Author Topic: Which mouth appliance and face pulling gear should I consider?  (Read 5075 times)

Maxzilla

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I am 25 years old male and my face changed dramatically in last two years: it became long, restless, tired looking, my-eye balls slightly bulge out of head, I developed exaggerated nasolabial folds and under eye circles, scleral show increased, nose may lengthened but it definitely became more pronounced on face, one eye-ball sunken vertically (down), head tilted forward, posture worsened, for some reason my face appears even more pale, whole face seem to sunk under the eye ridge...in short, just a bunch of signs which indicate vertical growth pattern. The same thing is happening to my sister and happened to my father, so it is either bad genes, syndromic (was already appointed to geneticist by maxillo facial surgeon to check out the situation) or due to airway problems (asthma, allergies, narrow nasal airways). IMPORTANT: No 4-teeth extraction was done ever.

clinical diagnosis I've gathered from multiple orthodontists and maxillo facial surgeon so far: midface deficiency, face asymmetry (mandible about 4mm shifted in left-right direction based on quick evaluation, actual measurements yet to come), vertical growth of face, maxillary and mandibular rotation, mandible recession, long face, teeth overcrowding, narrow upper palate and slight narrow down palate, malocclusion (type I on one side, type II other), was also recommended to visit geneticist (due to slight ear deformity, small ears, low set ears and midface deficiency)

Here are pics of my face changing during early 20's years (dropbox link to lateral, front and images taken from angle):
[link removed]
and here is a link to full directory, if someone can read xrays and would like to see them:
[link removed]

To hopefully improve my face or at least to stop this not-well-understood or better said unknown condition from worsening, I could use invasive methods (orthognatic surgery), but it's success based on seen results is questionable and potentially dangerous - the method that I was officially recommended by maxillo facial surgeon to undergo for my core problem (mid face defficiency) is LeFortIII, so no thanks to that. Also, I don't like the whole idea about surgery because I see it as imposed approach and what I'd want to have is a progressive method which slowly reshapes the form of a whole facial bones trough time and not just  moving some segments of bones without effecting others.



In search of solution, a lot of googling and doing homework gave me these options:
1. Orthodontics to expand very narrow upper palate and align teeth
2. Face pulling with head gear
3. "Mike Mew routine" (teeth,lips together and tong on roof of mouth at rest state and keep pushing tong forward and up when possible)
4. NCR

Where things get frustrating for me is point 1 and point 2, because there seems to be a lot of appliances available and the opinions about appliances are very mixed, but the most problematic thing is that I simply can not find any community which is devoted to cranio-facial remodelling so that I'd be able to get more and less biased opinions. When I asked orthos about appliances, of course, the one they use is the best and everything else is out of question, so a level of bias is unpromising.

I talked with persons like dr Hang, dr Mitani, the guy behind CP, the TMJ (hockey-helmet) guy, the patient zero and others,  the responses were in style
"I recommend biobloc"
"You shouldn't use biobloc, you're to old of that"
"Use Damon and face pull"
"Don't use Damon since it's too dental-oriented, instead cranial"
"The Crane is not good"
"Use ALF + The Crane"
"Face pull for 15-30 mins only"
"Face pull as much as possible"
...

After getting all that mixed feedback, things got a bit confusing and frustrating so at this moment I feel like I am where I started.

So far I came up with these appliances:
-biobloc appliances used by Mike Mew, probably an expander and maybe some "magical" accompanying appliances. Can't dig any info about this.
- ALF - seems to be very interesting device, because it is advertised as appliance which works on skeletal (3D) approach, rather just dental and this is exactly what I think that I need
- FaceMax - looks like a retainer built from plastic for a use with face pulling, but a but odd thing is that one should not wear it more than 30mins per day
-Maxvector appliance - probably face pulling appliance + helmet
- Damon - popular teeth straightening system, but I guess that is about it - just teeth strengthening, no expansion, no 3D effect
-Homeoblock - an appliance which is advertised to work skeletally (whole face, 3D), but I don't like the idea that it's only worn at night and it has no space for tong
- The crane - face pulling device, but this one seem to be mounted around neck rather on head

There are a lot of others too, but these seem to be most common choice.

Please share your opinion on appliance choices, treatment plan design, etc.

Thank you
p.s. please tolerate my English skills, it's not my native language
« Last Edit: January 20, 2015, 05:19:47 am by Maxzilla »

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Oliver

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I feel where you're coming from. Everyone says something different and it's hard to distinguish whats right or wrong.

I'm leaning towards ALFs because I feel like they would expand the palate more then just teeth. I think for expansion with the biobloc is the best, since it sits up in the palate and the expansion force is near the suture. If you live beside someone who uses biobloc then I'd go do that. If not then I think ALFs + braces might be your next best bet. My gut feeling tells me that damons might move teeth more than just actual suture expansion.

As for pulling the maxilla forward, I'd love to believe in FP ( I've never tried it ) but logically it seems that head-gear like the crane could work better. We all know that bones move over time and i'm pretty sure 30 min of FP isn't enough. Then again, I've never tried either so at this point I'm just guessing.


This is still a new thing and there aren't any established methods yet. I say go with your best feelings!

Maxzilla

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Quote
I'm leaning towards ALFs because I feel like they would expand the palate more then just teeth.

I'm also leaning towards ALF not only because of advertised palatal expansion, but it's effect on whole facial bones, especially midface. However, I can not get any feedback from engineer who developed it and orthodontists who use it in practise.

Quote
I think for expansion with the biobloc is the best, since it sits up in the palate and the expansion force is near the suture. If you live beside someone who uses biobloc then I'd go do that. If not then I think ALFs + braces might be your next best bet.
I'll have to go abroad in any case, so from this standpoint it doesn't matter.

Quote
My gut feeling tells me that damons might move teeth more than just actual suture expansion.
This is pretty common opinion that I'm getting about damons. Even my ortho said that they're too hyped, dental oriented and they don't work on palate that good. It's more about quick teeth straightening (tipping).

Quote
As for pulling the maxilla forward, I'd love to believe in FP ( I've never tried it ) but logically it seems that head-gear like the crane could work better. We all know that bones move over time and i'm pretty sure 30 min of FP isn't enough. Then again, I've never tried either so at this point I'm just guessing.
Same thoughts here, but again totally based on theory.


 Thank you for reply

Kratos

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so what changes did you find on your face and is it worth it ? because I'm planning to have this NCR treatment next year only if it works, I would have start my treatment from now on but due to money problem I'll have to manage it till next year for my 6 weeks and 40 sessions treatment, it is expensive too. I've had 1 NCR treatment just to see what will be the difference on my face but I didn't find any change in 1 time. doctor says that he'll guarantee that my face will become symmetrical and headache free after completing whole treatment. but I'm not sure if it will work.While in treatment he just had some massage on my nose, head, temples and neck. he said I won't need for nasal balloon therapy. but still I wanna make sure that IS NCR TREATMENT WORTH IT ? OR AM I WASTING MY MONEY AND TIME BEHIND THIS ?
I'm from India and the doctor or should I say NCR expert who's treating me is only one expert in Asia and he live in another state and comes once in a year in my state for the treatment and he said if I want NCR treatment I'll specially have to go in his clinic where is out of state and the charges will be high because I'll have to live in a hotel for 6 weeks and + treatment charges which is very much expensive as a student for me and my father is retired so I don't wanna put more stress on him. so please help me with my question thanks in advance

MessiahMews

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so what changes did you find on your face and is it worth it ? because I'm planning to have this NCR treatment next year only if it works, I would have start my treatment from now on but due to money problem I'll have to manage it till next year for my 6 weeks and 40 sessions treatment, it is expensive too. I've had 1 NCR treatment just to see what will be the difference on my face but I didn't find any change in 1 time. doctor says that he'll guarantee that my face will become symmetrical and headache free after completing whole treatment. but I'm not sure if it will work.While in treatment he just had some massage on my nose, head, temples and neck. he said I won't need for nasal balloon therapy. but still I wanna make sure that IS NCR TREATMENT WORTH IT ? OR AM I WASTING MY MONEY AND TIME BEHIND THIS ?
I'm from India and the doctor or should I say NCR expert who's treating me is only one expert in Asia and he live in another state and comes once in a year in my state for the treatment and he said if I want NCR treatment I'll specially have to go in his clinic where is out of state and the charges will be high because I'll have to live in a hotel for 6 weeks and + treatment charges which is very much expensive as a student for me and my father is retired so I don't wanna put more stress on him. so please help me with my question thanks in advance

If that doctor didn't use the balloons on you at all, then you didn't get the NCR or EndoNasal Cranial. 

The endo nasl balloons have to be done in order to get the results you want.  The sphenoid bone has to be moved to its optimal position and is only accessed via the balloons.  Massaging it isn't going to make the changes.  Gotta have the balloons used.

Kratos

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I can't send personal message to ben, I think he's having some privacy settings to his account !!

MessiahMews

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I can't send personal message to ben, I think he's having some privacy settings to his account !!

Go to his profile and look again.  His email is on there.

Knoppe

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You just answered your own questions.

Many appliances do the same thing. Bracers are a faster way of getting things done. The ALF is a slower process. I notice some tipping from the bracers at the same time as I now have sufficient width for correct tongue posture.

Rule of thumb for me is: will this appliance enable the tongue to function properly? If yes then why not. Homeoblock and DNA don't. Big nono for me.

Face pulling is easier. Gentle forces and your body tells you when it's had enough. People tend to over pull in terms of force used. BE GENTLE.

The appliances are supposed to help you regain function so that the tongue can function properly.

There is also the aspect of bite height. Check the starecta.com webpage out. The free book is very educational.

The changes in your apperance is symptomatic of a "melting face" as Dr.Mew puts it. It was what finally made me take action.

Ponder for a wile but you need to take action. I'd like to stress the importance of finding the right practitioner over specific treatment modalities. The reason for this is that someone who uses ALF'S to straighten your teeth still won't help you but someone who used homemade bulkier appliances but had the right mindset will be more benificial for you.
« Last Edit: February 06, 2015, 07:11:59 am by Knoppe »