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General Category => Functional Surgery Questions => Topic started by: x on April 24, 2013, 12:20:06 PM

Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: x on April 24, 2013, 12:20:06 PM
+1 to you for posting this as its very helpful, thanks

interestingly my smile looked very wide and very good a few years back just after I'd finished ortho treatment, but my face looked worse overall than it does now despite the narrowing the arch has since undergone
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: Lazlo on April 24, 2013, 12:21:15 PM
+1 to you for posting this as its very helpful, thanks

interestingly my smile looked very wide and very good a few years back just after I'd finished ortho treatment, but my face looked worse overall than it does now despite the narrowing the arch has since undergone

did you have extractions Euphoria?
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: Lazlo on April 24, 2013, 12:23:20 PM
What I would like to know is whether Rapid Palatal Expansion can be administered AFTER extractions. In a sense I'm sure this is possible since a multi-segment lefort I think can be done after extractions. I think it would require having the braces taken off, expander and surgery administered, and then closing the spaces that form through braces again.... quite a process, but again, one that had it been done at the outset would have greatly improved results AND reduced the treatment time considerably.
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: x on April 24, 2013, 12:24:51 PM
did you have extractions Euphoria?
No my ortho didn't believe in them

I had I think an expansion device, it was put on the roof of my mouth and my parents would have to crank it with a key every couple of days. I've since relapsed unfortunately
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: Lazlo on April 24, 2013, 12:28:11 PM
No my ortho didn't believe in them

I had I think an expansion device, it was put on the roof of my mouth and my parents would have to crank it with a key every couple of days. I've since relapsed unfortunately

well your ortho was smart. you may need surgically assisted palatal expansion which will actually grow the bone. it was probably too late for the non-surgical option as that is done before 12yrs of age.
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: x on April 24, 2013, 02:20:09 PM

This is so depressing: basically shows that extractions lead to very poor aesthetic outcomes.
http://www.montanaroorthodontics.com/docs/TheHollywoodSmile.pdf (http://www.montanaroorthodontics.com/docs/TheHollywoodSmile.pdf)

Case I still looks pretty good to me despite a narrower smile

Question for anyone, will SARPE add width to the lower face?
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: Lazlo on April 24, 2013, 02:39:35 PM
Case I still looks pretty good to me despite a narrower smile

Question for anyone, will SARPE add width to the lower face?

no but it will to the mid-face as well as cheekbone fullness.
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: Lazlo on April 24, 2013, 02:41:24 PM
on page 10 of the Hollywood smile article, none of those people have dark buccal corridors. They all have ideal perfect results.
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: CK on April 24, 2013, 03:20:38 PM
Quote
multi-segment (BUT as the A/G article we read indicated there's 30 percent relapse rates with this)

Seriously?!
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: pumukka on April 25, 2013, 01:03:01 PM
I was a borderline case too, my maxilla should had be expanded and then retrude the lower. Now I have a much smaller arch and you can see the teeth marks/shape on my tongue if I pull it out.

They told me the problem now is that if they were to expand my upper arch my lower arch wouldn't match the occlusion because the lower arch cant be widened, not with braces and they didnt mention or know about distrax surgery.

So if they were to do a multisegment or sarpe on you, how would you match the oclusion of the bottom teeth? wouldnt your top palate/arch would be wider than the lower and not fit properly? Im not sure how to explain it..
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: stupidjaws on April 25, 2013, 01:11:31 PM
I was a borderline case too, my maxilla should had be expanded and then retrude the lower. Now I have a much smaller arch and you can see the teeth marks/shape on my tongue if I pull it out.

They told me the problem now is that if they were to expand my upper arch my lower arch wouldn't match the occlusion because the lower arch cant be widened, not with braces and they didnt mention or know about distrax surgery.

So if they were to do a multisegment or sarpe on you, how would you match the oclusion of the bottom teeth? wouldnt your top palate/arch would be wider than the lower and not fit properly? Im not sure how to explain it..

great point.
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: Lazlo on April 25, 2013, 01:11:53 PM
I was a borderline case too, my maxilla should had be expanded and then retrude the lower. Now I have a much smaller arch and you can see the teeth marks/shape on my tongue if I pull it out.

They told me the problem now is that if they were to expand my upper arch my lower arch wouldn't match the occlusion because the lower arch cant be widened, not with braces and they didnt mention or know about distrax surgery.

So if they were to do a multisegment or sarpe on you, how would you match the oclusion of the bottom teeth? wouldnt your top palate/arch would be wider than the lower and not fit properly? Im not sure how to explain it..

Pumukka VERY good points. I take it you also had extractions. Those f**kers. We need to find someone who does the distrax.
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: stupidjaws on April 25, 2013, 01:14:23 PM
i think it becomes just too difficult like this lazio...RPE on top, DO on bottom...then surgery....what the hell!
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: Lazlo on April 25, 2013, 01:25:10 PM
i think it becomes just too difficult like this lazio...RPE on top, DO on bottom...then surgery....what the hell!



You are so right my tartufo di cioccolato, but what other options do I have to get the best results!?
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: pumukka on April 25, 2013, 02:20:11 PM
exactly, RPE/Sarpe on top and DO/distrax on the bottom, but its too much work and most wouldnt want to do it since they want the faster approach.

Originally I was a class III with just 2 incisors flared. My maxilla was a little small and my top teeth flared and the edge touched the lower teeth. on top I had some crowding: my fang a little up and pointy and a little crossbite on one side.

Had they expanded the upper arch, Id would have had that "hollywood smile" (full smile) I wanted, and I still want to, but its gonna be hard finding someone that does sarpe and lower arch DO. The only other option could be reopen spaces, and implants, and even so most orthodontists wont bother to do all that. Ill have a consultation next friday with a good orthodontist and let you guys know what he thinks, even tough I believe he did and still might do extractions because its what is normal to do here....  :-\

Now I'm still a Class III skeletaly, but with 4 bicuspid extractions and top teeth still flared to reach the bottom. Its not super bad but It would had been a very nice smile if it hadnt be f*** up with extractions instead of surgery  :'(

tartufo di cioccolato lol
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: pumukka on April 25, 2013, 02:44:40 PM
Same here, but my case not being that "bad" nor having started yet, whatever I do I wont take short half ass route.

If I go trough it again, wear braces again + surgery and taking all this time off or even trading off the last years of my aspiring "modeling-acting" career it wont be for anything less than that "hollywood full wide smile" I wanted from the start and enjoy it for the rest of my life without regrets of just getting braces to close the gaps from extractions and make my teeth a little less flared, no way jose! im going with that treatment plan, ha!
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: overbiter on April 25, 2013, 03:14:03 PM
i think it becomes just too difficult like this lazio...RPE on top, DO on bottom...then surgery....what the hell!


I've heard of people having both upper and lower distraction, then double jaw surgery. That's what I want too. There was a case on another forum where someone had posted pictures of themselves, before and after the ops. Apparently they looked really good after, a massive improvement in looks. I couldn't see the images because I didn't have the right privileges at the time. I can't remember which board it was, maybe archwired or that other one (not jawsurgeryblog).

Personally I think the real reason surgeons don't usually do distraction is that it is more trouble for them. Think about it, all that follow up work, showing the patients how to do the distraction/making sure everything is going right etc. It's a big myth that cutting and plating is better for adults, because whenever distraction is absolutely necessary, it is always viewed as a wonderful and beneficial fallback option.
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: Lazlo on April 25, 2013, 07:38:28 PM
I've heard of people having both upper and lower distraction, then double jaw surgery. That's what I want too. There was a case on another forum where someone had posted pictures of themselves, before and after the ops. Apparently they looked really good after, a massive improvement in looks. I couldn't see the images because I didn't have the right privileges at the time. I can't remember which board it was, maybe archwired or that other one (not jawsurgeryblog).

Personally I think the real reason surgeons don't usually do distraction is that it is more trouble for them. Think about it, all that follow up work, showing the patients how to do the distraction/making sure everything is going right etc. It's a big myth that cutting and plating is better for adults, because whenever distraction is absolutely necessary, it is always viewed as a wonderful and beneficial fallback option.

Hey overbiter, if you've looked at my other posts on this topic you'll see I'm massively interested in distraction since I do think it is the only/best way to address many of the most imp. issues with this surgery, especially if you have both narrow as well as retruded jaws. If you fine ANY more information or can find the name of the person who had both upper and lower distraction then I'd really appreciate you posting that info. Thanks.
Title: Re: RAPID EXPANSION /MULTI-SEGMENT for--NARROW MAXILLARY ARCH MUST READ!!!
Post by: treevernal on April 25, 2013, 08:12:30 PM
Lazlo, you crack me up LOL