I am in the process to find which procedures and professional would be best for me.
I went to ask if I would be a candidate for MSE. I have a narrow palate and also a small jaw, so there is little space to expand, only 3-4 mm max. Moreover, my bite is good and there is little justification to destroy good oclussion to widen that little bit.
Next step is to find if it is possible to widen my jaw first or at the same time in order to be able to widen the palate. I don't want to do Sharpe and double MMA, as I have flat cheekbones, I worry that would give me a monkey face. MSE would expand laterally my cheekbones.
The problem as you have said, modern jaws are not only recessed posterior/anteriorly, they are small in all three dimensions which is my case, Narrow palate, recessed chin, clockwise rotated jaw.
Thanks for your story. I have a eustachian problem where I get snap crackle pop in my ears. I believe my eustachian tubes are being pressed against. Had inner ear problems too throughout my life. Trouble breathing through my nose too. Right side of my face looks underdeveloped. You think maxillary expansion might be in order...and possibly DJS...?
Popping in the ears could be related to TMJ issues, which in turn could be related to an undersized airway and resulting Bruxism, recessed mandible putting pressure on the TMJs, etc.
Poor nasal breathing could of course wreak havoc on the sinuses and the nasal airways in general, which tie into the eustachian tubes.
Tube problems can also be related to incorrect swallow, which doesn't allow the tubes to drain properly. Incorrect swallow in turn can be related to lack of oral volume and a resulting tongue thrust.
Expansion could potentially address the root cause. See an ENT who understands the jaws, such as Kasey Li or Coral Tieu.
transversal expansion happens because of the mid-palatal suture. For the A/P expansion, potentially there are two other sutures that might be of interest: transverse palatine suture and the incisive suture. Are you aware of any experiment run in the past trying to leverage these sutures for forward expansion? Potentially we could have an appliance with screws fixed at the two sides of the suture (like a rotated MSE) and facilitating expansion by means of corticotomy or similar. Possible complications I would potentially see: less dense bone in the palatine bone (thus no good anchorage for the screws), more fused sutures, smaller space to fit the appliance.
It's an interesting thought but I am not aware of any studies investigating this, or anyone even asking the question informally.
Looking at an image of the transverse palatine suture, I would imagine that trying to place an MSE across it would result in screws dragging backward toward the spinal cord.
The bone at the posterior nasal spine is way too thin to be able to serve as an anchor against all of the bone at the front of the face.
I am in the process to find which procedures and professional would be best for me.
I went to ask if I would be a candidate for MSE. I have a narrow palate and also a small jaw, so there is little space to expand, only 3-4 mm max. Moreover, my bite is good and there is little justification to destroy good oclussion to widen that little bit.
Next step is to find if it is possible to widen my jaw first or at the same time in order to be able to widen the palate. I don't want to do Sharpe and double MMA, as I have flat cheekbones, I worry that would give me a monkey face. MSE would expand laterally my cheekbones.
The problem as you have said, modern jaws are not only recessed posterior/anteriorly, they are small in all three dimensions which is my case, Narrow palate, recessed chin, clockwise rotated jaw.
Thanks for your work Ron
Thank you for sharing this. Your conundrum is one faced by many. Best of luck and keep us in the loop.
Hi Ron,
Thanks for your story. I have a eustachian problem where I get snap crackle pop in my ears. I believe my eustachian tubes are being pressed against. Had inner ear problems too throughout my life. Trouble breathing through my nose too. Right side of my face looks underdeveloped. You think maxillary expansion might be in order...and possibly DJS...?
Thanks,
Carter
Popping in the ears could be related to TMJ issues, which in turn could be related to an undersized airway and resulting Bruxism, recessed mandible putting pressure on the TMJs, etc.
Poor nasal breathing could of course wreak havoc on the sinuses and the nasal airways in general, which tie into the eustachian tubes.
Tube problems can also be related to incorrect swallow, which doesn't allow the tubes to drain properly. Incorrect swallow in turn can be related to lack of oral volume and a resulting tongue thrust.
Expansion could potentially address the root cause. See an ENT who understands the jaws, such as Kasey Li or Coral Tieu.
Hi Ron,
transversal expansion happens because of the mid-palatal suture. For the A/P expansion, potentially there are two other sutures that might be of interest: transverse palatine suture and the incisive suture. Are you aware of any experiment run in the past trying to leverage these sutures for forward expansion? Potentially we could have an appliance with screws fixed at the two sides of the suture (like a rotated MSE) and facilitating expansion by means of corticotomy or similar. Possible complications I would potentially see: less dense bone in the palatine bone (thus no good anchorage for the screws), more fused sutures, smaller space to fit the appliance.
It's an interesting thought but I am not aware of any studies investigating this, or anyone even asking the question informally.
Looking at an image of the transverse palatine suture, I would imagine that trying to place an MSE across it would result in screws dragging backward toward the spinal cord.
The bone at the posterior nasal spine is way too thin to be able to serve as an anchor against all of the bone at the front of the face.
It's great that you've read the piece aloud yourself - keep up the great work, I do love your voiceover!
Thank you very much for the kind words, I will keep up with the voice overs.
20여년간 턱 문제로 고민해 왔던 저에게 당신은 나에게 보석과 같은 존재입니다. 너무 감사합니다