Looking for opinions on the options for creating a wider smile

[Dex1816]

Hi all,

Narrow and improperly formed jaws are synonymous with having a narrow pallet and narrow smile. This is my smile currently: https://imgur.com/GtvFZJP

The pallet isn’t overly narrow, but I would like more lateral tooth show and lessened buccal corridors. (My reasons for wanting DJS is that both jaws are retruded — actual bite is class 1).

As I understand it, there are a few options. The first and simplest is to simply achieve a wider smile as a result of the braces I’ll be having anyway. Of course, this doesn’t actually widen the pallet, but it does have a broadening effect in the way it tips the teeth. Perhaps this would be enough?

Then there’s SARPE of course, which would certainly do the trick, but requires another operation alongside DJS and and a very long time to wait before I can have the DJS op.

There’s also segmental lefort, which is appealing in that it can be done at the same time as DJS, although I have read about issues with relapsing. You’re also limited to only a few millimetres of expansion, but perhaps, along with the effect of the braces, this would suffice?

Finally, there’s the new FME expander that seems to work on people my age: https://www.reddit.com/r/orthotropics/comments/107qbzt/mse_progress_suture_split_this_one_is_actually_an/ 

I’m 26, so maybe this is an option — I welcome any insight on this if anyone has any as I’m still researching it.

Obviously this is all something I’ll ultimately have to discuss with whichever surgeon I end up going with for DJS, but I’d hoped some of you may have insight to offer as I continue to research before hand.

Thanks a lot!

[GJ]

Your teeth look to all be tilted inward. Did you have ortho/extractions?

Would just getting them more upright given the impression of a wider smile?

I'm not really sure about this.

[Dex1816]

Your teeth look to all be tilted inward. Did you have ortho/extractions?

Would just getting them more upright given the impression of a wider smile?

I'm not really sure about this.

Thanks for the reply. I’ve never had any ortho work or extractions, no. This is just how they are.

I thinking that them being in a more upright position may give the impression of a wider smile, yeah, which is why I was wondering if the orthodontics associated with DJS may actually be enough.

[beleriand]

I was at an ortho recently and he said he could give me more smile width with Invisalign alone.  Don't know how much though.

According to this study:

https://pubmed.ncbi.nlm.nih.gov/19062299/

there is more relapse with SARPE than segmental Lefort.  At the end of 2 years, there was only an average of 1mm difference in intermolar expansion between the two (3mm Lefort vs 4mm SARPE).

[Dex1816]

I was at an ortho recently and he said he could give me more smile width with Invisalign alone.  Don't know how much though.

According to this study:

https://pubmed.ncbi.nlm.nih.gov/19062299/

there is more relapse with SARPE than segmental Lefort.  At the end of 2 years, there was only an average of 1mm difference in intermolar expansion between the two (3mm Lefort vs 4mm SARPE).

Interesting, I haven't come across that study before so thanks for linking it. Hope your Invisalign goes well for you.

Perhaps I don't actually have that narrow a pallet and it's mainly the inclination of my teeth. Will have to wait for my scans to find out for sure.

[ChinaBoy420]

You can get maxillary expansion at any age now with custom MARPEs + piezo cortocotomy. They will take a piezo knife and run it down your midpalatal suture to ensure success. However this will require some times and orthodontic treatment, unless your surgeon thinks you can do the ortho portion after your jaw surgery.

I know quite a bit about MARPEs so if you have any questions feel free to ask.

[jigjaw10]

I'm interested in knowing more about options for expanding my pallet. Who does MARPE or similar in Europe?