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My Routine  

(@apollo)
Eminent Member

In the new year, I've decided to get serious about this. I plan to keep a record of my methods and results on this thread and would appreciate anyone's feedback. For the sake of anonymity, I will remain relatively vague about identifying characteristics. I am in my mid-thirties. I always allowed my tongue to rest on the bottom of my mouth, and I've had issues with allergies that might have contributed to occasional mouth breathing. I had traditional orthodontics and wisdom teeth extractions as a teen. After my braces were removed, my teeth were straight, but I remember having insecurities about my canted smile even then. I've had some crowding post-braces, especially my lower incisors, and my lower molars seem to be tipping inward slightly. My upper central incisors are just slightly overlapped. In recent years, my occlusal cant and midline deviation seemed to get worse, and this asymmetry inspired my research into craniofacial dystrophy. I realized that my palate is relatively narrow and vaulted and it was initially difficult to keep my tongue seated on the roof of my mouth. The bridge of my nose veers left of my midline, while the tip is pulled right of center with my dental midline. My nostrils are also different sizes.

I've been making concerted efforts to improve my oral posture and swallowing habits for over a year. During that time, I did a couple rounds of self-ncr/nasal release, every day for a week or more. I regularly chew gum with some tongue smashing motions mixed in. I've also tried to be more cognizant of my body posture and sleeping position, but not reliably. I believe I have seen some improvement. I think my dental midline was initially about 4mm right of my interpupillary midline. This seems to be down to about 2mm off. I also think my occlusal cant might be improved by a degree or two, but is still pretty obvious. The bridge of my nose remains notably skewed to the left. It has gotten easier to keep my tongue on the roof of my mouth, but I'm not engaging the posterior 1/3 as much as I would like, and I don’t trust that I am consistent while sleeping. Increasing my tongue space would help catalyze the other changes I want. I have begun putting together an extra-oral anchorage appliance. I plan to wear a palate expander as consistently as possible, but probably not in public. I will connect the expander to a rig that will pull up and forward at night and while relaxing alone. I still have a few pieces left to assemble, but hope to begin this process in the next month or so. I also want to begin some exercises to improve my forward neck posture and anterior pelvic tilt. Please let me know if you have any suggestions!

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Posted : 06/01/2018 3:57 pm Gregory liked
(@gjenopp)
Active Member

I appreciate your perspective; I appreciate your sharing.
There's plenty of this that is similar to my own situation. Plentyyy.
Even some of the things you mention...? The way I'm relating to you? The, the... canted smile you mention, for instance. I relate to that, and more.

Over the years, I would see a canted smile in the mirror and thought, "hm thats odd. I dont like that.  I dont like that at all! But I guess that's just a genetic flaw of mine! Guess I gotta just...accept it! Oh Well!"

And there's something about your sharing which makes me do a sort of exhale and say' wow...' you know, 'not alone' not alone.

No, I absolutely resonate with your experience, your perspective, and your newfound dedication to REALLY working on your routine.
I appreciat that; I appreciate your sharing.  (To repeat myself)

FHP and Anterior Pelvic Tilt. Kyphosis and Lordosis being under that umbrella. Main thing to do there is your stretches man.  Take it seriously.  Foam rolling.  Myofascial release. Get a massage therapist if you have to.  Get the tonic muscles to relax.  And get the phasic muscles to tighten up.  I'm still figuring this out myself, yet that is a framework to operate out of. 

Wish you the best with this all in the meantime. 

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Posted : 06/01/2018 4:44 pm Apollo liked
(@apollo)
Eminent Member

While I would like to achieve more prominent cheekbones, and cheek hollows, improving my facial symmetry is most important to me. My occlusal cant, deviated dental midline, and crooked nose were the main features that inspired my search for nonsurgical techniques to improve the structure of my face. I just took more precise baseline measurements of the deviation in my nose and my teeth to be able to track changes. My interpupillary midline aligns almost exactly with the crease between my eyebrows when I furrow my forehead. I took a piece of dental floss and tried to extrapolate that line vertically down the middle of my face. The middle of the bridge of my nose looks to be about 4mm left of that line, while my dental midline looks to be about 2mm right of that line. The overall discrepancy of 6mm between the center of my nose and the center of my teeth is most obvious. My occlusal plain is also canted about 3 degrees higher on my left side. I mentioned in my last post, that I think these figures show improvement from what I remember before I changed my oral posture. I believe my dental midline used to be about 4mm off center (an improvement of 2mm), and my cant used to be about 4 degrees (an improvement of 1 degree). I didn't measure the deviation of my nose previously, but I think it looks to be about the same.

Thanks for commiserating with me Gregory! It is reassuring to know there are others out there with similar problems who are also trying to find solutions!

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Posted : 07/01/2018 6:53 pm
(@apollo)
Eminent Member

 

The design for my extra-oral anchorage system is a hybrid of Plato's basic face pulling helmet ( http://jawpain-tmjtreatment.com/  ) and the MewVector ( https://www.youtube.com/watch?v=7dj1BGVsAhA ). Dr. Mew's more recent versions are stabilized by a neck brace rather than a head piece. I bought a neck brace and tried to make it work, but found there to be too much play between the fixation points and head motions, so I went back to a head-mounted strategy. My rig does incorporate 5 points of attachment like the Mew design (up in the front center, up in the back left, up in the back right, forward in the front left, and forward in the front right). Together, the resultant vector should distribute a protractive force across the maxilla better than Plato's standard face pulling setup with only two anterior vectors pulling up and forward. I just finished reinforcing the structure for the posterior anchorage points. I'm pleased with how it looks so far.

Planning my device around these two models brings up a few questions. To my understanding, Dr. Mew's philosophy suggests that I should maintain traction as consistently as possible, potentially throughout every night, and a few hours every day. Plato says I need only 30 minutes per day. Dr. Mew calibrates each of his elastics to about 200g of force. Plato is vague about how much force to use, but recommends starting with light tension and only increasing when you no longer see results. Dr. Mew uses orthodontic elastics connected to a facebow. Plato uses standard office supply rubber bands connected to paper clips.

So how do I reconcile these inconsistencies? I already have a facebow that I will interface with a palate expander. I plan to use orthodontic elastics stretched about 3x their small diameter rather than big rubber bands stretched to an anchorage on the top of my head, but I wasn't sure what size and strength elastics to order. I couldn't find any of the strength traditionally used for extra-oral applications, so I bought the strongest intra-oral elastics I could find. I also need to use these to hold the facebow and expander together. I'm unsure about what intensity and duration to use. I think I will start at a lower tension and less time than Dr. Mew recommends and then work my way up. Maybe about 100g on all 5 elastics for a couple hours every day/night to begin with, see how it feels, and increase from there. I intend to keep the palate expander in place for as many hours as possible (even when not connected to the extra-oral anchorage, potentially 12+ hours per day) and expand at a rate of 1mm per week as Dr. Mew recommends. Please let me know if you have any suggestions!

Edited: 2 weeks  ago
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Posted : 08/01/2018 10:50 pm
(@gjenopp)
Active Member

Re-reading your two posts. 

Yup there’s similarities in our cases and mindset. To the point that, I’m - - - mmm, awed — no, motivated — by your progressing plan in building your own device. 

Shortly after I thought, “(facebow?)” and looked at prices and acquiring. I was curious! Couldn’t help it  

I don’t have answers on the numbers, nor design side of things. 

However, did wish to offer that my last dentist visit had the man telling me that orthodontics needed to be engaging the mouth >=22 hours a day for results. I hope I heard him wrong. Related: I liked that dentist — he was the first traditional dentist that was an advocate for tongue being on the roof of the mouth, yet didn’t seem familiar with orthotropics.

your device/expander likely will be more effective but I had that to offer. 

From an uneducated perspective, I agree on your decision to take it slowly with the force that these elastics will exude. 

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Posted : 09/01/2018 10:25 pm Apollo liked
(@apollo)
Eminent Member

Thanks Gregory! When I say "facebow," I mean the the kind of wire attachment that interfaces with the headgear tubes on an expander, like the one Dr. Mew uses in the video I linked to. Google results for "facebow" might show a more substantial device used by prosthodontists to line up their prosthetics. It does seem hard to believe that facepulling for only 30 minutes per day could induce change as Plato claims. Maybe proper tongue posture between sessions helps prevent relapse?

I have installed a kind of metal tie plate with a grid of holes to provide options for where to anchor the posterior elastics. Now I am debating using a dremel tool to cut a channel connecting three of the holes so that a screw with a lock nut and a regular nut could be slid up and down that channel and tightened in place to precisely calibrate the desired tension.

 

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Posted : 10/01/2018 3:05 pm
(@apollo)
Eminent Member

I felt like trying a self-ncr/nasal release session last night. It has been several months since the last round when I treated myself every day for about a week. During my previous round, I struggled during the first couple sessions to inflate past the turbinates, but I didn't have that issue this time. I was able to successfully advance into the nasopharynx through all six meatuses. I try to use the thumb squeezing strategy to suppress my gag reflex, but it wasn't as effective as I remember, and I didn't really get any sensations of shifting or release that I have sometimes achieved in the past. I did feel some pressure in my right eustachian tube while inflating through the left middle meatus, but that was about the extent of what I could feel. I might try again today or sometime soon to see if I can get better expansion.

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Posted : 11/01/2018 3:20 pm
(@apollo)
Eminent Member

I cut the channels into the two metal tie plates on my protractive headgear so that the bolts I plan to use as my posterior anchorage points can be slid up and down freely to a desired position and then tightened down with nuts. I connected three holes in the tie plates creating a channel about 3cm long. I plan to tighten down the bolt at a position above and slightly forward from the hooks on the ends of my facebow, then measure the tension generated from an elastic stretched between those two points. If I want more or less tension, I will loosen the bolt, slide it up or down, tighten it, and then measure again. I wish that I had thought to do this before securing the tie plates in place because it was a little challenging to get the dremel tool into position to cut the plates, but I made it work, and smoothed off the edges with a file. I'll stop at the hardware store this evening to purchase the nuts and bolts I need.

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Posted : 13/01/2018 3:33 pm
(@apollo)
Eminent Member

While I wait for the final pieces of my DIY device to arrive, I want to ask a question about palate expansion. Is there any way to avoid or minimize opening a gap between the central incisors? I am worried that this would be the most obvious telltale to family and friends that I am doing something with my mouth, which I would rather keep private. The accounts of using a palate expander I have read here and in the breakthematrix forum differ on this point. Some say that their front teeth separated about the same amount as they expanded the appliance while others say that they had minimal separation between their front teeth but much less than the total expansion of the appliance. How might we control this outcome or correct it after the fact? My upper central incisors are just slightly overlapped, so it would be good to space them out about a mm, but I'd like to avoid much more than that if possible.

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Posted : 21/01/2018 10:15 pm
TGW
 TGW
(@admin)
TGW Admin Admin

Speed of expansion is what is going to determine that gap. In every literature I have read, with a healthy amount of expansion this gap always closes within a few months. The gums end up pushing the teeth together, and if you have your wisdom teeth they will move forward and advance all of your teeth thus closing the gap.

So if you go very slowly the gap may never develop, the teeth re-aligning throughout the process. You can stop expansion when you notice a gap and wait for it to close. The gap is noted most in rapid and semi rapid expansion (upwards of 1mm per week). 

I've read through the rest of your topic, I want to discuss it in length but forgive that I can only post from my phone right now and it's a pain typing out long replies. 

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Posted : 22/01/2018 7:29 am
(@apollo)
Eminent Member
Posted by: TGW

Speed of expansion is what is going to determine that gap. In every literature I have read, with a healthy amount of expansion this gap always closes within a few months. The gums end up pushing the teeth together, and if you have your wisdom teeth they will move forward and advance all of your teeth thus closing the gap.

So if you go very slowly the gap may never develop, the teeth re-aligning throughout the process. You can stop expansion when you notice a gap and wait for it to close. The gap is noted most in rapid and semi rapid expansion (upwards of 1mm per week). 

I've read through the rest of your topic, I want to discuss it in length but forgive that I can only post from my phone right now and it's a pain typing out long replies. 

Thanks TGW! So I want to go slow enough to minimize the gap between my central incisors but not so slow as to cause tipping of my molars rather than separation of the midpalatal stuture. I guess I will plan to follow the 1mm per week that Dr. Mew recommends, and then take a break as you suggest if the gap between my front teeth becomes noticeable. When you have time, I would definitely appreciate any thoughts about reconciling the differences between the approaches Dr. Mew and Plato take for their protractive headgear systems that I discussed in an earlier post in terms of short vs. long duration per day and fixed tension vs gradually increasing tension over the course of treatment.

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Posted : 22/01/2018 4:06 pm

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For research and dissemination I will be collecting in this community the adult expansion, cranial adjustment, NCR, and face-pulling results. I implore our community users to keep accurate records for themselves and others; these can include dental/palate impressions, before/after pictures, X-Rays and 3D scans.

The purpose of this collection is for use as evidence for theories proposed here. This collection will only be re-posted on this community and will not be submitted anywhere else.

For those looking into expansion and movement in the near future, please consider keeping records for your own sake and for others. Pictures of dental impressions alone can be very helpful.

If you have successfully completed any expansion/movement of facial bones and have any of the above records, please submit them to the community with your personal story of what you did and what the results were (use multiple posts if necessary). Palate expansion, Maxilla movement up and forward, development of the orbital rims, zygomatic, and mandible / jawline are of specific interest. Please ensure that pictures are taken with the same angle, distance, and lighting: This will allow the community to see sharper jawline, higher cheekbones, decrease in dark circles under eyes, changes in nose shape, a more oval face, and improved symmetry.

If you wish to share anonymously, please send me a personal message and we will arrange an anonymous transfer. If you do not have any records to share,  your personal experience is also very valuable. Please tell us what you have done and what the results were.

Your input could help many, many people