Narrow Palate and Jaw Surgery (MMA)

[jawzmcgee]

Hi all,

Does anyone know if MMA can widen the upper and lower palate (if they're both equally narrow right now)? And if not, can they be widened later down the line (post-MMA surgery recovery) in the event that it is deemed necessary?

I have a narrow upper and lower jaw, both are recessed. The surgeon is proposing MMA w/ CCW. The ortho said my jaw is narrow but not horribly so, and that they cannot widen both jaws, only the upper which would cause a crossbite if the lower is not widened.

[kavan]

They can only widen the upper jaw but not the lower one. Sometimes SARPE (Surgically Assisted Rapid Palate Expansion) can be offered PRIOR to the main surgery aimed at bringing both jaws forward. But it would depend on a prediction on whether the teeth of both jaws would 'mesh' correctly (have good occlusion) if you got palate expansion before hand.

[GJ]

Your ortho is generally correct. They will widen the lower in rare cases (e.g. birth defects), but since it's connected to the condyle, it puts too much torque on the joint to be a legit procedure. They can flare the teeth orthodontically, or if you're under 18 they can try actual expansion while the bone is malleable (debatable whether this works).

The upper can be cut into pieces and widened since it's not attached to the condyles. The big risk with that procedure is blood flow -- it can get cut off and cause the bone/tissue to die. So if you get that done, make sure to ask how many times the surgeon has done it. It's not super common, and some guys don't do it.

[jawzmcgee]

s**t well I hope I don’t need expansion then... hoping that the MMA alone solves the airway problem.

[jawzmcgee]

Welp... Saw an ENT who confirmed I have UARS due to a narrow nose + deviated septum as well as a narrow airway (5.5mm) and would need palatal expansion and likely MMA as well.

Now.. how do I choose the best expansion? From what I'm hearing, EASE would be the best but cost the most... MSE would be next but will take longer and may not expand me as I'm almost 30 years old... What about DOME or SARPE?

Anyone here know of MSE cases who expanded a 29+ year old male?

[kavan]

The attending surgeon will either choose for you or assist if there are multiple choices/options.

[Sergio-OMS]

Hi all,

Does anyone know if MMA can widen the upper and lower palate (if they're both equally narrow right now)? And if not, can they be widened later down the line (post-MMA surgery recovery) in the event that it is deemed necessary?

I have a narrow upper and lower jaw, both are recessed. The surgeon is proposing MMA w/ CCW. The ortho said my jaw is narrow but not horribly so, and that they cannot widen both jaws, only the upper which would cause a crossbite if the lower is not widened.

It is waybetter to get the expansion before MMA, but some degree of expansion is possible through a 2 or 3 piece (sometimes 4) Le Fort 1. Also, mandible can widen a bit by means of a midline osteotomy. It is not very conventional though and it requires (in my humble opinion) guided surgery + custom plates.

[PloskoPlus]

It is waybetter to get the expansion before MMA, but some degree of expansion is possible through a 2 or 3 piece (sometimes 4) Le Fort 1. Also, mandible can widen a bit by means of a midline osteotomy. It is not very conventional though and it requires (in my humble opinion) guided surgery + custom plates.

What do you mean by guided surgery?

[Sergio-OMS]

What do you mean by guided surgery?

Use of bone-borne custom (CAD-CAM) titanium cutting guides and subsequent use of custom titanium osteosynthesis material