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MSE Relapse without fowards expansion?

SB4
 SB4
New Member

I have downswung face, deepbite (underbite) and small pallet. If I change my bite so that the lower and upper incisors are touching edge to edge (normal bite) and then put my tongue in the correct position, which would be tongue tip resting just above front teeth, then palate width is only a slight/moderate issue. The real issue is the back third of my tongue is still stuck in my throat and if I raise it, it blocks off my air way.

So I am thinking, if I did MSE and expanded the width of my palette, my tongue back third would still be in the back of the throat and since the tip of the tongue is more narrow then it would no longer be touching the sides of my teeth. This I would imagine would cause the width to relapse over time.

The only thing that might give a benefit in this direction is a diastema forming on the top 2 incisors which would allow them to push forwards, as they are currently tipped inwards due to crowding. This would allow my lower jaw to come forwards more but then this would misalign my lower teeth and upper teeth further as they are used to a deep bite occlusion.

Any ideas? Is this what's happening in MSE patients who relapse?

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Topic starter Posted : 26/06/2021 8:27 am
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Apollo
Reputable Member

Because MSE involves skeletal expansion at the midpalatal suture, relapse would occur if new bone hasn't filled the gap at the suture after the retention period. I don't think you are so reliant on tongue pressure to hold the alveolar ridge out when the expansion wasn't achieved through dentoalveolar mechanisms like traditional expanders. Of course you could still have narrowing of the arch like anyone else if good tongue posture and/or retainer use isn't maintained, but it wouldn't be "relapse" per se, and I suspect it wouldn't happen as rapidly as relapse of dentoalveolar expansion. The MSE alone typically gives a very slight forward advancement of the maxilla and this could be modestly augmented with reverse pull headgear. I started with class III tendencies and it now feels like my lower jaw isn't so trapped behind my upper teeth. 

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Posted : 26/06/2021 12:13 pm
SB4 liked
SB4
 SB4
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Posted by: @apollo

I started with class III tendencies and it now feels like my lower jaw isn't so trapped behind my upper teeth. 

Thanks for the reply Apollo. I am a little confused by this statement though, class 3 would mean your lower jaw is protruding beyond your upper jaw, an underbite. So why would it feel like your lower jaw is trapped behind your upper teeth. I thought that would be the case with a class 2 / overbite.

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Topic starter Posted : 26/06/2021 12:34 pm
Apollo
Reputable Member
Posted by: @sb4
Posted by: @apollo

I started with class III tendencies and it now feels like my lower jaw isn't so trapped behind my upper teeth. 

Thanks for the reply Apollo. I am a little confused by this statement though, class 3 would mean your lower jaw is protruding beyond your upper jaw, an underbite. So why would it feel like your lower jaw is trapped behind your upper teeth. I thought that would be the case with a class 2 / overbite.

I meant that my lower jaw felt constrained if I held it behind my upper teeth. Even then, I was able to posture my lower incisors behind my upper incisors, but it felt like I was jamming my lower jaw backward to get into that position. An end-on-end bite, or even a slight underbite was more comfortable. Since My MSE+FM treatment, it feels more comfortable positioning my lower incisors behind my upper incisors, but I still think an end-on-end bite is around where my mandible wants to be when I hold good neck posture. I continue to use my reverse pull headgear hoping to advance the maxilla another millimeter or two. I haven't had a current lateral ceph to see if my A point has moved ahead of my B point.

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Posted : 26/06/2021 1:08 pm
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SB4
 SB4
New Member
Posted by: @apollo
Posted by: @sb4
Posted by: @apollo

I started with class III tendencies and it now feels like my lower jaw isn't so trapped behind my upper teeth. 

Thanks for the reply Apollo. I am a little confused by this statement though, class 3 would mean your lower jaw is protruding beyond your upper jaw, an underbite. So why would it feel like your lower jaw is trapped behind your upper teeth. I thought that would be the case with a class 2 / overbite.

I meant that my lower jaw felt constrained if I held it behind my upper teeth.

Ahh I see. Thanks.

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Topic starter Posted : 26/06/2021 1:41 pm