Heads-up people!! This video is just for information and isn’t medical or dental advice-I’m not a doctor, dentist or licensed healthcare provider of any kind. Always check with a qualified professional for your health questions. Use this info at your own risk-it’s not meant to diagnose, treat, or recommend specific providers, products or procedures.
THAnk you for speaking the truth, I am an orthodontist who has been doing tissue and bone borne expansion for over 25 years. I taught at U Penn for over 20 years and we studied and treated alot of these patients. So blessed to have trained some of the best orthodontist in the world who are experts in treating patients with expansion. Keep up the good work
Can you please help explain what happened to me? I wore my invisalign in reverse (I only got to the second aligner. I did it cheap overseas and regretted it). I wore an aligner as a retainer for 6 months part time, then wore my old retainer of my pre-treatment bite to fully reverse treatment. Now I have very little tongue space and my smile is really narrow. I'm assuming the alveolar bone changes weren't possible to reverse but my teeth adapted to the old retainer- so the alignment is similar but I didn't reverse the retraction?
can you name a few orthodontists that you recommend? I had a naso-maxillary expansion and my orthodontist put me in Invisalign and I had full body pains from it!! who can I go to that won't cause this much pain!?
Ok. I am at the 3hr 20 something minute mark......Dr. Li is definitely sounding like the most experienced, forward thinking surgeon.....to date.....who is trying to develop the most effective, least invasive outcome for maxillary expansion and other surgeries....he is trying to work with the natural anatomy so to speak. Thankyou for your tennacity and patience and thoroughness with your research and what you keep presenting.xx
Ron. I highly recommend you look into Christian Guilleminault, he was the Lewis and Clark of sleep apnea and airway restriction. Dr. Soroush Zaghi is the medical director of the Breathe institute and he has INCREDIBLE amounts of airway health and knowledge directly from CG.
Li worked directly with him hand on hand 20+ years. Li was the surgeon executing the research while he was the Neurologist. He worked more closely with him then Dr Zaghi who I dont agree with. Him and Coppelson there MIND procedure etc is terrible
Ron this is one of the most informative videos I’ve seen on airways, jaw surgery, expanders, and beyond. This subject has so many conflicting viewpoints and is still in its infancy in my opinion. You are a pioneer in your own right for getting these amazing doctors on your channel and asking great questions. Thank you
54:40 I feel like he’s not allowed to say but most doctors get a fat paycheque from it so they won’t tell you somethings not that effective. I think that’s what he wanted to say
Wow!!! Ron, amazing interview with Dr. Li. This video is a wealth of information. Thank you for continuing these talks that are so needed in this space with so many great providers. 🔥🌟🔥🌟🔥🌟 Jen Mason
I love the both you seriously man..in a world where everybody will do anything for a dollar especially in the medical community you can truly tell that both these individuals do their gods honest best to just bring the truth to light and honestly help people achieve their expansion/health goals. And that in itself I hope brings them the financial rewards they truly deserve. I can’t wait to be able to afford and go see Casey li. Thanks for your channel as well Ron it’s valued and appreciated!
I am curious as to why Dr. Li is not interested in sharing the EASE procedure with other surgeons........this is the question i asked him.....being that i am from Australia....i would love to have been able to have the operation in my own country..
He has responded to that in another interview. He thinks it's a difficult surgery and that if he comes across a surgeon he thinks he can trust, he can teach it to them. I don't think that's a very convincing reason of not teaching the procedure though. He can't be the only person in the world who can do the cuts he does.
2:35:30 - 2:53:00 is particularly interesting to me, IN ADDITION to Dr. Li's comment about MMA further upturning his patient's already upturned nose. I've noticed that my hook nose, as we discussed in our JawCast episode, can improve my nasal breathing drastically if I either A. manually lift my nose with my finger or whatever, or B. wear nose strips (both of these methods "lift" my hooked nose). So im VERY curious to say the least if I am one candidate who may be able to get away with going straight to MMA, lifting my down swung nose and thus subsequently improving sleep apnea and breathing issues in addition to the aesthetic. Going to consider this before I get back with Dr. Yousefian to start my treatment plan.
Since the TPD has no molar arms, I don't see how you would build in "facemask hooks" the way they do with MSE and custom MARPEs. Perhaps if you did EASE surgical assist combined with a custom MSE or MARPE with facemask hooks.
Theoretically you could use infrayzgomatic bollard plate implants as anchorage for the facemask, it's mainly done for younger people, like how Kasey Li mentioned @@JawHacks& the complete split/sutural disarticulation caused by the EASE surgical split and subsequent expansion would certainly mean a lot less maxillary & midface resistance to the protraction forces, making it easer to pull than something like a toothborne based facemask in a young person
Just had my EASE Procedure last week and I have NO REGRETS. Dr. Li is the GOAT. After working with him, you can consider me his biggest fan. I could immediately breathe better and while I had some slight complications, there is no one else I would go with in hindsight.
Amazing episode. Answered a lot of questions I’ve had floating around regarding expansion and MMA. Thank you Dr. Li for taking the time. Thank you Ron for putting this together.
Ron, At 28:50 you claim to see a faint black line “indicating separation”….How do you know this black line isn’t just the typical linear radiolucency as one would expect to see from post surgical use of piezoelectric device (or any thin bone cutting tool)? It doesn’t necessarily mean there has been a “palatal widening” . The black line just indicates there is no longer the same bone density in this region. A better indication of palatal widening would be to measure an increase in distance from structures that haven’t been altered. Ie inter molar distance, an enlargement of sinus size, etc. In other words, this black line could be just the result of SURGICAL REMOVAL of bone; the “pathway” of bone cutting instrument. In any case…I commend you on having such a distinguished guest to your channel 👍😊
Your assessment would be valid if Dr. Li didn't include the pictures of the alveolus/teeth. These pictures showed that the jaw is slightly wider, which means it was expanded. That means the suture was split.
Thank you so much for getting Dr. Li on here Ron. It’s so confusing trying to navigate through all this information of differing opinions. The orthodontists/doctors u have on ur channel all seem to do well with good results, I just wish there was definitive proof of what is truly the best option. I like what u said before, u can do mse + msdo first and then double jaw surgery later if needed. I have no idea how much expansion I actually need. I don’t want to put providers against each other, but it’s frustrating hearing different claims and stressful knowing I ultimately have to make the call on who to see.
Jawhacks I just wanna say you have increased my knowledge a lot and help me to properly mew. I’m 15 and I have been mewing for 2 months now I’m gonna be 16 in 3 months is it possible to fix what my braces did to me I used to have a protruding chin and good forward growth I haven’t got any extractions
It's the whole cost of the treatment. Including extra placements/devices if needed. Dr Li was basically on call for me the week after surgery. Came into the office on his days off for me multiple times too. The cost of the anesthesia is extra though, which honestly sucks. Mine after insurance cost about $7k. Still fighting with insurance to get the OON coverage they promised me too, but Li's office helps you get insurance approval and submit for reimbursement after surgery. Definitely pricy, but you may get some coverage depending on your insurance. if you want to get pre-approved, talk to Dr. Anil Rama at Sleep and Brain Palo Alto. He can help.
Going to share my thoughts on a few topics in the video. 02:22:13 "Anatomy doesn't change" > Say you're expanding a 50 year old male then sure I would agree that there will always be a lot of resistance to expansion. There are a lot of differences when it comes to anatomy though, such as a 16F is very different from a 50M in how much resistance there is. Some people have thin bone at the hard palate, some people did AGGA or alveolar bone damage, or problems with the teeth, etc. So I think the anatomy varies individual to individual. Now say you have an expander that is completely anchored to the hard palate, what is the rate of hard palate expansion that is possible for what ages of people per week or month or whatever? I don't really know, but it seems to me that due to the anatomy you would want to limit the rate of expansion so that you do not have excessive resistance to expansion. "FME is going to have more failures than custom MARPE" > I guess it depends on your definition of success. If the definition of success for custom is >1 mm at the incisors, or any dental expansion, then it's very successful! In fact every expansion is successful.. I think that the entire premise that custom MARPE is very successful, isn't very accurate, or it's inflated at the least, even though that is the perception. So I would agree that doctors who currently use custom MARPE and consider it 100% success, would likely perceive FME as less successful than custom MARPE, assuming FME doesn't have a spectacular success rate similar or better than EASE. The main issue I have with that perception though, is that you can have a custom MARPE do a 1 mm expansion with the rest dental, and someone will say that's a success, but if another expander had 1 mm of expansion without dental expansion, are they going to say that is a failure? Even though dental expansion doesn't really help the airway and let's say it's done specifically for airway? Correct me if I'm wrong, but I don't understand how that makes sense. The big question though (besides ethics), are customers and doctors going to have the same perception of quality, given the customers are the ones receiving it? If they're sold an airway treatment and in the end they're not better because it just tilted or pushed the teeth out, and they have to get a revision, then because of how online people are these days word of mouth will inevitably spread, especially if doctors aren't doing refunds, agreements, etc. to mitigate that, and so all of a sudden it begins to explain the supply-demand scenario that we have right now with custom or MSE, and EASE, where the wait list and price of EASE is a lot more than custom or MSE, because there's a lot of demand but little supply. In the end marketing quality in the long-term is not very effective, if it isn't of a high quality. Quality is a valuable asset to have when selling something, it increases demand. So as a customer I would hope doctors would want to provide an expansion that their customers want and will be satisfied with.
Thanks for taking the time to chime in on UA-cam comments. Many of the viewers here probably don't access the Discord where most of your thoughts are shared.
I deleted a previous comment because I was too harsh toward Dr. Li. Apologies. I would appreciate an interview with Dr. Coppelson in order to better understand the MIND procedure. It is so hard to decipher what provider to go with and affordability. I'm a 24 year tmj patient. I've only just learned about the airway approach in the last year. I have severe sleep apnea and am on cpap. I have a crossbite that seems too severe to correct with crowning. That is the main thing I want corrected. Although I have many symptoms that seem to fall into tongue tie. I've been told I have a posterior tie. I can't open the can of worms you've personally experienced. I have a low tolerance for arrogance in providers. Dr. Li has had complaints from some about his handling of patients, but he does seem extremely knowledgeable. I have an consult with Dr. Coppelson in a few days. I'm in Glendale, Az. I'm have analysis paralysis. Feeling so scared and overwhelmed but have to do something.
oh man that was a chuncky one. I appreciate you for posting the full thing in go (i wonder if the vid would perform better if it was broken into parts as mentioned in the video itself) I wish I had the funds to go with Dr. Li. As I don't believe the Canadian/ontario options will get me "what I'm looking for" in terms of MMA due to surgeons available .
I was quoted $40k. That did not include surgery room cost if done at the hospital and not at his office. In addition there is the added cost of staying near his office for an additional 10 days to 14 days post surgery.
It does make sense to split the maxilla surgically. Dr. Mew said that expansion can take place successfully right up to 62. I would then factor in or ask......once a woman goes through menopause and the adrenals take over from the ovaries with estrogen production.....the bones may weaken? So maybe just maybe they would be easier to seperate?
For me the only option is probably the EASE because i am missing the teeth that Dr. Marianna Evans Device attach to. I would love to do expansion without surgery under general anaesthetics. I can't wait to see if Dr. Li comes up with something where there is no general anaesthetic.
I also am missing molars and have gum recession so was terrified of MSE pushing on the teeth and the ortho work required to correct the massive diastema from MSE. I did EASE in May and am LOVING how I'm feeling. To me the general anesthesia was worth it to wake up with a diastema and breathing relief. It's PRICY though.
Ron, At 2:15:40 you try to clarify Dr Li’s statement by saying EASE has the best ratio of nasal change to dental change. Highlighting the fact they EASE may have greater result in changing nasal volume without dental change. But…isn’t a large part of the benefit of MSE “arch expansion”? Most of us that are seeking out maxillary expansion are SEEKING FOR SKELETAL ARCH EXPANSION…seeking for more space for our tongues. We want larger nasal volumes, ALONG WITH increasing ORAL volume. So, to just focus on “nasal” volume is only focusing on half of the issue. We need extra room for our tongues to sit against the roof of our mouths. I don’t completely trust this guy. He spends too much time “trying” to prove what he is doing is beneficial, with radiographic scans that don’t prove much. He spends much time trying to degrade others. He never answers your questions with clear answers (too much dancing around issues instead of giving solid answers) If there’s one thing this interview did was allow me to cross someone off my list of potential providers.
May be you don't like his style but is he wrong? Are there good research publications on MARPE or custom MARPE in helping sleep apnea and breathing? I see a decent series that he published on EASE with sleep study results. About the roof of the mouth widening, if the floor of the nose is widened, which is the roof of the mouth, isn't the oral volume increased? He said he has a lot of CBCTs and pictures of his patients in his past lectures so we can all verify it with our own eyes.
If you want improvement in oral volume, you want to expand the mucosa of the palate, which is attached to the hard palate, not the teeth. Dental expansion will provide less improvement to intraoral volume than expansion of the basal bone. The bite can be maintained using Ting's "spiderchain" method to decompensate the angulation of the teeth. That's how you achieve a maximal increase to intraoral volume. Parallel expansion will also provide not only expansion of the oral volume, but also increase the nasal airway dimensions and expand the lateral pharyngeal walls. Expansion of the hard palate is far superior.
I'm curious, Ron, how this interview has resonated with you given all of the great docs you've interviewed, including Dr. Li. Have any of Dr. Li's opinions caused you to change any of your thinking regarding the procedures you discussed here? I appreciated Dr. Li's conservative approach on the patient's behalf.
I'd be interested to hear more about this. I had EASE last month with no issues but some bleeding. I haven't heard anything about this on Reddit or anything either.
For about two years after my consultation with Paul.....i observed the patients who had a Le Forte and or double jaw surgery and i noticed that the patients jaw ended up moving back to its original position....doing what it had been doing for most of its live. There was no other supportive work being suggested.....Mewing...Cranio Sacral work ect......which was another reason i didn't go down that path.......so it wasn't just Paul.....but his response did alarm me. The answer i wanted to hear i guess was how passionate he was about his work and that he wanted to help his patients.
Thanks for doing this. Informative but i still dont have much clarity on EASE and how it really stacks up against MMA and custom MARPE. His answers tend to be meandering and full of insinuation rather than direct.
@@nicholasbrown3443 Sorry, I'm not sure. I searched for him because he was mentioned in this video and I'm looking for a jaw surgeon - I live in Australia. His profile on the Australian Medical Board site says he's been suspended
I don’t understand all of the positive comments. I listened to him for an hour, and he is incredibly talented at using a lot of words without saying anything. My god, it was like a pulling teeth to get any clear answer from him. And, his ego had to be repeatedly stroked to stay on task. Awful presenter, and I feel hardly any more educated than I did an hour ago.
What is this discussion even about ??😂 I was watching a different video while doing chores and somehow UA-cam played this video next. Sounds like two very intelligent people are talking about something related to teeth, and bone expansion, and some crazy treatment people do to expand their...bones?? What??? Are we talking about braces? Are adult braces BAD? I am 26 mins in and I am still not sure about the exact topic.
Lipkins priced have not gone up significantly as far as I know. All he has done is stopped subsidizing the initial consult. The first meeting is $1,500 but that rolls into the cost of treatment which is still sub $13K for MARPE + Invisalign last I heard
Funny....i have had a zoom consultation with Paul Cocranerge......years ago when i was looking at having double jaw surgery for my class III......I asked him why did he choose to become a surgeon....he said he wanted to be an engineer but his father talked him into becoming a urgeon because he would make more money.......i crossed him off my list immediately. He is narrow-minded and not progressive thinking Like Dr. Li and Dr. Evans.....always looking to do better and get better results. I am in Australia in Northern NSW and Paul is also in NSW Sydney Australia.
Heads-up people!! This video is just for information and isn’t medical or dental advice-I’m not a doctor, dentist or licensed healthcare provider of any kind. Always check with a qualified professional for your health questions. Use this info at your own risk-it’s not meant to diagnose, treat, or recommend specific providers, products or procedures.
THAnk you for speaking the truth, I am an orthodontist who has been doing tissue and bone borne expansion for over 25 years. I taught at U Penn for over 20 years and we studied and treated alot of these patients. So blessed to have trained some of the best orthodontist in the world who are experts in treating patients with expansion. Keep up the good work
Can you please help explain what happened to me? I wore my invisalign in reverse (I only got to the second aligner. I did it cheap overseas and regretted it). I wore an aligner as a retainer for 6 months part time, then wore my old retainer of my pre-treatment bite to fully reverse treatment. Now I have very little tongue space and my smile is really narrow. I'm assuming the alveolar bone changes weren't possible to reverse but my teeth adapted to the old retainer- so the alignment is similar but I didn't reverse the retraction?
can you name a few orthodontists that you recommend? I had a naso-maxillary expansion and my orthodontist put me in Invisalign and I had full body pains from it!! who can I go to that won't cause this much pain!?
Thanks Ron for posting the whole interview. Thanks Dr. Li for sharing your wisdom, opinion, and experience.
My pleasure.
Ok. I am at the 3hr 20 something minute mark......Dr. Li is definitely sounding like the most experienced, forward thinking surgeon.....to date.....who is trying to develop the most effective, least invasive outcome for maxillary expansion and other surgeries....he is trying to work with the natural anatomy so to speak. Thankyou for your tennacity and patience and thoroughness with your research and what you keep presenting.xx
I'm grateful to Ron for asking amazing questions. Dr. Li, not so much, he's inaccessible.
Holy smoke, 3h of Kasey Li stream of consciousness!!
Indeed!
I want to thank Dr. Kasey Li for speaking the truth, regardless of the consequences.
Indeed.
Ron. I highly recommend you look into Christian Guilleminault, he was the Lewis and Clark of sleep apnea and airway restriction. Dr. Soroush Zaghi is the medical director of the Breathe institute and he has INCREDIBLE amounts of airway health and knowledge directly from CG.
Li worked directly with him hand on hand 20+ years. Li was the surgeon executing the research while he was the Neurologist. He worked more closely with him then Dr Zaghi who I dont agree with. Him and Coppelson there MIND procedure etc is terrible
The MIND is horrible. Expansion pattern etc all crap.
I'm Korean and I'm listening to the Google Caption feature and there are so many mistranslations. Can you please provide the correct English captions?
Ron this is one of the most informative videos I’ve seen on airways, jaw surgery, expanders, and beyond. This subject has so many conflicting viewpoints and is still in its infancy in my opinion.
You are a pioneer in your own right for getting these amazing doctors on your channel and asking great questions. Thank you
So EASE is the best way currently to improve nasal volume and nose breathing.
But, isn't Dr Li the only person offering the treatment ? I read on reddit that it costs like $30K !
@@nouyed no dr. coppelson in la does it.
@@teethree141no coppleson does MIND. But mind and ease are the best expansion methods
In Dr. Li's opinion, yes. How many are providing his technique, though? Why isn't it more widely available?
54:40 I feel like he’s not allowed to say but most doctors get a fat paycheque from it so they won’t tell you somethings not that effective. I think that’s what he wanted to say
“Ron I’m starting to like you”
Ron:😊
Hi Ron - Does EASE help with maxilla cant? I didn’t hear this being covered.
oof. thats a good one. @JawHacks
Wow!!! Ron, amazing interview with Dr. Li. This video is a wealth of information. Thank you for continuing these talks that are so needed in this space with so many great providers. 🔥🌟🔥🌟🔥🌟 Jen Mason
Thank you!
I love the both you seriously man..in a world where everybody will do anything for a dollar especially in the medical community you can truly tell that both these individuals do their gods honest best to just bring the truth to light and honestly help people achieve their expansion/health goals. And that in itself I hope brings them the financial rewards they truly deserve. I can’t wait to be able to afford and go see Casey li. Thanks for your channel as well Ron it’s valued and appreciated!
Check out the JawHacks official ebook publication on Substack!
substack.com/@jawhacks
I am curious as to why Dr. Li is not interested in sharing the EASE procedure with other surgeons........this is the question i asked him.....being that i am from Australia....i would love to have been able to have the operation in my own country..
Did you watch the video? He answers that in detail..
At what time point in the video did he explain in detail why he is not prepared to train other surgeons? Thankyou.@@dinobambino21
He has responded to that in another interview. He thinks it's a difficult surgery and that if he comes across a surgeon he thinks he can trust, he can teach it to them. I don't think that's a very convincing reason of not teaching the procedure though. He can't be the only person in the world who can do the cuts he does.
2:35:30 - 2:53:00 is particularly interesting to me, IN ADDITION to Dr. Li's comment about MMA further upturning his patient's already upturned nose. I've noticed that my hook nose, as we discussed in our JawCast episode, can improve my nasal breathing drastically if I either A. manually lift my nose with my finger or whatever, or B. wear nose strips (both of these methods "lift" my hooked nose). So im VERY curious to say the least if I am one candidate who may be able to get away with going straight to MMA, lifting my down swung nose and thus subsequently improving sleep apnea and breathing issues in addition to the aesthetic. Going to consider this before I get back with Dr. Yousefian to start my treatment plan.
Good luck with your treatment Robby, keep us posted
You da man Robby
@@JawHackshey Ron can I combine face mask with EASE? Or how else can I get forward growth without surgery. I’m 16 btw
Since the TPD has no molar arms, I don't see how you would build in "facemask hooks" the way they do with MSE and custom MARPEs. Perhaps if you did EASE surgical assist combined with a custom MSE or MARPE with facemask hooks.
Theoretically you could use infrayzgomatic bollard plate implants as anchorage for the facemask, it's mainly done for younger people, like how Kasey Li mentioned @@JawHacks& the complete split/sutural disarticulation caused by the EASE surgical split and subsequent expansion would certainly mean a lot less maxillary & midface resistance to the protraction forces, making it easer to pull than something like a toothborne based facemask in a young person
We asked and he delivered. Next get Lebron on the show.
Just had my EASE Procedure last week and I have NO REGRETS. Dr. Li is the GOAT. After working with him, you can consider me his biggest fan. I could immediately breathe better and while I had some slight complications, there is no one else I would go with in hindsight.
so how much do you actually expand after the device is implanted?
Hello. How are you doing today? I need to have this procedure, but I have fear of the unknown. Paralysis by analysis.
Hi, what have the results been like so far?
So what i like about Dr. Li is that he recognizes that each case is 'unique'. He loves his work......this says it all. xx
Amazing episode. Answered a lot of questions I’ve had floating around regarding expansion and MMA. Thank you Dr. Li for taking the time. Thank you Ron for putting this together.
Ron, At 28:50 you claim to see a faint black line “indicating separation”….How do you know this black line isn’t just the typical linear radiolucency as one would expect to see from post surgical use of piezoelectric device (or any thin bone cutting tool)? It doesn’t necessarily mean there has been a “palatal widening” . The black line just indicates there is no longer the same bone density in this region.
A better indication of palatal widening would be to measure an increase in distance from structures that haven’t been altered. Ie inter molar distance, an enlargement of sinus size, etc.
In other words, this black line could be just the result of SURGICAL REMOVAL of bone; the “pathway” of bone cutting instrument.
In any case…I commend you on having such a distinguished guest to your channel 👍😊
Your assessment would be valid if Dr. Li didn't include the pictures of the alveolus/teeth. These pictures showed that the jaw is slightly wider, which means it was expanded. That means the suture was split.
I love the truth of your channel......keep up the great work. Thanks for bringing Dr. Li onto your channel. xx
Thank you for the kind feedback.
Thank you so much for getting Dr. Li on here Ron. It’s so confusing trying to navigate through all this information of differing opinions. The orthodontists/doctors u have on ur channel all seem to do well with good results, I just wish there was definitive proof of what is truly the best option. I like what u said before, u can do mse + msdo first and then double jaw surgery later if needed. I have no idea how much expansion I actually need. I don’t want to put providers against each other, but it’s frustrating hearing different claims and stressful knowing I ultimately have to make the call on who to see.
I agree. Just take your time and keep on learning. I am personally learning at a rapid rate. Give it another year maybe.
Jawhacks I just wanna say you have increased my knowledge a lot and help me to properly mew. I’m 15 and I have been mewing for 2 months now I’m gonna be 16 in 3 months is it possible to fix what my braces did to me I used to have a protruding chin and good forward growth I haven’t got any extractions
1:49:44 they cut out all of his turbinates? wow
how much money is really needed for EASE? is the 30-35k all in one? with all the support after the operation?
Yes
I honestly don't know.
thanks man!!!@@UsamaKhan-xs9do
Yes, that's all in with follow up contacting multiple times per week by text.
is the 30K cost for all the journey with EASE? or does each analysis via phone 3x a week cost also?
I believe it's the whole treatment, start to finish.
Mine was $30k all in, and I had text access to Dr. Li the entire treatment. He was extremely responsive.
It's the whole cost of the treatment. Including extra placements/devices if needed. Dr Li was basically on call for me the week after surgery. Came into the office on his days off for me multiple times too. The cost of the anesthesia is extra though, which honestly sucks. Mine after insurance cost about $7k.
Still fighting with insurance to get the OON coverage they promised me too, but Li's office helps you get insurance approval and submit for reimbursement after surgery. Definitely pricy, but you may get some coverage depending on your insurance.
if you want to get pre-approved, talk to Dr. Anil Rama at Sleep and Brain Palo Alto. He can help.
@@markmoore3086How are you doing today? Are you happy with the results?
So roughly 37k including hospital/anaesthesia fees?
Can you get neuromuscular dentistry who uses splint and stuff with MSE to interview? ❤
Ron big fan of your content I was wondering if I could book a call with you. About the Orthognathic industry. I couldn’t book one on your website.
Can you fix the Diastema the ease creates ?
Going to share my thoughts on a few topics in the video.
02:22:13
"Anatomy doesn't change"
> Say you're expanding a 50 year old male then sure I would agree that there will always be a lot of resistance to expansion. There are a lot of differences when it comes to anatomy though, such as a 16F is very different from a 50M in how much resistance there is. Some people have thin bone at the hard palate, some people did AGGA or alveolar bone damage, or problems with the teeth, etc. So I think the anatomy varies individual to individual. Now say you have an expander that is completely anchored to the hard palate, what is the rate of hard palate expansion that is possible for what ages of people per week or month or whatever? I don't really know, but it seems to me that due to the anatomy you would want to limit the rate of expansion so that you do not have excessive resistance to expansion.
"FME is going to have more failures than custom MARPE"
> I guess it depends on your definition of success. If the definition of success for custom is >1 mm at the incisors, or any dental expansion, then it's very successful! In fact every expansion is successful.. I think that the entire premise that custom MARPE is very successful, isn't very accurate, or it's inflated at the least, even though that is the perception. So I would agree that doctors who currently use custom MARPE and consider it 100% success, would likely perceive FME as less successful than custom MARPE, assuming FME doesn't have a spectacular success rate similar or better than EASE.
The main issue I have with that perception though, is that you can have a custom MARPE do a 1 mm expansion with the rest dental, and someone will say that's a success, but if another expander had 1 mm of expansion without dental expansion, are they going to say that is a failure? Even though dental expansion doesn't really help the airway and let's say it's done specifically for airway? Correct me if I'm wrong, but I don't understand how that makes sense.
The big question though (besides ethics), are customers and doctors going to have the same perception of quality, given the customers are the ones receiving it? If they're sold an airway treatment and in the end they're not better because it just tilted or pushed the teeth out, and they have to get a revision, then because of how online people are these days word of mouth will inevitably spread, especially if doctors aren't doing refunds, agreements, etc. to mitigate that, and so all of a sudden it begins to explain the supply-demand scenario that we have right now with custom or MSE, and EASE, where the wait list and price of EASE is a lot more than custom or MSE, because there's a lot of demand but little supply. In the end marketing quality in the long-term is not very effective, if it isn't of a high quality. Quality is a valuable asset to have when selling something, it increases demand. So as a customer I would hope doctors would want to provide an expansion that their customers want and will be satisfied with.
Thanks for taking the time to chime in on UA-cam comments. Many of the viewers here probably don't access the Discord where most of your thoughts are shared.
What app is Ron using to take notes and show his pictures
Streamyard
I deleted a previous comment because I was too harsh toward Dr. Li. Apologies. I would appreciate an interview with Dr. Coppelson in order to better understand the MIND procedure. It is so hard to decipher what provider to go with and affordability. I'm a 24 year tmj patient. I've only just learned about the airway approach in the last year. I have severe sleep apnea and am on cpap. I have a crossbite that seems too severe to correct with crowning. That is the main thing I want corrected. Although I have many symptoms that seem to fall into tongue tie. I've been told I have a posterior tie. I can't open the can of worms you've personally experienced. I have a low tolerance for arrogance in providers. Dr. Li has had complaints from some about his handling of patients, but he does seem extremely knowledgeable. I have an consult with Dr. Coppelson in a few days. I'm in Glendale, Az. I'm have analysis paralysis. Feeling so scared and overwhelmed but have to do something.
oh man that was a chuncky one. I appreciate you for posting the full thing in go (i wonder if the vid would perform better if it was broken into parts as mentioned in the video itself)
I wish I had the funds to go with Dr. Li. As I don't believe the Canadian/ontario options will get me "what I'm looking for" in terms of MMA due to surgeons available .
Glad you enjoyed the interview!
The only issue is the $40K+ he charges for EASE and the lack of training others
$40,000? Holy Moley....It is no wonder he only does three operations per week!!
it is 30k i think??
I was quoted $40k. That did not include surgery room cost if done at the hospital and not at his office. In addition there is the added cost of staying near his office for an additional 10 days to 14 days post surgery.
When were you quoted this price? Maybe he has increased the price now because it was $30k until recently.
25% inflation seems moderate
I was expecting 60k by now seeing comments of 30k 3 years ago
Great vid. Could someone please provide access to the discord servers (shuikai or jawshanks)? Dumbear here lost access to my old acc
Link is in the description
It does make sense to split the maxilla surgically. Dr. Mew said that expansion can take place successfully right up to 62. I would then factor in or ask......once a woman goes through menopause and the adrenals take over from the ovaries with estrogen production.....the bones may weaken? So maybe just maybe they would be easier to seperate?
I really wish you could do in person with Dr. Li, similar to Dr. Alfi
For me the only option is probably the EASE because i am missing the teeth that Dr. Marianna Evans Device attach to. I would love to do expansion without surgery under general anaesthetics. I can't wait to see if Dr. Li comes up with something where there is no general anaesthetic.
I also am missing molars and have gum recession so was terrified of MSE pushing on the teeth and the ortho work required to correct the massive diastema from MSE. I did EASE in May and am LOVING how I'm feeling. To me the general anesthesia was worth it to wake up with a diastema and breathing relief. It's PRICY though.
Ron, At 2:15:40 you try to clarify Dr Li’s statement by saying EASE has the best ratio of nasal change to dental change. Highlighting the fact they EASE may have greater result in changing nasal volume without dental change.
But…isn’t a large part of the benefit of MSE “arch expansion”? Most of us that are seeking out maxillary expansion are SEEKING FOR SKELETAL ARCH EXPANSION…seeking for more space for our tongues. We want larger nasal volumes, ALONG WITH increasing ORAL volume.
So, to just focus on “nasal” volume is only focusing on half of the issue. We need extra room for our tongues to sit against the roof of our mouths.
I don’t completely trust this guy. He spends too much time “trying” to prove what he is doing is beneficial, with radiographic scans that don’t prove much. He spends much time trying to degrade others. He never answers your questions with clear answers (too much dancing around issues instead of giving solid answers)
If there’s one thing this interview did was allow me to cross someone off my list of potential providers.
May be you don't like his style but is he wrong?
Are there good research publications on MARPE or custom MARPE in helping sleep apnea and breathing?
I see a decent series that he published on EASE with sleep study results.
About the roof of the mouth widening, if the floor of the nose is widened, which is the roof of the mouth, isn't the oral volume increased?
He said he has a lot of CBCTs and pictures of his patients in his past lectures so we can all verify it with our own eyes.
If you want improvement in oral volume, you want to expand the mucosa of the palate, which is attached to the hard palate, not the teeth. Dental expansion will provide less improvement to intraoral volume than expansion of the basal bone. The bite can be maintained using Ting's "spiderchain" method to decompensate the angulation of the teeth. That's how you achieve a maximal increase to intraoral volume. Parallel expansion will also provide not only expansion of the oral volume, but also increase the nasal airway dimensions and expand the lateral pharyngeal walls. Expansion of the hard palate is far superior.
Excellent interview. You should have Dr Soroush Zaghi.
Would love that.
Can you do a video on mandible expansion in future.
Plz
There was a really important discussion about mandibular expansion in this interview. Check the timestamp for MSDO
I will go with sfot for correcting arch since it is faster and read articles it has less chance of relapse of teeth .
I'm curious, Ron, how this interview has resonated with you given all of the great docs you've interviewed, including Dr. Li. Have any of Dr. Li's opinions caused you to change any of your thinking regarding the procedures you discussed here? I appreciated Dr. Li's conservative approach on the patient's behalf.
There is a patient of Li's that ended up with vision problems after EASE. Have you heard about this? It's happened in MSE patients too.
I'd be interested to hear more about this. I had EASE last month with no issues but some bleeding. I haven't heard anything about this on Reddit or anything either.
@@Lise-in-the-Streets it’s spoken about in adult expansion groups on Facebook
For about two years after my consultation with Paul.....i observed the patients who had a Le Forte and or double jaw surgery and i noticed that the patients jaw ended up moving back to its original position....doing what it had been doing for most of its live. There was no other supportive work being suggested.....Mewing...Cranio Sacral work ect......which was another reason i didn't go down that path.......so it wasn't just Paul.....but his response did alarm me. The answer i wanted to hear i guess was how passionate he was about his work and that he wanted to help his patients.
fascinating, truly
will you have scars on your palate because of MSE expander, or will they go away?
also what is “AUGA”
AGGA?
AGGA Kadabra
You finally talked to the boss, Ron. Fantastic interview. Well done, brother.
Yessir. Thank you for the feedback.
Ron out here pitting the orthodontic/orthognathic world against each other @1:53:09
Haha not my intention, just looking for answers
@@JawHacks yeah of course that's what is most important. Just cracking jokes
Thanks for doing this. Informative but i still dont have much clarity on EASE and how it really stacks up against MMA and custom MARPE. His answers tend to be meandering and full of insinuation rather than direct.
FYI, Dr Paul Coceancig was suspended from practising in Australia by medical authorities in 2024. He's mentioned in this video
Why?
@@nicholasbrown3443 Sorry, I'm not sure. I searched for him because he was mentioned in this video and I'm looking for a jaw surgeon - I live in Australia. His profile on the Australian Medical Board site says he's been suspended
I don’t understand all of the positive comments. I listened to him for an hour, and he is incredibly talented at using a lot of words without saying anything. My god, it was like a pulling teeth to get any clear answer from him. And, his ego had to be repeatedly stroked to stay on task. Awful presenter, and I feel hardly any more educated than I did an hour ago.
Bro @jawhacks you literally asked ALL the questions I had on my mind. I can’t wait to listen. You’re doing god’s work, thank you !
Awesome. Thanks bro
Thankyou Ron and thankyou Dr. Li.........Happy New Year 2024. xx
Do you know how old he is?l
To bad its like 35k
$35-60K with almost zero bonus aesthetic benefits
Isn’t it 30k?
@@hazexo1131 i mean mse doesn’t have much asthetic either
@@Sunrise-fr9jb doesn’t it widen the smile, every patient I’ve seen after results they have a wider smile
@@Sunrise-fr9jb regardless its still pricey af
3:10:51 😂😂😂😂
What is this discussion even about ??😂 I was watching a different video while doing chores and somehow UA-cam played this video next. Sounds like two very intelligent people are talking about something related to teeth, and bone expansion, and some crazy treatment people do to expand their...bones?? What???
Are we talking about braces? Are adult braces BAD?
I am 26 mins in and I am still not sure about the exact topic.
Well done. Now after this video prices are gonna increase drastically just like Lipkins ‘100% succes rate’ MSE
Lipkins priced have not gone up significantly as far as I know. All he has done is stopped subsidizing the initial consult. The first meeting is $1,500 but that rolls into the cost of treatment which is still sub $13K for MARPE + Invisalign last I heard
I'll stick with the MSE and Dome for maximum jaw expansion.
DOME is over bro
@@JawHacks , what does Dr. Joseph Yousefian use to expand the mandible? That's what I was referring to.
@@profortunebaron I believe he uses DAME (Distraction Assisted Mandibular Expansion) = mandibular distraction similar to MSDO
@@marissa7680 oh yes, thank you. That's what I meant to say. DAME, not Dome. 😁✌🏻
Funny....i have had a zoom consultation with Paul Cocranerge......years ago when i was looking at having double jaw surgery for my class III......I asked him why did he choose to become a surgeon....he said he wanted to be an engineer but his father talked him into becoming a urgeon because he would make more money.......i crossed him off my list immediately. He is narrow-minded and not progressive thinking Like Dr. Li and Dr. Evans.....always looking to do better and get better results. I am in Australia in Northern NSW and Paul is also in NSW Sydney Australia.
I appreciate Dr. Li's knowledge and experience, but I think he doesn't want to debate because he doesn't like to be challenged. Good try though Ron.
It’s not clear to me but are you in med school? I think you need to be a surgeon haha
You cannot blame yourself for asking the wrong question.....you are vey neutral and non-political...........