jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: PatientZ on September 13, 2015, 02:15:25 PM
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This is the headgear and intra-oral appliance I have made to expand my palate and bring my maxilla up and forwards.
(http://oi58.tinypic.com/2uny6wm.jpg)
Provides an upwards and forward force on the palate, without touching the teeth and leaving enough space for proper tongue posture to assist the movement. The reaction force is splint between the forehead (70%) and the chin(30%). It also expands the palate from the bone exclusively as the appliance is NOT teeth anchored. I am getting about a total of 2kg of constant force on my maxilla. I am actually wearing a newer version of this headgear, which is less bulky and more comfortable during sleep.
(http://oi62.tinypic.com/2mi49z7.jpg)
This is still the best proof I have that it can work. I talked to the author of that study and he said that the key is VERY HIGH force and VERY FREQUENT wear, although he doubts it's feasible on humans. In the study, they used 1kg of force (monkey's head is smaller than human's) and a 24h wear for 4 months. Skeletal changes are huge for four months, but it messed up the occlusion as his appliance was anchored to the molars.
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Why are you doing this instead of going to a professional?
Because my case is too mild to warrant a significant LF1. I am going for aesthethic improvement, and I can only get 3mm advancement with a LF1 (too little aesthetic improvement) and I would have to wear braces for years. It also does not include palatal expansion or maxillary impaction.
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The headgear "works best" through moderate and even force. Anyhow, it's all for nothing unless you want to wear it for the rest of your life. Nearly everyone I know that has gone this route have stated that the "results" go back over time. I've tried the headgear stuff too- back in the day- and it's not really that great; you should look into the biobloc for adults instead since it focuses on oral posture (mouth breathing) and addresses needed expansion.
By the way, these headgears can end up making the face looking rat-like since it does nothing for the orbits/upper part of the face.
If I get satisfying results, I will decide whether I want to stop wearing it or not. I have not heard about anyone that has gone this route and achieved actual results, let alone notice them recede over time. Biobloc is great, and I forgot to mention that this whole process is USELESS without continuous proper tongue posture. I am working very hard on maintaining a perfect tongue posture, and complementing it with this headgear. Also, I don't actually need expansion. I am expanding my palate to get a wider maxilla for aesthetic reasons. I can still afford 3mm of expansion before I mess up my bite. After those 3mm, I will wear an invisible retainer and continue to expand the palate while maintaining my occlusion. This is possible because my intra-oral appliance does not touch the teeth at any place.
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You don't actually expand the palate- there's no way of expanding the maxilla unless you surgically do so or start a device at a very young age when the hard palate is "soft" enough. The expansion that biobloc can achieve (in adults) is tipping/flaring the teeth out. This can help with mild crowding and it may avoid extractions.
The issue with head gears is that the bones will always want to go back to where it once was. Muscles can't change unless you elect for resection but, the anatomical layout of your bones, tissue, muscles, etc. etc. can't be altered by the means of a device- especially after you've gone past at least 11 or 12- maybe younger (?). Even surgery for those under 25 have a higher chance of relapse due to the continuation of the bones growing.
I've come across a few adults that have tried this route (head gear/biobloc)- many years ago- at a Mew seminar. We all decided to give adult expansion a try but, in the end- it's somewhat of a "hoax".
Keep up with your headgear project though- who knows, you might be the only person I know (out of the 10 or so adults) that comes out with permanent results.
Btw, how long have you been at this? Does your ortho agree with you?
hes gotten expansion, I've been skyp messaging with him.occasionally for the last couple months, he has gaps between his teeth where there were none.
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You will not get any expansion. You will simply tip your teeth, risking damaged roots and gum recession in the process - all the negatives of orthodontics without any of its benefits.
This stuff is in the same category as urine therapy.
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There is an ortho (dr. Craig jester) literally twenty minutes from my house that does adult non surgical palate expansion, it works just not as fast as kids
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Also why do you care where i live 0__o
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Supposedly this works. What happens to the lower arch?
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I live near Boston and as many of you will know, this is a medical mecca.
My upper palette was narrow. I was told in no uncertain terms by multiple reputable intitutions and professioanls that palette expansion as an adult wasn't happening in any way reliable or methods they would entertain as a solution beyond surgery.
I think what the OP is suggesting is dangerous.
So, OP....good luck on your quest for improvement but I suggest you continue to consult with professionals and investigate your choices including the otion of living with what you have because if your case is too mild for surgery, then maybe you are more fine than you think you are. We are always our own worst critics.
PS. The thing that 27F is telling you about muscle shaping the face (and perhaps returning things to where they were) is very real so please consider her advice.
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I live near Boston and as many of you will know, this is a medical mecca.
My upper palette was narrow. I was told in no uncertain terms by multiple reputable intitutions and professioanls that palette expansion as an adult wasn't happening in any way reliable or methods they would entertain as a solution beyond surgery.
I think what the OP is suggesting is dangerous.
So, OP....good luck on your quest for improvement but I suggest you continue to consult with professionals and investigate your choices including the otion of living with what you have because if your case is too mild for surgery, then maybe you are more fine than you think you are. We are always our own worst critics.
PS. The thing that 27F is telling you about muscle shaping the face (and perhaps returning things to where they were) is very real so please consider her advice.
I do hope that I am my worst critic, so that I can always improve myself. I have consulted several professionals and their advice ranged from "this definitely will work (current ortho)", to "Your procedure is safe but I doubt you will get any results (author of the adult monkey headgear study)" to "there is no way this will work (researching orthodontist at a university)".I am being very careful with the whole process, but I can now say that I am at a stage where my appliance is safe, because it will not alter my bite in any way except if it actually manages to move my whole maxilla. If I get there, I will have to reconsider the safety issues.
My first appliances touched the teeth and expansion was painful and my teeth were sore because it was tooth movement and not bone movement. Now, I can wear the headgear for 8 hours with high forces and then start chewing hard gum immediately after and my teeth will not be sore at all.
Yes, this discussion is reinforcing my belief that muscle forces will always try to bring my facial bones back to their original position. This can also play in my favour because the tongue is quite a strong muscle and I can use it to bring my maxilla up and forwards.
Supposedly this works. What happens to the lower arch?
My lower arch is currently untouched, as I have a mild Class III skeletal relationship, meaning that my maxilla is smaller and further back than my mandibule. I must maintain my occlusion during the process and if I manage to move my maxilla up and forward, my jaw will also slightly move forward maintaining a good balance. This is all speculation though, I am still focused on obtaining any kind of movement on the upper jaw.
You don't actually expand the palate- there's no way of expanding the maxilla unless you surgically do so or start a device at a very young age when the hard palate is "soft" enough. The expansion that biobloc can achieve (in adults) is tipping/flaring the teeth out. This can help with mild crowding and it may avoid extractions.
The issue with head gears is that the bones will always want to go back to where it once was. Muscles can't change unless you elect for resection but, the anatomical layout of your bones, tissue, muscles, etc. etc. can't be altered by the means of a device- especially after you've gone past at least 11 or 12- maybe younger (?). Even surgery for those under 25 have a higher chance of relapse due to the continuation of the bones growing.
I've come across a few adults that have tried this route (head gear/biobloc)- many years ago- at a Mew seminar. We all decided to give adult expansion a try but, in the end- it's somewhat of a "hoax".
Keep up with your headgear project though- who knows, you might be the only person I know (out of the 10 or so adults) that comes out with permanent results.
Btw, how long have you been at this? Does your ortho agree with you?
You say there is no way to expand the palate in an adult, this study begs to differ:
Rapid Palatal Expansion in the Young Adult: Time for a Paradigm Shift? • Dan A. Stuart, DDS
(http://i61.tinypic.com/2we9s7q.jpg)
This shows clear mid-palatal separation on adults using a teeth anchored RPE.
I agree that traditional palatal expanders will simply tip the teeth out in adults, but this is the most important feature of my headgear: it does NOT touch the teeth at any place. It's impossible for my appliance to tip my teeth because it has ZERO contact with them. I am sure that a lot of people tried to move the facial bones in adults, but they cannot be all grouped together because the method is different. If I had attached a reverse-pull facemask to a RPE in my mouth, I would agree with you, I would completely displace my teeth before any kind of bone growth. But here, the force is transferred directly to the walls of the palate which makes it more efficient and removes the risk of tipping my teeth.
Relapse is one of my big concerns. If i manage to get any kind of results, I know it will probably a constant fight to keep them from going back. But who knows, I will worry about that if and when I get there.
I have been working on this project for 1 year, but most of this time was for the design of the appliance/headgear. I haven't been wearing the non-teeth anchored prototype yet. I came across a lot of challenges in creating this appliance and headgear that took a lot of time to solve.
My ortho this it will work, and other orthos I consulted think it wont.
I don't... but why did you think it was prudent to note that you live 20 minutes away from this guy? Does that make him more "legit" somehow? Anyways, upon further inspection- this Jester guy utilizes palate expanders- nothing new or out of the ordinary.
http://47jp8tgf9ge2lyv7z4740vok.wpengine.netdna-cdn.com/wp-content/uploads/2014/06/Palatal-expansion-document.pdf (http://47jp8tgf9ge2lyv7z4740vok.wpengine.netdna-cdn.com/wp-content/uploads/2014/06/Palatal-expansion-document.pdf)
It's still a huge misnomer though since it doesn't really expand the maxilla but rather pushes the gums and teeth to gain more space/room to tip and widen the arch.
I noticed that the "token cases" these articles like to publish are mainly geared towards slight class ii's, moderate crowding issues or deep bite cases. I've yet to see a good/solid result with a class iii. In theory- if they're able to expand the maxilla by widening the arch- then they should be able to project the maxilla too (since the widening happens across the whole jaw). But alas, it can't because it's not real expansion of the bone. If you look at each type of device made by "insert doc's name here"- the most anterior projection they can offer is to add dinky wires to the backs of each tooth. The biobloc that's modified does something of the sort too but again, it's just tipping the teeth out.
Yes I looked at the expanders used by this doctor and, just like every other expander I have ever seen, it is attached to the molars. This makes it completely unusable to get palatal expansion in adults.
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What was the author of the study's reason for thinking it won't work on humans?
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Wow really cool. What are you going to do in regards to plagal expansion?
Edit. I looked at your picture again and I noticed an expansion screw. Do you think this has enough force to actually expand the maxilla? also are you able to wear this device just for the purpose of palatal expansion?
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I live near Boston and as many of you will know, this is a medical mecca.
My upper palette was narrow. I was told in no uncertain terms by multiple reputable intitutions and professioanls that palette expansion as an adult wasn't happening in any way reliable or methods they would entertain as a solution beyond surgery.
I think what the OP is suggesting is dangerous.
So, OP....good luck on your quest for improvement but I suggest you continue to consult with professionals and investigate your choices including the otion of living with what you have because if your case is too mild for surgery, then maybe you are more fine than you think you are. We are always our own worst critics.
PS. The thing that 27F is telling you about muscle shaping the face (and perhaps returning things to where they were) is very real so please consider her advice.
Haven't read too much of this thread, however just theoretically wouldn't OP improving oral posture improve his chances of avoiding relapse?
And what exactly causes this greater risk of relapse in instances of facial pulling vs surgery? If it's a result of rigid fixation couldn't someone face-pull then get some titanium screws put in? Not that I expect anyone would do that of course.
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The upper jaw has the two halves that it's referring to as the means of "expansion". This isn't going to do jacks**t in the long run- "why?" Like I've mentioned before- it'll go back to what it's accustomed to. The bone needs to be cut in order to make the actual, lasting changes. What you gain through RPE is merely bending the two halves away from each other. SARPE cuts through and allows for the adjustments to heal/fuse. A segmental LF is supposedly the most effective- according to Arnett.
But yes, every ortho will tell you something different. It's difficult to really know what will work and what's best for you. I went through this and it was a total scam so, I don't have a lot of positive things to say. In the beginning, I thought I was getting great results but, in the end- they weren't permanent; just a camouflage technique some orthos swear by.
Since you say it's only for cosmetic purposes, I don't see why not? Just make sure you're not damaging your joints through the whole process.
There is a video of Dr. John Mew where is says that non-surgical and slow(er) palatal expansion is actually more stable than RPE in children, because you leave enough time for the bone to grow when separating it. My goal is to stretch the sutures and and let bone grow in between over long periods of time. I dont see why the surgical option is favourable, if you are able to stretch out / separate the maxilla non-surgically in young adults.
Posture is one thing but, your genetic makeup/anatomical structure is another. It's like doing yoga and eating super clean for all your life thinking it'll prevent you from getting cancer.
Bad analogy, there are a lot of unrelated factors that cause cancer, whereas craniofacial forces can single-handedly influence the growth of the maxilla.
Wow really cool. What are you going to do in regards to plagal expansion?
Edit. I looked at your picture again and I noticed an expansion screw. Do you think this has enough force to actually expand the maxilla? also are you able to wear this device just for the purpose of palatal expansion?
The appliance and expansion screw are very solid and can sustain high forces. They are not a limiting factor in this process. If I only wanted expansion, I would saw off my appliance to only keep the screw and palatal coverage. I could wear this 24h a day and expand very efficiently. I am however going for a 3-directional movement, which requires the bulky appliance/headgear.
What was the author of the study's reason for thinking it won't work on humans?
He didn't say it's impossible, only that it seems unfeasible. He was using high forces for 24h/day on monkeys to be able to obtain a sutural response. Its hard to achieve that much wear time and force on humans because we want the process to be comfortable.
I am hoping that headgear wear + tongue posture will simulate a 24h force exertion on the maxilla and obtain results.
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Op do what you feel best. Make sure to work with an ortho so that he can see if damage will occur. To the people saying there will be no changes, that's a lie. Bone move with short term forces. So theoretically you will see changes over a long time
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OK here is a picture update, after about 1-month wear of my headgear.
(http://oi62.tinypic.com/10hjbpy.jpg)
I have a definite space that appeared between my two front teeth. I had to stop expanding my palate because I don't want it to become bigger. I now have an invisible retainer that goes from canine to canine on my upper teeth, so that I can maintain their position while continuing to expand my palate. This should prevent the gap from getting bigger.
For the people that think this is dental movement, let me remind you that my appliance DOES NOT touch my teeth at any place in my mouth. It only covers the hard palate.
Also, here is an interesting article showing that slow palatal expansion IN ADULTS increases facial width (measured from cheekbone to cheekbone).
http://www.scielo.br/scielo.php?pid=S0034-72992006000200004&script=sci_arttext&tlng=en
OP, I admire your ingenuity. I would like to point out to you that the human skull is a complex, delicate structure. It's really easy to mess it up. I just think you should consider another method and involve experienced professionals in your plan to move your facial bones. I am concerned you may do some damage to yourself.
From personal experience, I would rather say that the skull is a very resilient structure that is hard to disturb. I have been applying various experiment forces on my skull for a year and there has been close to no change. I am hoping that with this finalized prototype will make it happen though.
Please post the after pictures of the damage done to your teeth and jaw in 5 years or so, so no one else will be inclined to try this again.
thanks
The only way I will damage my jaws with this headgear is if I actually manage to displace my maxilla. But since I am displacing it to a more favourable position, there should be no damage. I cannot damage my teeth because they are untouched by my appliance.
I am also being followed by an orthodontist.
Op do what you feel best. Make sure to work with an ortho so that he can see if damage will occur. To the people saying there will be no changes, that's a lie. Bone move with short term forces. So theoretically you will see changes over a long time
I also believe that it is possible in theory. The challenge lies in wearing the contraption consistently for long periods of time.
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PatientZ can i ask you some questions on PM?
What material did you use for the palate expander? where did you get the expansion screw? Did you make that yourself or with the help of an ortho?
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PatientZ can i ask you some questions on PM?
What material did you use for the palate expander? where did you get the expansion screw? Did you make that yourself or with the help of an ortho?
Yes
I used acrylic and bought the expansion screw from an ortho lab. Its all home-made
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@Tom2 RPE as an adult is definitely possible and has been documented up to 70 I think. It's just not possible in everyone. You can actually check with a CBCT but most surgeons are too busy for that and, well, they like surgery. I checked mine but no luck :( Fused solid.
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do you have any before and after pics that show the aesthetic benefit gained my 3mm expansion?
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How about pressures put on the top of your head (and perhaps neck strain) because of the headgear? Are you not worried it might alter your posture with all sorts of other consequences? Just curious cause I can see why the concept to avoid surgery would seem appealing to many but it would be good to also discuss the risks involved with this kind of self-doctoring.
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How about pressures put on the top of your head (and perhaps neck strain) because of the headgear? Are you not worried it might alter your posture with all sorts of other consequences? Just curious cause I can see why the concept to avoid surgery would seem appealing to many but it would be good to also discuss the risks involved with this kind of self-doctoring.
My posture is actually improved when wearing the headgear, because I am focusing on maintaining my tongue on the roof of my mouth. Having a straight neck with chin tucked in allows to exert much more pressure with the tongue. Even when not wearing the headgear I have better posture because I am doing this constantly.
do you have any before and after pics that show the aesthetic benefit gained my 3mm expansion?
I got nowhere near 3mm of expansion yet and no I don't have pictures as of now, no benefits seen. I am still in the early wear stages.
@Tom2 RPE as an adult is definitely possible and has been documented up to 70 I think. It's just not possible in everyone. You can actually check with a CBCT but most surgeons are too busy for that and, well, they like surgery. I checked mine but no luck :( Fused solid.
True, also my headgear is very different from RPE which is messes up the teeth to get skeletal expansion.
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It won't work. My orthodontist made one didn't even work.
They do expand slowly in kids. Some wear the expander for 9-12 months to stabilise. After my headgear didn't work I had SARPE and it's the best result I've ever had.
I don't know where you get your 'information' but it isn't all correct.
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It won't work. My orthodontist made one didn't even work.
They do expand slowly in kids. Some wear the expander for 9-12 months to stabilise. After my headgear didn't work I had SARPE and it's the best result I've ever had.
I don't know where you get your 'information' but it isn't all correct.
Ok... well what did your orthodontist make exactly, I strongly doubt it was a reverse-pull facemask that is not teeth anchored, like mine is. The facemask is also different from an expander and SARPE. I linked at least two studies showing that palatal expansion can be achieved in adults, so this is where I get my 'information' from. I would say that this is more valuable from the opinion of a single ortho, as most of the time they don't bother with complicated methods and send adults straight to surgery.
Also if your goal was to widen your palate to get a better occlusion, then sure go with SARPE its much faster. But my goal is to expand and constrict my palate repeatedly while applying an up and forward force on my maxilla so that I can move the whole bone in my face. For this goal, SARPE is not a good solution. I also have not seen a single picture with aesthetic gains from SARPE.
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I think you need stable results first and then you can back up this argument.
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Hello, PatientZ!, I would like to make my own reverse pull facemask, (otherwise proposing it to my dentist) like yours is, but I don't know how to bulid it up! Can you give more instructions? and tell us how is it going with that? Are you having results??
Also, I would like to share with you these two things that you can search on the internet, and read your opinion:
First is "the Mew vector"
made by Mike Mew, and of which there are some videos of the Mew clinic which explain almost entirely (a part from the back placed elastic) how it is built, and how the force is given: upward and forward.
The other one is: "the Grummons facemask"
a mask that you can search for on the google and even purchase it...
what do you think about those two devices??
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that s**t doesn't work on adults, sorry. and mike mew is scammer.