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Possibly new "holy grail" for moving the maxilla up and forwards? [MSE + Facemask Therapy]  

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varbrah
Estimable Member
Posted by: @apollo

It's unclear to me why traction parallel to the occlusal plane (0 degrees) isn't an option to consider. Does pulling down and forward (e.g. -30 degrees) give more forward displacement than just forward? Maybe it helps create separation so there's less resistance from the circummaxillary sutures. Personally, I have a low lip line with reduced incisal display, so I'd gladly accept a shift downward one millimeter to get a shift forward of a few millimeters. Pulling upward and forward (e.g. +30 degrees) like @ronaldead demonstrates in his video about MSE+FM looks like it would be uncomfortable where the elastics press into the upper lip. I wonder if Dr. Newaz recommended an upward angle for FM traction or if this was Ronald's own decision, maybe based on the MewVector or Plato helmet designs.

This is just my opinion, but what often needs to be done is stimulating maxillary sutural growth. The four "main" sutures of the maxilla are the frontomaxillary, zygomaticotemporal, zygomaticomaxillary and pterygopalatine sutures, which are all more or less parallel to one another, and are angled from downward posteriorly to upward anteriorly (see below for a rough sketch). Growth at these sutures would translate the maxilla down and forward.

Pushing "against the grain" or up and forwards is probably counter-productive in regards to producing sutural growth, but may be helpful for remodeling existing bone. In adult cases (like my own) I'd imagine it's more important for us to stimulate sutural growth via pulling forward and down (-15 to -30 degrees) since growth largely ceases here by about age 10.

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Posted : 03/11/2019 6:45 pm
Apollo liked
Apollo
Reputable Member
Posted by: @varbrah

Pushing "against the grain" or up and forwards is probably counter-productive in regards to producing sutural growth, but may be helpful for remodeling existing bone. In adult cases (like my own) I'd imagine it's more important for us to stimulate sutural growth via pulling forward and down (-15 to -30 degrees) since growth largely ceases here by about age 10.

This makes sense to me! I asked @ronaldead on his blog if Dr. Newaz recommended FM traction angled upward from the occlusal plane, but he hasn't responded.

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Posted : 03/11/2019 8:48 pm
MadMaxilla
New Member

doesnt your reasoning contradict the whole point of mewing? i will get my mse and face mask next week and i will do 30 degree upward direction. pay close attention to cephalometric assessment, you can use webceph to see if your downward angle is doing you any clockwise or anticlockwise movement of maxilla.  dont jump into conclusion too soon based on uncertainty of information, especially if it contradicts well known sources from dr mew and dr.zubad as well as mewing. just saying, in the end only you are left with your face and result.

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Posted : 09/11/2019 12:48 pm
Apollo
Reputable Member
Posted by: @madmaxilla

doesnt your reasoning contradict the whole point of mewing? i will get my mse and face mask next week and i will do 30 degree upward direction. pay close attention to cephalometric assessment, you can use webceph to see if your downward angle is doing you any clockwise or anticlockwise movement of maxilla.  dont jump into conclusion too soon based on uncertainty of information, especially if it contradicts well known sources from dr mew and dr.zubad as well as mewing. just saying, in the end only you are left with your face and result.

I think you're correct that the best angle probably depends on the individual case. Since I have a low lip line covering much of my upper incisors, a downward angle might be more appropriate for me than someone with a gummy smile. Please keep us posted about your treatment and what your MSE provider recommends!

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Posted : 09/11/2019 1:25 pm
MadMaxilla
New Member

@apollo

when your maxilla move forward your lip will cover less of your gum, the most attractive smile is the smile that shows the most teeth, requires your maxilla to be parallel to the ground, your molar will disappear when you have downward smile, then you only wish you don't have downward maxilla. if you really really want to know which facemask angle is the best then email biomaterial korea or purchase this article from Dr.Won Moon fixed many class 3 with mse+facemask https://www.sciencedirect.com/science/article/abs/pii/S1073874618300094

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Posted : 09/11/2019 7:45 pm
Apollo
Reputable Member
Posted by: @madmaxilla

@apollo

when your maxilla move forward your lip will cover less of your gum, the most attractive smile is the smile that shows the most teeth, requires your maxilla to parallel to the ground, your molar will disappear when you have downward smile, then you only wish you don't have downward maxilla.

I understand that forward displacement will increase incisor display:

Posted by: @apollo

Posted by: Apollo

moving the maxilla forward fills out that soft tissue in the horizontal direction so that there is less of it to drape down in the vertical direction. 

 So if I am able to shift my maxilla forward, it should display more of my incisors when I smile.

I just suspect that I might be able to achieve more forward displacement by including a downward component so that none of the traction goes toward holding the sutures together. I think a result like simulation G might be better for my case than counterclockwise rotation like simulation F in the paper Varbrah linked:

I already have a copy of the paper you linked. It doesn't seem to mention what traction angle was used, but figure 4 in that paper is the same image as simulation G above, which makes me think they are using traction at -30 degrees from the occlusal plane.

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Posted : 09/11/2019 8:20 pm
MadMaxilla
New Member

This study the skull already have occlusal plane parallel to the ground which is the ideal occlusal plane angle, now try a maxilla that is downward like most of us, you will see counterclockwise rotation is needed. Can you please share the full version of the study?

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Posted : 09/11/2019 9:14 pm
entelechy
Trusted Member

@noctilucentnikki

Can I please ask how the MSE has gone?   I am about to do MSE and then SFOT.  Thanks much!

entelechy

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Posted : 10/11/2019 3:33 am
BurlapMantra
New Member

I posted this to a thread that I started, but I thought it pertained to this thread as well.

Have any researchers thought of poking holes in bones or otherwise causing microdamage to bones that need change or expansion, creating a sort of growth-promoting or higher plasticity environment and then also applying force in the direction of desired growth?  Microinjuries cause the release of growth factors. Poking holes in bones make them temporarily less dense and may make changes in bone easier. Just a crazy, intriguing thought that I had. Don't try this at home, obviously.  Also, several peptides (such as BPC-157) are currently available that interact with growth hormone and healing pathways I wonder if these could assist with growth under these circumstances.

See Wilkedontics:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740718/

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Posted : 10/11/2019 3:36 pm
Apollo
Reputable Member
Posted by: @madmaxilla

This study the skull already have occlusal plane parallel to the ground which is the ideal occlusal plane angle, now try a maxilla that is downward like most of us, you will see counterclockwise rotation is needed. Can you please share the full version of the study?

I tried attaching the PDF here but it's not working. I'll see if I can send it to you in a PM.

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Posted : 10/11/2019 4:06 pm
MadMaxilla
New Member

@apollo

Thanks for your help, please send me to this gmail: leon226zero@gmail.com

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Posted : 11/11/2019 12:40 am
MadMaxilla
New Member

@burlapmantra

yes that is Microosteoperforation or MOP, most of research on MOP are about closing space but there is nothing on expanding mandible.

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Posted : 11/11/2019 2:05 am
NoctilucentNikki
Eminent Member
Posted by: @entelechy

@noctilucentnikki

Can I please ask how the MSE has gone?   I am about to do MSE and then SFOT.  Thanks much!

Hello-

I finally made an update here: https://mseat35.blogspot.com/

 

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Posted : 11/11/2019 12:03 pm
Apollo liked
entelechy
Trusted Member

Dear Nikki!   thank you so much!      So exciting to hear your update---and especially uplifting to me right now as I just saw a jaw surgeon who scoffed at my idea of doing MSE .    Your own success speaks volumes.

Interestingly, I am heading the exact same direction as you:  my plan is MSE then SFOT to enlarge the lower arch.   I was told by  a peridontist I can get 2 mm of bone graft with SOFT.

Can I please ask you what state you are doing this in?   I am in Paris, France--and plan to move to the US to do this treatment.

What is also great to learn is that you only waited three months from suture split to having the SFOT.  I thought one had to wait 8 months until the suture is completely healed.

Invaslign has also been recommended to me.    It sounds a little uncomfortable  (I do not mind braces) but if it works better, and can allow less travel, it will be good.

By the way, might you happen to be Greek in origin?  I  have spend a lot of time in Thessaloniki!

thanks for your post!

 

 

 

 

 

 

entelechy

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Posted : 11/11/2019 12:25 pm
Mr Link
New Member

@le_fort_or_bust

What is the age 20-30 success rate like?

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Posted : 11/11/2019 4:28 pm
entelechy
Trusted Member

I will be interviewing Dr. Won Moon this week.  If anyone has serious good questions to share, I will be happy to include some in my interview and get back to you with the responses.

entelechy

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Posted : 20/11/2019 7:28 pm
bigolhead
New Member

@entelechy

I would be interested in his thoughts on doing MSE+FM AND Lefort 1 (not at the same time of course).

Greatest maxillary protraction he has achieved in an adult with MSE+FM?

Average maxillary protraction he achieves in adults? 

Does he have thoughts on doing one round of MSE+FM (expanding half way) and then doing a second round later to achieve more protraction? 

 

 

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Posted : 21/11/2019 2:37 am
ronaldead
Verified Account
Posted by: @apollo
Posted by: @varbrah

Pushing "against the grain" or up and forwards is probably counter-productive in regards to producing sutural growth, but may be helpful for remodeling existing bone. In adult cases (like my own) I'd imagine it's more important for us to stimulate sutural growth via pulling forward and down (-15 to -30 degrees) since growth largely ceases here by about age 10.

This makes sense to me! I asked @ronaldead on his blog if Dr. Newaz recommended FM traction angled upward from the occlusal plane, but he hasn't responded.

The recommendation came directly from Dr. Newaz. He adjusted the facemask right there in his office.

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Posted : 27/11/2019 6:50 am
kota and Apollo liked
Stolten
New Member

@apollo

I would also be very grateful if you could send the MSE + Facemask for correcting class III maloclusion Won Moon study to my e-mail: egronstolt@gmail.com

Best regards

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Posted : 05/01/2020 6:03 pm
Apollo
Reputable Member
Posted by: @stolten

I would also be very grateful if you could send the MSE + Facemask for correcting class III maloclusion Won Moon study to my e-mail

I sent it to you by PM.

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Posted : 05/01/2020 9:35 pm
klestom
New Member

@apollo

Could you please pm the above mentioned study to me aswell?

Thank you in advance!

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Posted : 10/01/2020 6:05 pm
Apollo
Reputable Member
Posted by: @klestom

Could you please pm the above mentioned study to me aswell?

Just sent. Check your PMs.

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Posted : 12/01/2020 9:34 pm
klestom
New Member

@apollo

Thanks!

 

 

@varbrah I'm looking forward to your summary. Just one question: I think Woon Moon told Ronald Ead's orthodontist (Dr Newaz) that you should have the facemask on as much as you can bear, and having as much elastic force as you can bear. Do you think if someone hade the facemask on 24/7 and significant elastic pulling, that the results could be very significant movement or growth of the maxilla, and be more impressive than the curret studies? Because it seems to me no one has tried to maximize the possible results with the mse facemask combination. 

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Posted : 13/01/2020 9:29 am
ideasman
New Member

@klestom

When did Ronald Ead talk about Won Moon telling him this? I was under the impression one shouldn't pull too hard, 1.5kg being the upper limit. Do you have the link to where Ronald Ead said this?

I have MSE and am doing facemask. So far I'm pulling +15-20 degrees to the occlusal plane since I have a long midface+crooked nose, though the main issue is retrusion. Based on the study with the 20 year old girl it seems the maxilla (measured by the A-point) moves proportionally to the force, ie. she pulled at -30 degrees and the maxilla moved roughly in that direction. I understand the philosophy of pulling perpendicular to the angle of the sutures, but that kind of movement would only exacerbate my problem.

My orthodontist recommends a pulling force roughly parallel to the occlusion plane, slightly tilted upwards. 

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Posted : 22/01/2020 6:47 pm
Apollo liked
klestom
New Member

@ideasman

About 5:20 in this video https://www.youtube.com/watch?v=1ptdF2ukctc&list=PLNWHPvNAnjyNLrJ41HsIp-BsONkwYNYqi&index=42&t=185s  

It was Won Moon telling Dr Newaz to be correct.

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Posted : 23/01/2020 9:30 am
klestom
New Member

@ideasman

How has the procedue gone and have you seen any changes? How much expansion did you get and did it help your bite and your aesthetics?

I also have a long midface and crooked nose but class 3 bite and crossbite aswell. 

Also wondering why you chose 15-20 degrees and not 30 degrees which was done in the simulated study (to get counterclockwise rotation (all the other vectors resulted in downward growth)).

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Posted : 23/01/2020 6:06 pm
ideasman
New Member

@klestom

Bite is [Rude Language or Insults are not tolerated] since my upper teeth are way wider now than my lowers. Helped my cheekbones a bit, though nothing too noticeable. Invisalign will tip my lowers out to meet my upper teeth, which will then be tipped in after they take the appliance out.

Can't rely on simulation studies, I'll do 15-20 for now and readjust depending on whether I get growth or not. Right now I'm just doing what my ortho recommends based on my x-rays and CBCT.

 

 

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Posted : 25/01/2020 1:51 pm
Apollo liked
Neigh
Active Member
Posted by: @neverrelaxed

hello boys, "I have facemask and mse, i did 10mm of expansion flared zygo and helped harmony not huge boost tho"  this was me, doing MSE again!! round two just trying to find a doc

10mm expansion is quite a bit. As you mentioned in your main thread you started out at 38. I can't imagine anyone would want to further expand that. You go much over 50 and you'll look like the Cheshire Cat from Alice.

That was a major update from your thread to drop here though.

https://the-great-work.org/community/case-discussions/msefacemask-orthondotic-harmony/

48 IMW is very close to Mew's ideal, and IMO is absolutely the top range you want. I know he says cavemen had around 55, but that's neither functionally useful now, nor is it aesthetic.

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Posted : 15/04/2020 10:28 pm
Maxillary Impacted
New Member
Posted by: @varbrah

also, get excited @FutureModel.

Got my MSE in today, log coming soon. I'll be doing MSE + FM protraction, and I'll be helping growth/remodeling along by speeding up bone turnover with MK-677 and GH peptides. Results should be sickening. I am not sure if I will post facial pics since I don't want to dox myself, but definitely x-rays at the very least.

So did you get results?

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Posted : 30/04/2020 12:50 pm
MagnumOpus
Eminent Member

Are there downsides to protraction/using the facemask at 30 degrees up from the occlusal plane? At least for a person with a long midface, a upwards pull of 15 or 30 degrees seems the goal, theoretically maybe could shorten the face.

But for example, could this damage occlusion or cause an open bite? Imagine if the maxilla rotates some small amount, a couple of degrees, but the mandible doesn't rotate as much so the molars of the upper and lower jaw meet but not the front teeth. Maybe this could be dealt with later though, and the CCW rotation is the main goal and if that can be attained then it's worth it to mess up occlusion.

 

-MO

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Posted : 26/06/2020 8:15 pm
sun_storm
New Member

Wow, I basically just binged this whole thread in just under 2 hours, there was so much good info! Thank you very much @varbrah for sharing your experiences. Could you post your x-rays and a summary of your journey now? Would love to see how far you've come!

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Posted : 04/08/2020 12:33 pm
mysterecessed
Active Member
Posted by: @marmew92

Who are you seeing? Which angulation protocol did he place you in? Is it left in till specific protraction goals, or just "see how much we can get" till the MSE device comes out?

I have putting my faith in MSE + FM for quite awhile now. MARPE/MSE providers easy to find even locally but knew nothing about the FM combination protocol. I'm in South East Asia and don't want to have to travel all the way to see Won Moon if necessary. 

How much reverse overjet do you have? Any prior retraction ortho?

I'm also monitoring the AGGA/ALF stuff. Can't decide which to do first. My PT and neuro-optometrist wants me in an ALF for a pretty bad left-sidebend cranial strain. I want the physiologic benefits of the ALF stuff but nothing beats the overlay scans showing 2-3mm lateral orbital rim expansion and the sickening FEM lefort 3 simulations in the various MSE papers. I can't get an opinion from both dentist/ortho side because both sides think each other's method is bullshit.

Please update on your progress throughout!

Hey, which part of SEA are you in? I'm from there too and I've been having a hard time finding many MSE providers and I can't find any DNA/Y-palate/Homeobloc providers.

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Posted : 10/08/2020 11:50 am
NoctilucentNikki
Eminent Member

Hello everyone, just checking in. My MSE is finally out and I'm just starting week 36 of invisalign 😎 

I feel so much better, so pleased with results and my smile looks so much better already, which is a pure bonus for me.

Although I don't have technical data, my story is here and now up to date: https://mseat35.blogspot.com/

I can at least offer a qualitative review of my process. 

 

I was wondering who else on this site has also had the MSE or has it in now??

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Posted : 22/08/2020 4:45 pm
Apollo liked
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