensmoothies

Thanks for your post! I guess it's possible to get some bone remodelling this way. My concern is teeth tipping when using a lower palate expander as well. Wondering if use of a myobrace might help with this issue... CP wrote more about this here. Even if it might not help in this area, I found it difficult to keep up with doing all my Mewing-related activities when pregnant, so a myobrace could help me with preventing stagnation of progress, and there are some other effects I believe I could obtain from use of a myobrace that I can't seem to achieve otherwise (chiefly, getting Roman arch-shaped arches). I'm not totally sure, but I'm thinking of trying it out.

I'm intrigued by the idea of using a myobrace after I finish expanding my upper arch to help the lower arch catch up and make both arches more curved and symmetrical. I still don't totally understand how they work, if it is doing anything more than correcting my oral posture, but I think it is worth exploring. I think I would still want to wear my expander as a retainer for several months after I finish expanding to cement my progress before moving on to the myobrace. We discussed this topic in another thread (  https://the-great-work.org/community/main-forum/where-can-i-get-a-myobrace/ ). If I decided to take this route, I would probably want the A2.

Improved arch development and dental alignment for adults.

The adult appliances come in a series (A1, A2, and A3) of increasingly hard material. The A1 is supposed to be for people with significant crowding. I only have minor crowding on my lower incisors so I could probably start with the medium firmness. The adult appliances come in a regular or large size. I can't find anywhere that lists a sizing guide, but I suspect (especially after I finish my upper expansion) that the large size would be better for me.

Posted by: Greensmoothies

going to start on the largest size as this was recommended to me elsewhere.

@allixa already owns a myobrace and gave it a negative review, suggesting that they only work by training the tongue and face muscles, and could cause problems because they sit between the teeth. I'm curious to hear his opinion about using them to help the mandible catch up with the expansion of the maxilla and achieve more symmetrically curved arches. 

Posted by: Allixa
I own a Myobrace and a Myomunchee.

Honestly, they aren't even that good and they don't do anything that you can't do on your own. They are just muscle trainers. They don't actually 'do' anything. What's worse is that because they go between your teeth, they lead to face lengthening and jaw joint issues.

I wouldn't recommend spending your money on them, but if you really wanna experiment then go ahead and give it a shot.

The best way to expand the palate is with your tongue alone or with an acrylic expander if you need major expansion or if your tongue doesn't fit. The guy who made this thread said that he wants help to keep his tongue up at night, and that MIGHT be something the myobrace can help with, but I think it would be even better to do some myofunctional therapy to solve that issue.

@allixa posted a comparison of Claimingpower's mandible casts before and after expansion.

 Posted by: Allixa

 Here's CP's before and after. Wider jaw but canine area is the same:

 This is curious since the screw for his mandibular expander sits just behind his incisors it seems like it would cause disproportionately more expansion in the anterior section. With his forward expansion to fit in the implants, his "after" result is almost more of a "gothic" shaped arch than his "before."

Here is what Claimingpower wrote about mandibular expansion in the article @greensmoothies linked to (  http://claimingpower.com/mandible-expansion-k1-of-myobrace-bone-remodeling-nutrition/ ):

This girl used the Myobrace K1 Appliance only which is a mouth piece that has a tag to serve as reminder for getting the tip of tongue on the “spot” or incisive papilla. It is empirical evidence that bone remodeling occurs in the lower jaw, and dental arches can expand by getting the tongue on the roof of the mouth...

It is interesting to note that the lower jaw expanding in conjunction with the upper.

Doctors find that there is often spontaneous lower arch expansion when you expand the upper. “The lower arch will take care of itself” was a remark made by one of the first orthodontists to begin using RPE on patients back in (early 60’s?) … long time ago.

It could be due to the fact that as the upper arch expands slowly, the teeth distribute the expanding forces onto the lower teeth as well when the mouth is closed.

and/or as the upper arch expands various other soft tissues are getting expanded/wider as well, which is putting light expanding forces on the lower.

Or combination of above/and some other factors.

This is similar to what @abdul-2 summarized above:

Posted by: abdul

appliance expands and holds upper arch
chewing strengthens mastication muscles
closing mouth forces teeth to proper occlusion

So there still seems to be a lack of consensus about how much the mandible can/will really catch up to the maxilla on its own or if an appliance like an expander or myobrace might help facilitate mandibular expansion. Conventional wisdom seems to be that only dental and not skeletal expansion is possible on the mandible, even in children (  http://www.scielo.br/scielo.php?pid=S2176-94512011000300004&script=sci_arttext&tlng=en ).

In general, the easiest way for a clinician to alter the growth of the face is in the transverse dimension, orthopedically in the maxilla, orthodontically in the mandible. Rapid maxillary expansion has been shown to be an extremely efficient and effective way of widening the maxillary bony base. In the lower arch, however, there is no mid-mandibular suture—so it is virtually impossible to produce orthopedic change in the mandible other than in combination with surgical distraction osteogenesis at the midline. The changes in the lower arch essentially are dentoalveolar in nature, such as those resulting from the use of a removable lower Schwarz appliance.

Even the most optimistic assessments suggest very modest skeletal remodeling is the most we could hope for with the mandible. I will be sure to update about my experience as I progress with my upper expansion. I found an interesting article last night that mentions this topic (  https://www.smlglobal.com/sites/default/files/PBB20.pdf ). 

It is often the patient’s mandibular intercanine width that is the limiting factor to treatment, as it only increases slightly throughout growth. In fact, most of the mandibular correction in arch width that is seen during treatment is the uprighting of lingually tipped teeth back over the basal bone.

This is not to say that an increase in mandibular arch width cannot be accomplished. It can. Small amounts of widening of the basal bony width of the mandible can occur by orthodontic stimulation of bony deposition on the lateral borders of the corpus mandibularis.

This is basically what we figured out here as a community from our own anecdotal evidence without the benefit of clinical research! In support of this assertion, the article references Handbook of Orthodontics by R.E. Moyers, 1980 Chapter 7 pages 192-207. I haven't had time to research this further. The article is also of interest because it recommends a formula (albeit rooted in conventional orthodontics) to calculate the patient's ideal target width for expansion based on the sum of the widths of the four incisors. It also factors in if you have a long, narrow face or a short, wide face into the calculation (not acknowledging how expanding the palate could change the shape of the face). It gives a goal intermolar width but uses a convention between the pits of the teeth rather than the lingual edges, so I need to do some measuring and calculations before I can determine what it recommends for my ideal arch. I'll probably write more about that in the thread logging my routine.

ReplyQuote
Posted : 27/03/2018 5:46 pm
Allixa
(@allixa)
Estimable Member

Alright so for the myobrace.. Here is what I can say for sure. My lower jaw is more expanded than my upper jaw due to a low tongue posture before I found Mew. I bought the myobrace thinking that it could fix this issue.. this was before I knew that expansion worked on adults. What I noticed was that the myobrace puts all of its force directly onto the teeth and nothing into the actual skull bones. After wearing the myobrace for a few hours my teeth all became very very sore, and it hurt to chew as if I were wearing braces. So my guess is that any movement a myobrace could produce would be completely due to teeth tipping. And it's a pain to keep in as well.

Myobrace works for children by training them to keep their tongue up which leads to maxillary expansion. You can experiment with it though and see what you can make happen.

--

Now as for CP's before and after photos, I wonder if his canines would be more expanded if they didn't get pushed forward to make room for the implants? Something to think about.

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Posted : 28/03/2018 2:09 am
Apollo liked
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As you undergo correction in the near future, please consider keeping records for your own sake and for others. Pictures of dental impressions, scans, medical reports reports can be very helpful even with all personally identifying information blocked out.

Your input could help many, many people

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