Author Topic: Could you please give advice to a Doctor trying to perfect maxillary protraction  (Read 10136 times)

Complexx

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I've heard complaints from people using that device & so I was just trying to help. If you feel like you are doing wonderful following your current regime, then I'll just leave it at that, perfectly fine with me.  ;)

I will say this though...

1) According to Tyler's profile he is 23, not 18. <=== Very important.

2) Palatal expansion barely had any "supporting evidence" either just a couple years back.... There is enough anecdotal evidence on the web about FacePulling (from very reputable people by the way) to just call it a "theory", but this is simply just my opinion. IMO there MUST be SOMETHING "appealing" about this FacePulling stuff if you've got 10 positive results being replicated in nearly every person that undergoes this "face pulling treatment" after a couple months- 1 year+, 2) if you've got doctors wondering it/creating their "own" FacePulling device, patenting it and adding it to their practice (Dr.Dean Howell, & if you've got NCR doctors themselves obtaining great results from it.
« Last Edit: January 08, 2014, 08:41:07 pm by Complexx »

Gaia

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I just read that Dr. Howell suggests that you only wear dental appliances such as the Homeoblock for 5-7 minutes a day.

http://www.cheeseslave.com/q-a-october-28-2012/

Scroll down to question #4.

Quote
He says, for most people, the maximum amount of time to wear any dental appliance is somewhere around 5-7 minutes per day. He says that that most dentai/orthopedic appliances such as braces, head gear and palate expanders don’t work because people wear them for too long. If you put your body under stress, your body kicks into the sympathetic mode and builds scar tissue instead of bone. It can only build bone in the parasympathetic mode.

That just sounds crazy to me, but hey, who knows...


eusebius

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My idea is to use the ncr helmet for 30 min a day at a moderate pulling force then using something like the crane at a lower pulling force while I sleep. I have a schwartz palate expander and would use that through the night with the head gear. In the day I am focusing on placing pressure on the roof of my mouth with my tongue ALL THE TIME. It's a habit that has to be developed.

My reasoning is that the space created with the ncr mask must be maintained in order for maximum new bone growth to be created rather than just shifting the position of the different bones in the skull, but pulling forces that are too high for too long may cause scar tissue and activate the sympathetic nervous system.

What do you think about this Dr. Mew?

Mike Mew

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Thank you all for your comments and opinions this is what I was wanting to hear. I did try the old crane which was anchored to the chest and was too mobile compared to the head, but have a hunch that I could make a better design based on the RAMPA japan- not much written in English on it- but I've personally seen the best facial results in adults from it.
It does seem strange that you can get much from even 30min a day, if so would a heavy and long meal not affect the cranial structure and teeth. From Ilizarov and the old orthopeadic surgeons I would expect a much longer wear to get the effect.
I agree what things in the mouth are going to be limited which is why I want to look at paranasal inflation and cranial osteopathy and anything else that might work.
The premaxilla is an interesting question, we could discuss it for days but in all the adult skulls that I've seen it is fused as it says in the text books. Also I don't like swartz or DNA or homeoblocks because they are taking up too much of the tongue space and at the end of the day the tongue is one of the major factors that hold the maxilla up and forward. So this is worsening the cause while treating the symptoms- which needs to be minimised.
The research on maxillary expansion really boils down to 4 rather poor papers, I read one in detail only to discover that the patients did not actually expand at the rate that he was talking about, he could have noticed this from his own results. In general the younger you are the more skeletal effect you have and the faster you expand the same- although I thing that rapid expansion is too damaging. It seems that above 25 and 45 make a difference- only anecdotal although if you have a stroke at any age the face melts down fast enough.
Has anyone been using harder levels of inflation or wearing their headgear for several hours a day?
Also I've contacted Plato and would be interested if anyone could recomend anywhere else to goto to ask such questions. Sorry for not being able to respond fast I am up to my eyeballs most of the time. Best wishes, Mike

MessiahMews

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Dr. Mike, here is Plato's Facebook profile, if you would like to friend him on Facebook.

And he's also a very handsome guy and newly certified NCR practitioner in the NYC area.

https://www.facebook.com/plato.powers

Knoppe

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Dr.Mew, thank you for replying and for perticipating in the discussion. It's of much help for people like me who live abroad and have very limited possibilities to find a pro to work with.

About the treatment time for face pulling. Would you say that the effect your talking about is bone growth or maxillary movemet? I'm thinking that bone growth for sure would resuire more time but that some peoples results, including the NCR results could be from moving bones (instead of growing bones)? I'm thinking adjustment like chiropractic/osteopathic ones.

Thank you all for your comments and opinions this is what I was wanting to hear. I did try the old crane which was anchored to the chest and was too mobile compared to the head, but have a hunch that I could make a better design based on the RAMPA japan- not much written in English on it- but I've personally seen the best facial results in adults from it.
It does seem strange that you can get much from even 30min a day, if so would a heavy and long meal not affect the cranial structure and teeth. From Ilizarov and the old orthopeadic surgeons I would expect a much longer wear to get the effect.
I agree what things in the mouth are going to be limited which is why I want to look at paranasal inflation and cranial osteopathy and anything else that might work.
The premaxilla is an interesting question, we could discuss it for days but in all the adult skulls that I've seen it is fused as it says in the text books. Also I don't like swartz or DNA or homeoblocks because they are taking up too much of the tongue space and at the end of the day the tongue is one of the major factors that hold the maxilla up and forward. So this is worsening the cause while treating the symptoms- which needs to be minimised.
The research on maxillary expansion really boils down to 4 rather poor papers, I read one in detail only to discover that the patients did not actually expand at the rate that he was talking about, he could have noticed this from his own results. In general the younger you are the more skeletal effect you have and the faster you expand the same- although I thing that rapid expansion is too damaging. It seems that above 25 and 45 make a difference- only anecdotal although if you have a stroke at any age the face melts down fast enough.
Has anyone been using harder levels of inflation or wearing their headgear for several hours a day?
Also I've contacted Plato and would be interested if anyone could recomend anywhere else to goto to ask such questions. Sorry for not being able to respond fast I am up to my eyeballs most of the time. Best wishes, Mike

Complexx

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Dr.Mew, with all due respect, you sound too "traditional orthodontics" based. It's almost as if you have a "protective shield" up to protect you from this new up and coming approach that completely disagrees with traditional orthodontics. If you (or any other Dr. for that matter) is still going by the traditional orthodontics guidebooks then you are just going to go around in circles FOREVER! I'm not accusing you of being stuck on the "old way of thinking", I'm just saying that it kind of sounds like you have a certain "guard" up & that you also have many doubts about this type of stuff.


By the way, you said most skulls you have seen were fused? Have you ever had some of your direct patients undergo palate expansion the "new age" way?

In my opinion, traditional orthodontics and all that it stands for is flawed, period. There are some great case studies & papers out there on adult palate expansion (even blog posters that provide pictures) and some anecdotal evidence of adults claiming they've expanded more than 5-10mm/changed their face shape for the better ie:higher/wider cheekbones, stronger chin/jaw, broader smile, better lip support etc. You can even see thatwe have people reporting positive results in the "skeptical inquiry blog" from the DNA appliance. There are positive results EVERYWHERE.

Also, everytime somebody posts a positive review on a site endorsed by traditional orthodontists they get shut down by the moderators... Ironic huh? Lol. It's an honor to have you hear though Dr.Mew.... Hope you don't take this the wrong way.

Complexx
« Last Edit: January 12, 2014, 06:16:38 am by Complexx »

Mike Mew

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Complex,

I really don't give a monkies about what you think of me, this is the internet, you have to have a thick skin, not offence taken. I am here to find the truth and I don't care where I get this from. If you are interested in who I am and my beliefs doing then please do search, I gave enough at the beginning of this post. Try searching me and "black swan" and see if you can follow the letters after it.

Many of you are literally performing experiments on your selves, which are valuable case studies that needs to be recorded and understood completely.

If we are going to find the whole truth and we are certainly not there yet, then we can start with case studies and opinons but we must also use the scienfitic process. Just because one part of the establishment of science is lost it does not mean the whole things is, look at the great advances in some areas of medicine or technology, eveyone acecssing this site has a computer and uses the internet. Quality research and good logic works. Don't throw the baby out with the bath water. Published evidence, even by the old gaurd is still evidence, it is an observation and there is truth in it. WHen you have the full truth then it fits all the facts, of all the papers and give a good explanation for the observations. We need this explanation, the answer or the phylosophy that explains eveything, and few are as focused as me in getting that. I've been through several ideas and philosophies and now I am focused on NCR. I'm talking to Dean and Plato and have take an osteopath on and we are going to see what we can do. What I get from this discussion will guide us in what we are doing.

Also only refer to the premaillay suture, I rely on the other sutures for my treatments, they very active in healthy individuals.

Has anyone here used longer pulling times and who can send me photos of what they have achived?

Finaly, please please please, could I ask people to talk some god quality images of them selves before they start treatment as good comparisons. The standard views are frontal, lateral and 45 degree. It is best to take them from a distance by zooming in, and having excellent light, may be not flash (depending on the situation) with a white background, without make up, hair pulled back (try a shower cap), standing upright looking forward ideally into a reflection of your selves (this is best practice), or pretend that you are gazing at the horizon over the sea in the distance. It is important to do this away from natural light that varies at times. Use the same equipment and the same differences, (if you are a real fanatic fix your aperture and magnification).

You never know what is going to happen. I would love to see some good results, but what ever happens you will have a good record even just for your self. You will need someone to give you a hand. Also try a variety of head inclinations, this is from expereince to trying to match before and afters, you can retake one today but not one in the past- unfortunately.

All the best,

Mike

Gaia

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The premaxilla is an interesting question, we could discuss it for days but in all the adult skulls that I've seen it is fused as it says in the text books.

You might want to talk to Dr. Brendan Stack in DC about the premaxilla. He uses the ALF appliance and talks a lot about developing the premaxilla (I heard this from a 45 year old patient).

My cheekbones (the part just below the outer corners of the eyes) have widened quite a bit after I started using the transverse Schwarz appliance. Would this be a sign that the actual palatal suture has widened or could it be something else? (This was before any facepulling or balloon therapy.)



« Last Edit: January 13, 2014, 10:14:25 am by Gaia »

Mike Mew

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Gaia,

Seeing some movement in the malar region (which is what I think that you are describing) is not uncommon with expansion, it does depend on the rate, amount and your age. I think that talking about the premaxillary suture is a bit of a red herring, I would love it to be open to help me with my treatments, but  it does not stop the teeth anterior (the premaxillary region) from being moved in any direction. I could ask Brendan, he is a good friend of my father but I do think it is of much relevance in the larger picture.

Anyone able to give me more concrete feedback? It would be really usfull.

Mike

Gaia

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Seeing some movement in the malar region (which is what I think that you are describing) is not uncommon with expansion, it does depend on the rate, amount and your age.

Is that because the actual mid-suture of the palate expanded though? (As opposed to alveolar bone, teeth tipping, something else.)
I ask this because in Sweden, where I'm from, this debate hasn't even started yet. Doctors here still claim that any expansion in adults is simply teeth tipping. I'm thinking cheek bones coming out might work as some kind of proof that it is in fact the suture. I'm 36 btw and have expanded 1 mm per month, 4.5 mm total.

I intend to post a before and after picture of my cheek in the canine area that came out because of face pulling (separate from the above). Maybe in a couple of days though since I'm currently on a trip.

Again, thanks for checking back here every now and then!

Knoppe

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Gaia. It's good to hear that you're making progress and that you're seeing results. We've talked before, I'm also a swedish resident who dabbled in self-treatment before getting external help.
Sweden is no doubt one of the worst countries when it comes to health care. We pat ourselves on the back for having "free" healthcare but as soon as it's dental, the cost shoots through the roof. Change is needed. Progress pictures is the first step to help people seek help outside of Sweden so that the orthodontic community is forced to consider other ways of treatment. Starve their business and make them change their ways.  It's a free market and I'll be damned if i allow some punk surgeon or dentist to have their way with my body without giving me any options.

rachel

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Dr. Mike Mew --

I commend you for having the balls, curiosity, and integrity to be associated with the Orthodontic Island of Misfit Toys we have going on here.

"The premaxilla is an interesting question, we could discuss it for days but in all the adult skulls that I've seen it is fused as it says in the text books. Also I don't like swartz or DNA or homeoblocks because they are taking up too much of the tongue space and at the end of the day the tongue is one of the major factors that hold the maxilla up and forward. So this is worsening the cause while treating the symptoms- which needs to be minimised."

My tongue is massive and my palate is small and NCR has not fixed any of this.

As noted in a previous post I had an NCR session done after a 6 month break from NCR and I am having very very noticable sensitivity on my infraorbital nerve. This region was noted as being swollen and protruding by my rolfing practitioner after a year of NCR (the only time he was startled and noted something surprising vs. something out of place).

CP

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I would like to add my 2 cents here.
I have tried face pulling as outlined in Plato's site and I've tried the crane headgear.

Also I have been expanding my palate using biobloc (Dr. Gibbs patient from Grand Rapids, MI).

Also the whole time I have been performing self-NCR on myself as taught by Ben of this site.

What I now realize was that as a kid I had blocked nose a lot so I was probably mouth breathing often, especially while I slept.
This was the root cause of crooked teeth, and my maxilla falling downwards and not growing horizontal. This is evident when I view my side profile.

I stopped using the crane because I was only wearing while I slept, and I felt it was too unstable to use while I slept, was worried that it was pulling on the maxilla with uneven forces.

Also Plato's facepulling technique gave me some noticeable results at first, like my cheekbones becoming more pronounced. however I stopped seeing changes after a while. this technique seem to slightly bring the whole face forward, not just the maxilla.

With face pulling technique I felt most pressure on the cheekbones during treatment, so it wasn't necessarily bringing the maxilla up and forward in the face, it was pulling on the whole face more.

I was doing all of these technique before I learned about the importance of correct tongue posture...

My current understanding is this, what I need is for my maxilla to come up and forward in the face, because it had dropped back and down as a kid since I resorted to mouth breathing often, this is evident by the fact that I had clogged nostrils a lot.

2 months ago I finally go the biobloc out and I went into light wire braces to align the teeth. I had expanded the palate considerably (for 1.5 years), and reopened the extraction spaces that had been closed by previous orthodontics.

What I am learning now, is that since I expanded the palate, I now have larger nasal passage way, so my nose is way less clogged, this allows me to train to make nose breathing the habit and always keep my mouth closed. Also because of the expansion, I now have the room to rest my tongue on the roof of the mouth.

Gram for gram I read the tongue is the strongest muscle in the body, so I am now using the tongue to push the maxilla up and forward in the face. I am beginning to see subtle results already with this. My guess is that If I continue to habitualize proper tongue posture and become a nose breather, and also as an daily exercise push the maxilla up and forward with the tongue, over time this is how I will get proper maxillary protraction. Also my new tongue posture will stabilize the expansion of the dental arch I gained.

As a kid I never learned to rest my tongue like this, so it will be interesting to see how adopting new posture of the tongue will affect my face at a later age. (I'm 24), As an experiment, through out the day I use my tongue to push on the alveolar ridge to encourage/drive the maxilla up and forward.

Also I am still continuing self-NCR on myself, this treatment may be helping this process a long as well.

Although even with self NCR I feel that I am seeing better results after I became conscious of the importance of keeping mouth closed and tongue on the roof of the mouth. It could be possible that when I first began self NCR 2 years ago,, I was still leaving my mouth open often and it was hindering my progress greatly.

This article below was a big eye opener for me:
http://www.jfdental.com/pdf/article-horizontal-growth.pdf

Dr. Mike Mew in your Craniofacial Dystrophy: Modern Melting Faces presentation you mentioned that your face has become better looking over the past 7 years as a result of adopting proper oral posture which is mouth closed with tongue on the roof of mouth.
and your assistants as well have been seeing positive facial changes as a result of adopting these new postures.

Are you saying that before, you and your assistants used to leave your mouth open as well?

Did you just adopt mouth closed, and tongue on roof of mouth as practice just to see positive facial changes? or were you doing other things? like chewing exercises? since you mention one of the issue is we eat foods that are too soft.

if angle of mandible is slanting down, could an adult reshape the mandible at late age to more horizontal mandible, by adopting proper posture?

for example, did you see changes to your mandible as an adult ? since I see that your mandible is pretty horizontal...

Like you said, if so much can go wrong at late age due to conditions like muscle dystrophy, then by using the muscles of jaw and tongue, we should be able to re-shape the bones to the more ideal design. since I believe bone is more like clay that is moldable.

So if our ancestors had well developed mandibles because they chewed a lot more, then if I was to begin doing a lot more chewing, will I be able to change the bone of lower jaw itself towards more developed jaw? for example, chewing more could cause more bone deposition in the lower jaw and actually make the bone bigger over time? Do you have any experience or insight in this, I'd very much like to see your viewpoint on this.

thanks.

Complexx

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I've had braces for 5 years and got them age 16. I have a pushed back mandible, narrow top and bottom dental arches, and I have proper tounge posture (I've had proper tounge posture since God knows when)

I seriously think that it works both ways... If you undergo FP, NCR, Palate Exoansion without proper tounge posture, you will not receive optimal results. Now, in my case, I feel like since my tounge posture is good everything should go great and I shall receive the best results possible since tounge posture seems to be extremely important. I don't really think that you can get around your entire problem if you're not addressing EVERYTHING. Practicing proper tounge posture without fixing a narrow top or bottom arch will just leave you disappointed & vice versa.

CP: Did you expand your bottom arch considerably width wise?