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Won Moons MSE (Maxillary Skeletal Expander) Appliance is the best appliance for what we are trying to achieve  

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FutureModel
Trusted Member

I have not seen any other appliance that will give as good results as this in this short amount of time. This MSE literally is the best option for people 18+ years old.

The mse expands your entire midface and nudges it forward, if you combine it with a facemask you can pull your maxilla up and forwards, like an upswing as Mike Mew was talking about

This link goes into more detail https://www.semortho.com/article/S1073-8746(18)30009-4/pdf

Quote
Posted : 08/12/2018 10:07 am
Ezcanor and Apollo liked
Apollo
Reputable Member

Thanks for sharing this article! The before and after pictures are pretty impressive. Unfortunately, I don't think this appliance is an option for me because of the obstruction of my torus palatinus, the cost, and the lack of providers in my area.

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Posted : 09/12/2018 5:51 pm
Apollo
Reputable Member

This quote from the article is interesting:

The more mature the patient, the faster expansion is required in order to build adequate inter-sutural tension for initial disarticulation. A diastema will typically appear after a successful split, and the activation rate can be slower onwards since the resistance has been reduced significantly.

Varbrah has reported the same thing with his MSE treatment. I questioned a few days ago in a thread about the rate of palate expansion (  https://the-great-work.org/community/main-forum/whats-better-rapid-maxilla-expansion-or-slow-expansion-in-adults/# ) if a similar tapered approach could be used with a removable expander: 

Posted by: Apollo

For those using removable acrylic expanders, I wonder if a tapered schedule might be most effective, faster to initially induce some suture separation, but then slower to avoid traumatizing the fibrous connective tissue in the sutures that abdulrahman is talking about and limit compression of the periodontal membrane. What about something like 4 days for the first millimeter (turning 1/4mm every day), then 8 days for the second millimeter (turning 1/4mm every 2 days), then 12 days for the third millimeter (turning 1/4mm every 3 days), before slowing down to about 28 days per millimeter for the rest of the expansion (turning 1/4mm every 7 days)? I think this kind of approach might achieve more suture separation and dramatic improvements in breathing and appearance than the kind of subtle remodeling changes I saw from advancing 1/4mm about every 2 days to begin with and then slowing to about every 5 days. What do you think?

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Posted : 09/12/2018 6:07 pm
Apollo
Reputable Member

I'm also curious to read this citation, which suggests that alternating between expansion and constriction could help disarticulate perimaxillary sutures:

Wang YC, Chang PM, Liou EJ. Opening of circumaxillary sutures by alternate rapid maxillary expansions and constrictions. Angle Orthod. 2009;79(2):230–234.

http://www.angle.org/doi/pdf/10.2319/031208-141.1

The study, alternating between expanding and constricting the midpalatal sutures of cats as an animal model, found that sagitally-running circummaxillary sutures disarticulated significantly more than coronally-running circummaxillary sutures that required more than 5 weeks to increase opening. This makes sense that opening the midpalatal suture sideways would induce separation of other sutures around the maxilla sideways, but would be less effective at separating circummaxillary sutures in a forward direction.

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Posted : 09/12/2018 6:57 pm
varbrah
Estimable Member
Posted by: Apollo

I'm also curious to read this citation, which suggests that alternating between expansion and constriction could help disarticulate perimaxillary sutures:

Wang YC, Chang PM, Liou EJ. Opening of circumaxillary sutures by alternate rapid maxillary expansions and constrictions. Angle Orthod. 2009;79(2):230–234.

http://www.angle.org/doi/pdf/10.2319/031208-141.1

The study, alternating between expanding and constricting the midpalatal sutures of cats as an animal model, found that sagitally-running circummaxillary sutures disarticulated significantly more than coronally-running circummaxillary sutures that required more than 5 weeks to increase opening. This makes sense that opening the midpalatal suture sideways would induce separation of other sutures around the maxilla sideways, but would be less effective at separating circummaxillary sutures in a forward direction.

Applies to less sophisticated forms of MARPE. MSE does this just fine without.

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Posted : 09/12/2018 11:52 pm
Abdulrahman
Reputable Member
Posted by: Apollo

Thanks for sharing this article! The before and after pictures are pretty impressive. Unfortunately, I don't think this appliance is an option for me because of the obstruction of my torus palatinus, the cost, and the lack of providers in my area.

Why would you be interested in this? Didn't you use an expander successfully?

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

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Posted : 10/12/2018 1:41 am
Apollo
Reputable Member
Posted by: Abdulrahman

Why would you be interested in this? Didn't you use an expander successfully?

Starting at about 34mm, my intermolar width is still below 40mm, and I haven't achieved any discernible forward progress. My desire for at least a little more transverse expansion and any sagittal expansion is what has me intrigued by options like AGGA and MSE+FM.

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Posted : 10/12/2018 2:45 pm
Pame
 Pame
Trusted Member

What is he going to do about he gap between the incisors? Why does this occur, and could it happen with just regular mewing? Also, John Mew posted a video explaining why they prefer semi rapid expansion over rapid expansion  https://www.youtube.com/watch?v=YtzHjF6qP8Y

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Posted : 10/12/2018 4:35 pm
Apollo
Reputable Member
Posted by: Pame

What is he going to do about he gap between the incisors? Why does this occur, and could it happen with just regular mewing? Also, John Mew posted a video explaining why they prefer semi rapid expansion over rapid expansion  https://www.youtube.com/watch?v=YtzHjF6qP8Y

The midline diastema opens because of the separation of the midpalatal suture. With regular mewing, some people have reported smaller gaps forming between their central incisors. It's more likely that the contacts between your teeth (not just the central incisors) will become less tight but you won't get an obvious diastema because any expansion will mostly occur through remodeling rather than suture separation and at a rate slow enough for mesial drift of the teeth to maintain interproximal contact. Mike Mew also warns against rapid expansion in this video (  https://youtu.be/QCNqbvOALZI ). 

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Posted : 10/12/2018 4:48 pm
Abdulrahman
Reputable Member
Posted by: Apollo

Starting at about 34mm, my intermolar width is still below 40mm, and I haven't achieved any discernible forward progress. My desire for at least a little more transverse expansion and any sagittal expansion is what has me intrigued by options like AGGA and MSE+FM.

I see, are you wearing a retainer, or are you able to maintain all the gains you made so far on your own?

I am asking because just last night I met with the only doctor in the country that offers this treatment. While MSE was not the main topic of our discussion he was so against traditional acrylic expanders and implied that if he were to use it on a case like mine or yours he would would wait for recession to take place and for the bite to stabilize before attempting such treatment. 

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

ReplyQuote
Posted : 10/12/2018 8:09 pm
Apollo liked
Apollo
Reputable Member
Posted by: Abdulrahman

I see, are you wearing a retainer, or are you able to maintain all the gains you made so far on your own?

I am asking because just last night I met with the only doctor in the country that offers this treatment. While MSE was not the main topic of our discussion he was so against traditional acrylic expanders and implied that if he were to use it on a case like mine or yours he would would wait for recession to take place and for the bite to stabilize before attempting such treatment. 

I have been using a large myobrace A2 and A3 for the past 4 months to help stabilize my expansion. If I've had any relapse it has been minor, and could just be uprighting of any dental tipping that occurred during the expansion. The width of the large adult myobrace at the level of my first molars is approximately 40mm so it isn't really exerting significant expansive or contractive force on my upper arch. I'm planning to continue using the myobrace for at least 2 more months for a total of 6 months.

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Posted : 10/12/2018 9:22 pm
Fred
 Fred
Estimable Member

What happens to the tooth gap? Is it just gonna be there?

ReplyQuote
Posted : 10/12/2018 9:40 pm
Apollo
Reputable Member
Posted by: Fred

What happens to the tooth gap? Is it just gonna be there?

No, they use braces or other orthodontic methods to bring the teeth together. I believe they do this after several months of stabilization to minimize skeletal relapse.

ReplyQuote
Posted : 10/12/2018 9:53 pm
Apollo
Reputable Member
Posted by: Apollo
Posted by: Abdulrahman

I see, are you wearing a retainer, or are you able to maintain all the gains you made so far on your own?

I am asking because just last night I met with the only doctor in the country that offers this treatment. While MSE was not the main topic of our discussion he was so against traditional acrylic expanders and implied that if he were to use it on a case like mine or yours he would would wait for recession to take place and for the bite to stabilize before attempting such treatment. 

I have been using a large myobrace A2 and A3 for the past 4 months to help stabilize my expansion. If I've had any relapse it has been minor, and could just be uprighting of any dental tipping that occurred during the expansion. The width of the large adult myobrace at the level of my first molars is approximately 40mm so it isn't really exerting significant expansive or contractive force on my upper arch. I'm planning to continue using the myobrace for at least 2 more months for a total of 6 months.

@abdulrahman what do you think of my stabilization strategy? Do you think 6 months using the myobrace will be long enough to prevent relapse if my tongue posture is good?

ReplyQuote
Posted : 11/12/2018 3:34 pm
Abdulrahman
Reputable Member
Posted by: Apollo

@abdulrahman what do you think of my stabilization strategy? Do you think 6 months using the myobrace will be long enough to prevent relapse if my tongue posture is good?

That depends on how your teeth occlude but in general yes, 6 month is a sufficient period of time. Now weather your tongue will maintain your expansion afterwards all depends on how well it's adapting to it's new role. Are you able to swallow correctly? Have you seen a reduction in size of your facial muscles around your mouth?  

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

ReplyQuote
Posted : 11/12/2018 10:54 pm
Apollo
Reputable Member
Posted by: Abdulrahman

That depends on how your teeth occlude but in general yes, 6 month is a sufficient period of time. Now weather your tongue will maintain your expansion afterwards all depends on how well it's adapting to it's new role. Are you able to swallow correctly? Have you seen a reduction in size of your facial muscles around your mouth?  

My expansion made it much easier to practice good tongue posture, and I believe that I am now reliably maintaining it even during sleep. I believe that my swallowing technique is good, but I haven't noticed obvious buccinator atrophy. I think my structure is just too retruded for defined cheek hollows, and my body fat percentage isn't ideal. If I finish using the myobrace in February, I'll have to decide if I am going to move on to another appliance that might help me get some forward changes, or monitor my progress/regress with oral posture alone.

ReplyQuote
Posted : 11/12/2018 11:09 pm
neverrelaxed
Active Member

Could this bring the LORs forward @futuremodel 

ReplyQuote
Posted : 27/12/2018 2:51 pm
darkindigo
Reputable Member

Myobrace lengthens the face.  See my other posts on it... there's a link to their own publication.  

This looks good but to be aware that eyes may drop.  You may be able to help this by manually pushing just behind last maxillary molars somewhat.  🙂  When people here decide that intermolar width should be some figure above 38/39 mm then something must give, unless that suits their mouth.  It's all individualistic.  See my post here on this originally explained concept:   https://the-great-work.org/community/main-forum/growing-an-awesome-face/#post-13146  

ReplyQuote
Posted : 27/12/2018 10:32 pm
darkindigo
Reputable Member
Posted by: FutureModel

I have not seen any other appliance that will give as good results as this in this short amount of time. This MSE literally is the best option for people 18+ years old.

The mse expands your entire midface and nudges it forward, if you combine it with a facemask you can pull your maxilla up and forwards, like an upswing as Mike Mew was talking about

This link goes into more detail https://www.semortho.com/article/S1073-8746(18)30009-4/pdf

I have heard of some aggressive orthos attempt traditional (non-surgical) fixed palatal expansion for up to 20/22.  One I know turns a couple... unwind if no separation then try again.. back and forth a few times.  It is Dr. Barrowes in Utah.  Not sure how friendly for potential root absorption with that pressure.  On second thought, probably does okay with it because it's hand crafted and poured in front part of maxilla cavity with arms and multiple strong wraps around back teeth if needed.  This is not your kid's hyrax.  Very natural looks the way he does it.  Palatal expander extraordinairre!  He's board certified, has a good sense of humor and takes on challenging cases.  Message me if you're thinking about going to him.

ReplyQuote
Posted : 27/12/2018 10:57 pm
darkindigo
Reputable Member
Posted by: FutureModel

I have not seen any other appliance that will give as good results as this in this short amount of time. This MSE literally is the best option for people 18+ years old.

The mse expands your entire midface and nudges it forward, if you combine it with a facemask you can pull your maxilla up and forwards, like an upswing as Mike Mew was talking about

This link goes into more detail https://www.semortho.com/article/S1073-8746(18)30009-4/pdf

So when are you going to do it?

ReplyQuote
Posted : 27/12/2018 11:03 pm
Peterpp
New Member

What is the cost of this appliance? 

ReplyQuote
Posted : 08/10/2019 9:06 am
EddieMoney
Reputable Member
Posted by: @apollo
Posted by: Abdulrahman

Why would you be interested in this? Didn't you use an expander successfully?

Starting at about 34mm, my intermolar width is still below 40mm, and I haven't achieved any discernible forward progress. My desire for at least a little more transverse expansion and any sagittal expansion is what has me intrigued by options like AGGA and MSE+FM.

Your Mew line is 43. I doubt much "forward" progress is possible

ReplyQuote
Posted : 08/10/2019 4:16 pm
Ezcanor
Active Member

@apollo

I’m looking into getting MSE, I have a narrow palate and asymmetrical face and jaw I will be posting photos soon so I can get feedback. So I struggle with sleeping and I have tmj issues as well. When I was 17 years old I had a problem breathing I felt like I was out of breath best way to describe it is, you ever ate so much that it was hard to breath? Well that’s how it felt I went to the doctors and they told me it was allergy’s and nothing really happened I basically was gasping for air for about half a year. I also had braces when I was a younger but by that time i was already finished with the treatment. 
Fsat forward you now I’m 22 I live in nyc and I struggle with quality of sleep, breathing, asymmetries  and I have tmj issues along with other psychological issue as well like anxiety and depression. 
So what I want to know is if MSE would help with my breathing and tmj issues? I also want to know if I can aid with my asymmetries? This is because I noticed that one side of my jaw is bigger than the other. 

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Posted : 31/10/2019 9:32 pm
sinned
Estimable Member

@ezcanor

I'm pretty sure MSE is clinically proven to improve the airway, as for TMJ I don't know about that.

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Posted : 01/11/2019 12:43 am

Would any reputable medical professional accept a patient (who is willing and able to pay) who is seeking this treatment for strictly cosmetic improvement? I have no issues with my airway; however, I could certainly benefit from the aesthetic improvements of a more broadened, proportional face.

 

My indicator value matches the Paleolithic ideal; my intermolar width, however, does not.

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Posted : 03/11/2019 8:10 pm
Wellwellwell
Active Member

@apollo

Have you used an expander at home by yourself or did you have an ortho do it for you?

- Age: 30
- Started soft mewing on 12 Feb 2019. Have not seen any real results or changes.
- Starting IMW: 35 mm
- Current IMW: 35 mm

ReplyQuote
Posted : 04/11/2019 6:15 am
Apollo
Reputable Member
Posted by: @ezcanor

@apollo

I’m looking into getting MSE, I have a narrow palate and asymmetrical face and jaw I will be posting photos soon so I can get feedback. So I struggle with sleeping and I have tmj issues as well. When I was 17 years old I had a problem breathing I felt like I was out of breath best way to describe it is, you ever ate so much that it was hard to breath? Well that’s how it felt I went to the doctors and they told me it was allergy’s and nothing really happened I basically was gasping for air for about half a year. I also had braces when I was a younger but by that time i was already finished with the treatment. 
Fsat forward you now I’m 22 I live in nyc and I struggle with quality of sleep, breathing, asymmetries  and I have tmj issues along with other psychological issue as well like anxiety and depression. 
So what I want to know is if MSE would help with my breathing and tmj issues? I also want to know if I can aid with my asymmetries? This is because I noticed that one side of my jaw is bigger than the other. 

I am exploring MSE treatment for my sleep disordered breathing. I haven't found a reputable provider in my area, so others on the forum have more experience with the appliance than I do. I'm satisfied that it should significantly improve airway and sleep issues. The effect of MSE on asymmetries is less clear to me. I have a modest occlusal cant similar to Ronald Ead's. From what I can tell from the pictures on his blog, I don't think his cant changed substantially during his MSE treatment, but he hasn't mentioned it. However, it looks like one side of his maxillary arch moved farther out beyond the mandibular arch than the other side. I guess this will be corrected with aligners, but it makes me wonder if he now has more skeletal asymmetry which will only be cosmetically corrected by moving the teeth instead of bone. I think varbrah has said in the other thread that asymmetries aren't really corrected or exacerbated by MSE treatment, but widening the arch might make the same amount of asymmetry proportionately less visibly obvious. Regarding TMJ, the extent to which MSE achieves sagittal displacement (perhaps facilitated by the addition of FM), should theoretically help decompress the joint and relieve some of those symptoms. Improving oxygenation and reducing chronic pain and inflammation could redound to more systemic health improvements.

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Posted : 04/11/2019 11:26 am
Ezcanor liked
Apollo
Reputable Member
Posted by: @wellwellwell

@apollo

Have you used an expander at home by yourself or did you have an ortho do it for you?

I didn't have formal treatment, but I had some level of professional supervision and advice from someone I know. I generally discourage self-treatment because of the significant risk and limited reward. I've retained a few millimeters of increased intermolar width and I think this has helped me practice better tongue posture, but I haven't noticed any airway/sleep improvements, which is my main goal and why I'm now exploring professional treatment.

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Posted : 04/11/2019 11:34 am
Ezcanor
Active Member

@sinned

Well, my TMJ isn't bad I don't get headaches as many people do. I think I just caught in its early stages cause my father has TMJ and my mother says that she can hear his jaws popping. I only hear clicking and crackling when I yawn because since I don't breathe through my mouth I compensate with yawning. This is why since with the facemask and MSE the maxilla is repositioned forward giving a knock-on effect with the jaw up swinging forward as well. I only say this because I feel like I'm on the same path as my father because he's in his early 40s and has no front teeth only molars. But with my situation, my face hasn't grown right compared with my father who had no orthodontic treatment and me with braces and extractions. I have made a post with my images pictures to explain my dilemma. 

https://the-great-work.org/community/case-discussions/should-i-do-mse/#post-25966

ReplyQuote
Posted : 07/11/2019 11:18 am
Ezcanor
Active Member

@apollo

How much is the cost? And does it depend on location? I live in NYC btw

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Posted : 13/11/2019 2:17 pm
Apollo
Reputable Member
Posted by: @ezcanor

@apollo

How much is the cost? And does it depend on location? I live in NYC btw

Since I have not found an MSE provider in my area yet, I cannot speak from personal experience. Ronald Ead has answered this question several times on his blog and his provider is in NYC. I think he estimated 8-15 thousand dollars in total, including both the expansion and realignment.

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Posted : 13/11/2019 2:31 pm
entelechy
Trusted Member

MSE expander:  range of price 1000 euros in Europe to 6000 dollars in the US.   

providers on East Coast:  Mariana Evans, Zubad Newaz

providers on West Coast: Won Moon's UCLA clinic, Dr. Ting, and several others.

provider in Arkansas possibly:  Dr. Roblee

yes can be done for cosmetic purposes: but note it does not just change your maxillary area.  it will change the entire midface.  The MSE is a skeletal expander: sutures in nose, zigomatic area and between the eyes also widen.   Check before and after photos on science research articles to see the changes.

yes, it improves airway, by breaking the sutures of the nasal cavity as well and expanding.

TMJ issues:  undetermined whether improves or what effects it has. 

Biggest issue with MSE is how to match the bottom arch to top after the expansion on the top makes this arch wider than the lower.  Solutions are simply teeth tilting, or using bone grafts and SFOT on the bottom gums and then expanding.

Note that MSE does not always have a 100% success rate.   Depending on palate bone thickness, age, gender, it ranges from 50% to 100% success in patients.  Older men have less success.

What can block success are the zigomatic bones that resist the expansion of the palate.

 Note that there are two kinds of MSE:  fast (two weeks) or slow (three months).     The latter will give less midface changes, and may be more successful.   Palate expansion should be achieved with both.

After the split, the patient wears the MSE in the mouth for six more months, with its arms cut off, until new bone grows in the suture.  The MSE is the stabilizing effect.

The above info is the result of interviews with four MSE providers, and attendance at two MSE orthodontic seminars.

 

 

 

 

 

 

entelechy

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Posted : 13/12/2019 11:43 pm
Ezcanor and kota liked
kota
 kota
New Member

@entelechy

Thank you for the info. So MSE could increase the distance between the eyes? I have been trying to spot this in the few before and afters I've seen but not really been able to make a conclusion. Would be very interested to see if there are any examples.

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Posted : 14/12/2019 8:39 am
entelechy
Trusted Member
Posted by: @kota

@entelechy

Thank you for the info. So MSE could increase the distance between the eyes? I have been trying to spot this in the few before and afters I've seen but not really been able to make a conclusion. Would be very interested to see if there are any examples.

I hope you wouldn't do MSE to increase the distance between your eyes!     You do realize that changing the orbital shape of your eyes and the distance between them can have vision consequences?     The opening of the suture here is actually problematic according to some opthalmalgists and occulists, and one orthodontist advised me to be very cautious to check my vision before and after MSE. 

I am going to do MSE because it is medically necessary (for breathing).  I would not do it for any aesthetic reason, including having a nicer "shaped jaw line" or fuller lips.     Changing the shape of an adult skull is not a small intervention, equal to getting a nose job or lip injection.    Maybe it has no consequences whatsover, and is safe, but wait ten years to see the longterm studies of consequences on vision, TMJ, headaches, etc before you do something like this for "beauty" purposes.    It is a relatively new procedure.  No longitudinal studies exist as far as I know as to health risks.

But it may very well be worth the risk of not knowing what these risks may be (if any)  for those who are seriously suffering lack of tongue space, sleep apnea, poor  breathing, abnormal swallowing, neck pain or any other major health issue caused by a narrow palate.

 

entelechy

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Posted : 14/12/2019 11:44 pm
kota liked
kota
 kota
New Member

@entelechy

Thanks. I'm doing it for both functional reasons (poor nasal breathing and sleep) as well as cosmetic reasons related to my narrow palate and midface. Both SARPE and bimax has already been proposed to me by surgeons but would like to try this first. Was upfront about my reasons in the consult and the ortho didn't have any objections.

So while I'm hoping to benefit functionally, I am also very interested to know what the cosmetic changes would be. I really appreciate your input.

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Posted : 15/12/2019 9:11 am
megamandude
Trusted Member
Posted by: @entelechy

MSE expander:  range of price 1000 euros in Europe to 6000 dollars in the US.   

providers on East Coast:  Mariana Evans, Zubad Newaz

providers on West Coast: Won Moon's UCLA clinic, Dr. Ting, and several others.

provider in Arkansas possibly:  Dr. Roblee

yes can be done for cosmetic purposes: but note it does not just change your maxillary area.  it will change the entire midface.  The MSE is a skeletal expander: sutures in nose, zigomatic area and between the eyes also widen.   Check before and after photos on science research articles to see the changes.

yes, it improves airway, by breaking the sutures of the nasal cavity as well and expanding.

TMJ issues:  undetermined whether improves or what effects it has. 

Biggest issue with MSE is how to match the bottom arch to top after the expansion on the top makes this arch wider than the lower.  Solutions are simply teeth tilting, or using bone grafts and SFOT on the bottom gums and then expanding.

Note that MSE does not always have a 100% success rate.   Depending on palate bone thickness, age, gender, it ranges from 50% to 100% success in patients.  Older men have less success.

What can block success are the zigomatic bones that resist the expansion of the palate.

 Note that there are two kinds of MSE:  fast (two weeks) or slow (three months).     The latter will give less midface changes, and may be more successful.   Palate expansion should be achieved with both.

After the split, the patient wears the MSE in the mouth for six more months, with its arms cut off, until new bone grows in the suture.  The MSE is the stabilizing effect.

The above info is the result of interviews with four MSE providers, and attendance at two MSE orthodontic seminars.

 

 

 

 

 

 

@entelechy Don’t you mean slower expansion will produce better midfacial results? Like Ronald ead went very fast with MSE and his palate expanded but I don’t too much difference in his midface.

Also with regards into the vision problem you talk about when increasing ipd, I’m sure if you take expansion slow there will be little to none issues. Your ipd changes drastically from being a baby to an adult and there’s no vision issues there.

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Posted : 15/12/2019 12:15 pm
entelechy
Trusted Member

@megamandude

slow according to Won Moon produces far less midface changes.  This is a quote.    According to another MSE dr, there may not even be a diastema.   One theory is that it is because you are "stretching' the palate gradually rather than "splitting" it with tremendous force.     Again, no studies on this, and I don't know if any of this is "fact", but it is what I have been told.

Ronny Ead did get dramatic midface results in my opinion.  Check his Youtube videos five months before and one month after MSE.   Cheekbones wider and more protruding, and maxilla came significantly forward.

 

 

 

entelechy

ReplyQuote
Posted : 15/12/2019 1:19 pm
entelechy
Trusted Member

@kota

Dear Kota,  I would be happy to chat with you one day about my findings, if it is helpful.   If so, send me your number by message and I will call in the next couple weeks.

Re  bimax.   I saw six jaw surgeons to discuss bimax, and have read extensively on consequences.  For myself, I would avoid at all costs-- since at my age, the high risk of relapse, permanent numbness, nerve damage and poor adjustment to the new 'face' may destroy my life.      Another concern is that every surgeon I spoke to had very little understanding of what insufficient tongue space actually means:  "the tongue does not interest me," said one.   Another told me "to hypnotise the tongue" to make it fit on the (very narrow!) palate.   So I would want to go with a surgeon who really understood functional issues like breathing and tongue space, and who dialogued with an ENT.  Apparently there are a few in the US : none in the country I live in.

That said, I will note that I have spoken to a couple successful jaw surgery patients who were very satisfied with the health results (although they had consequences: there is no way to avoid consequences).  

Re sarpe:  I read through several research articles and they all pointed out to "many consequences".  One critiqued the view that Sarpe is a "less invasive" procedure than Lefort l.       I would read up on all these articles if I were considering sarpe, so you are prepared and know exactly what is at stake.  Originally I had just thought it meant splitting the suture.  Apparently it is many surgical cuts in the skull, and is identical to Lefort l in cuts, except for the lateral downward cut (whatever that means).  Note I am no doctor, so do your own investigation.

MSE seems a safer bet than the two above.   MSE is also well-researched to help breathing issues: widens the nasal passages.   Whether it will be sufficient and whether you can find an excellent orthodontist to then re-do the occlusion to your satisfaction is another challenge.  It depends on where you live, as to how much choice you have with finding an MSE practitioner and/or an excellent orthodontist who understands your functional issues.

Hope this helps.  Do note:  I am a VERY cautious person when it comes to any medical procedure.   So maybe I am more alarmist than necessary...but be careful.

k

 

 

 

 

 

 

entelechy

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Posted : 15/12/2019 1:30 pm
greyham and kota liked
kota
 kota
New Member

@entelechy

Thank you.

I'm in a similar situation myself where I have been contemplating about bimax but I am hoping that MSE + facepull could achieve something similar (and maybe more in regards to the upper midface). My jaws are both narrow and recessed and nasal breathing difficult. 

I live in Europe and don't have access to an MSE ortho in my area, but have consulted with one on Skype and will travel for the treatment. Getting the occlusion right in the end will be another challenge that I will have to discuss with the ortho.

For now I am just trying to learn as much as I can about what changes to expect, both functional and visual, before making any decisions. You are probably right to be careful but in my case it's either MSE or surgery so this seems like the less invasive option to try first, even though I'm on the older side so not sure if it will work at all in my case.

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Posted : 19/12/2019 11:01 am
greyham liked
entelechy
Trusted Member
Posted by: @kota

@entelechy

Thank you.

I'm in a similar situation myself where I have been contemplating about bimax but I am hoping that MSE + facepull could achieve something similar (and maybe more in regards to the upper midface). My jaws are both narrow and recessed and nasal breathing difficult. 

I live in Europe and don't have access to an MSE ortho in my area, but have consulted with one on Skype and will travel for the treatment. Getting the occlusion right in the end will be another challenge that I will have to discuss with the ortho.

For now I am just trying to learn as much as I can about what changes to expect, both functional and visual, before making any decisions. You are probably right to be careful but in my case it's either MSE or surgery so this seems like the less invasive option to try first, even though I'm on the older side so not sure if it will work at all in my case.

Hello Kota,  We are exactly in the same situation.     I live in France.  I found a good MSE provider in Munich, Germany: Christoph Moschik.    There is also one in Italy named Daniele Cantarella.   

My choices have been between MSE with facemask, DOME,  Lefort 1, or simple camouflage orthodontics with SFOT.     I have done so many interviews and investigations about these alternatives that I will be putting up a multi-media website with explanations of all pros and cons of each procedure, plus filmed interviews with the lead doctors behind this methods, including surgeons, ENTs, sleep doctors, orthodontists, periodontists, dentists and myofunctional therapists, so people can choose with less bewilderment.     I will also be putting a complete list of all doctors, orthos, etc who deal with these alternative methods to reverse extractions or widen palates worldwide.   I will also consolidate all medical research articles on each of these methods, so you have ALL the research in one place----and not have to zigzag around the world as I have for the last two years.

  Am curious what people think of this idea, and if anyone wants to  volunteer skills, please do let me know.  My own function will be providing the filmed interviews, bibliographies, overviews and lists of providers.    Would welcome camera-people in some of the areas I will interview (next is Dallas Texas with lead doctors there)  as well as anyone with web-design skills.  I have a film crew in Paris  (we just filmed a two hour interview I did with Won Moon),  but the plan is to film doctors worldwide.  So filmmakers worldwide, interested in the project, please let me know if you could volunteer (or be paid, if the funding comes through), to film a couple hours on location.

Now--in the meantime!--I would be happy to discuss with you personally any questions about MSE, bimax, and other methods- by phone or whatsapp.      Since I have so much to say--I have had over 200 interviews worldwide and read extensively in the medical journals accessible to me at the university library--- it would be too lengthy to write up the findings now, so phone is best.    Eventually, in the next year, the website should be launched.  

I am in the US now and can be reached either on my French cell, my Mexican whatsapp or on a US landline.   Just send me a personal message with your details and time to call over the holidays, and we can talk soon!

I know how serious this decision is, and hence my own two year journey to make sure I take the right step.   We are together on this.

 

 

 

 

entelechy

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Posted : 19/12/2019 12:35 pm
Stolten, greyham and kota liked
kota
 kota
New Member

@entelechy

Looking forward to that website. People are generally unaware of these alternative methods but hopefully they will grow and get more attention in the near future.

Thanks for the offer, I'll shoot you a PM right now.

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Posted : 22/12/2019 3:10 pm
Ama
 Ama
New Member

Hey guys I naturally have a 39mm IMW and I only have a slight tooth crowding. My wisdoms are impacted and I fear that they are making my teeth become more crowded. Do you think MSE could save my wisdoms if I get some decent expansion? I just turned 22 if that matters 

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Posted : 22/12/2019 4:01 pm
Robbie343
Trusted Member

@entelechy

How similar is DOME to MSE? I have providers of both near me

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Posted : 22/12/2019 8:55 pm
Stolten
New Member

@entelechy

That website seem like a very good idea to me. I'd be more than happy to read about your findings.

I have a class III maloclusion were my mandible is wider than the maxilla. The orthodontist I have talked to here in Sweden have suggested surgery as the only method they know to correct. MSE + facemask seem like a viable and less invasive method that would also benefit the nasal airway. I'd be happy to chat to you over whats app if you have time. I will send you a PM.

Best regards 

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Posted : 05/01/2020 6:46 pm
Stolten
New Member

@entelechy

I can not find out how to send a PM over the forum. Please send me a PM with your phone number or whats app address and than we can chat.

All the best

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Posted : 05/01/2020 6:58 pm
entelechy
Trusted Member

@admin_delete_this_account

I believe Mariana Evans in Philly offers it to patients for aesthetic resasons as well as health reasons.   Note that other things change in MSE not just your cheekbones:   eyes for ex.

entelechy

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Posted : 05/01/2020 7:33 pm
entelechy
Trusted Member

@robbie343

I am speaking to one of the inventors of DOME in the next week and will ask him this question.   I can tell you already that DOME includes a surgical component:  3 cuts that are the same cuts as in a Lefort surgery.     MSE currently does have a surgical component, but it is being investigated in clinical trials.   The surgery makes the expansion more sure as the cuts are in the buttressing areas of the face (zigomatic, etc) that resist expansion.    You can see Stanley Lui's youtube lecture on this.    Note that the surgery has an attractive component:   you don't get uncontrolled suture splitting.   For example, if you are not in favor of having sutures unpredictably split in temples and in eye area (as may happen  in mature patients wihtMSE, I believe) , DOME would (I think) control the splitting is limiting to the cheekbone and palate area.   I will see if I can get a better explanation.    DOME was invented with one of Moon's former students, so in the same line, I believe.

entelechy

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Posted : 05/01/2020 7:38 pm
entelechy
Trusted Member

@stolten

MSE sounds ideal for you as it is best recommended for people with Class III as it expands the upper arch beyond the lower arch.  

I live in France, and there the only solution for any palate issue in adults is surgery, surgery, surgery.    I find France very behind the times in orthodontic treatment, so maybe it is the case also in Sweden?   My solution is to travel to Germany to do MSE with Christoph Moschik,  You can google him in Munich. Speaks perfect English, trained with Won Moon, wonderful kind conscientious practitioner.  You can tell him Karin sent you.    It is far cheaper with him than in the US (where it is 3000 - 6000 dollars), so worth the travel investment.  I am trveling myself now so cannot talk for the next few weeks. When I can I will send you my whatsapp in a message. Good luck!

entelechy

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Posted : 05/01/2020 7:42 pm
Stolten liked
Stolten
New Member

@entelechy

Thanks for the tip! I will contact Christoph for sure.

Looking forward to chating with you after the holidays.

All the best

ReplyQuote
Posted : 05/01/2020 8:07 pm
greyham
Active Member
Posted by: @entelechy

I am speaking to one of the inventors of DOME in the next week...

Can you please ask them if and why DOME surgery is preferable to corticopuncture as demonstrated here: https://www.youtube.com/watch?v=uOYEbghAoOI

Thanks, Graham

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Posted : 05/01/2020 8:53 pm
entelechy
Trusted Member

@greyham

I can already answer this question in part, based  on what I learned in my attendance of MSE seminars.  But do remember to take everything I say  with a grain of salt and question it, as I am not a doctor.    Here goes:

Corticopuncture just prepares the suture itself to split.   It is mini-pierces in the suture.  An ortho can do it.  It is NOT surgery.     THis helps the split happen, but is not the whole picture.

What is the challenge for the suture to split is that this lateral movement is going to be blocked by the other bones of the skull that DO  NOT want to move:  ie. the cheekbones, the bones in the nose etc.  You cannot break the palate open of the mouth without the whole skull having to be in on the expansion.   

So the MSE is yanked up to have tremendous force to BREAK through the resisting forces.  When it is successful, the palate suture will split and SO WILL THE OTHER SUTURES---in the zigomatic (cheekbone), nasal area, and even the sutures  in the temples and between the eyes.    This is one reason people's faces look  different before and after MSE.   

Now, when MSE does NOT work, it is sometimes (I think) because the resisting ( buttressing) forces are too strong and solid, and will resist back.  

THat is when surgery comes in.  You surgically CUT the nasal  one, the zigomatic bone and some other bone with one cm cuts (corticoTOMIES I believe they are called).  So there is no more resistence!   The split is guaranteed.

THe other advantage, that I heard about DOME, is that by doing these cuts, you control which sutures are going to split open in your skull and how.

Without surgery, what splits is NOT predictable.   Nor HOW it splits. Notice that it is a given that the split in the palate will be ASSYMETRICAL because that is how the suture splits, and the face is already slightly assymetrical.  Usually no problem.  But in some cases will split too asymmetric.

Also, I think if you get DOME you avoid the upper suture splits (*between the eyes) but I am not sure.    

I will ask all these questions to a specialist in DOME when I speak to him and see if I can share a more accurate summary.

In the meantime, any other questions regarding Dome, please do forward to me  (as soon as possible) and I will make sure to ask them.  

entelechy

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Posted : 06/01/2020 1:02 am
greyham liked
greyham
Active Member

Thanks @entelechy. This is really helpful to me. I'm seeking palate expansion in the hope of treating my severe sleep apnea, and I want to minimise the risk of failure. I'm a 51 year old man so my palatal suture will need more than just MSE to open it, but the less invasive the better. The whole thing freaks me out to be honest; but I also don't want to die in my sleep 20 years early due to heart failure so I need to fix my overly narrow palate. I'd also appreciate if you could ask whether there is any difference in the impact on the nasal airway  using the different techniques. I'm hoping palate expansion will address my nasal airway resistance without turbinate reduction surgery, and what you've said about the other sutures in the skull makes me wonder whether the different methods of opening the palatal suture might give different degrees of change in the nasal structures.

 

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Posted : 06/01/2020 2:06 am
Stolten
New Member

@entelechy

I just got answer from Won Moon regarding MSE practioners in Europe and there is actually one in Paris.

The list that Won Moon sent me is below. I suppose there are others here that would be interested i this info. 

1. UK: Richard Cousley took my course in the past.

Richard Cousley BSc, BDS, MSc, FDS, FDS(Orth) RCS

Consultant Orthodontist and Clinic Director

The Priestgate Clinic

www.priestgateclinic.co.uk

‪01733 865000‬

 

2. France: Dr. Fillion Sponsored my course for two years in Paris.

Dr. Didier Fillion

smile@drfillion.com

 

3. Here are my other European colleagues with extensive MSE experience (my former students and now my collaborators):

 

Spain (Madrid): Dr. Ramon Mompell, ramon.mompell@gmail.com 

Italy (Treviso): Dr. Daniele Cantarella, danielecant@hotmail.com 

Germany (Munich): Dr. Christoph Moschik, christoph.moschik@gmail.com 

 

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Posted : 06/01/2020 6:31 pm
Sceriff liked
Ezcanor
Active Member

@entelechy

Thank you so much i'm in NYC so there is a provider in my area. Yea I'm hoping to reverse the effects of extractions that I had when getting braces which have made my arch narrow but I've always had okay tongue posture but never had enough space so I grew up with some asymmetries. Hopefully, MSE can improve my mid-face cause there is a lack of bone definition in that area.

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Posted : 10/01/2020 1:20 pm
entelechy
Trusted Member

@greyham

  • I would suggesr Dome.  I spoke to one of fhe inventors.  Stanley liu at stanford. For two hours.  Am convinced it is best option and better than mse alone.  You coukd email him and say I tecommended Dome to you and if knows who in your area can do it.  He is a specialust in apnea issues and sleep and is both an ent and a surgeon. Brilloant kind guy. I would do it with him in a flash if i had insurance in the usa

entelechy

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Posted : 10/01/2020 5:13 pm
entelechy
Trusted Member

@ezcanor

Hello Ezcanor,  I am in NYC on Sunday, and could either meet or speak that afternoon (anywhere by either Penn Station or by 14th and 6th)  about all options for reversal.     I have investigated every option for two years, and interviewed about 100 doctors on these options, from Bill Hang to  Won Moon, and have a complete list of possible providers.  As summing up 2 years of research is not possible in a message, speaking   by phone or in person would be best.  Can send you my whatsapp number in a private message.  I also am working on an advocacy project to help all extraction victims , and can tell you more about it when we speak.     In the meantime, here is a survey I devised, which will give you an indication of the symptoms that most premolar victims have.   Please do take it if you have  a moment.   The results for the last quarter have just been published in the UK craniofacial magazine Clio, and I can send you these results as well.   

'survey  (please pass on to anyone you know who had extraction ortho):  https://docs.google.com/forms/d/e/1FAIpQLSfES0DTiu4DxUvaKIePxDXnTNZYF6GMTZN9DO0uE8xAYec6nw/viewform?vc=0&c=0&w=1

entelechy

ReplyQuote
Posted : 10/01/2020 6:44 pm
greyham
Active Member
Posted by: @entelechy
  • I would suggesr Dome.

Thanks again. My orthodontist recommended I get DOME+MMA and referred me to a local ENT surgeon who I believe does it. I'll ask him more at my appointment with him, next month. Cheers, Graham

ReplyQuote
Posted : 10/01/2020 7:36 pm
Stolten
New Member

@entelechy

I would be interested in the results of your survey prensented in Clio. Please e-mail it to me at egronstolt@gmail.com or by PM.

Best regards

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Posted : 10/01/2020 7:44 pm
Ezcanor
Active Member

@entelechy

 I would very much like to be in contact and be updated on the case. I have received your PM but I don't have WhatsApp do you any other ways of communication. Unfortunately at this moment, I'm very busy as I would be attending a wedding out of the country in a few hours and won't be back until February. 

Sorry if it takes longer to respond

 

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Posted : 10/01/2020 8:00 pm
entelechy
Trusted Member

@ezcanor

Here is the survey attached, and the results of the survey attached.  

https://docs.google.com/forms/d/e/1FAIpQLSfES0DTiu4DxUvaKIePxDXnTNZYF6GMTZN9DO0uE8xAYec6nw/viewform?vc=0&c=0&  

Please take the survey and pass on.   If it can get more than 5000 signatures, this could lead to significant advocacy work for victims.

w=1

entelechy

ReplyQuote
Posted : 11/01/2020 2:47 am
greyham liked
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