MARPE Expander, MSE, Homeoblock, DNA Appliances for TMJ Sleep Apnea and Mouth Breathing

Palatal expansion with the DNA appliance compared to maxillary palatal expansion (MSE). MSE and DNA appliances are two different ways to do adult palatal expansion. MSE is a more aggressive form of rapid maxillary expansion. MSE uses mini implant assisted bone level techniques. The DNA appliance is a conventional orthodontic expander that works for adults.
The treatment of TMJ pain, sleep apnea and mouth breathing is an area of great debate. There are many different treatments and there is not one clear way to properly treat these conditions. Maxillary skeletal expanders or MSE is a surgical technique used by many orthodontists and oral surgeons to address a small upper jaw. There are also many other jaw surgery techniques to address TMJ pain and sleep apnea.
An alternative to surgery is using orthodontic expanders such as the DNA appliances and the Homeoblock device. These devices are also called tooth born expanders and adult forward growth or anterior growth appliances.
This video discusses the advantages and disadvantages of maxillary skeletal expansion versus tooth borne appliances such as the DNA and Homeoblock appliance. The basic gist of this video is that one is not better than the other one, but rather the appliances can sometimes be used together to deliver the best result. There are certain situations where a more conservative approach with the DNA appliance and Homeoblock appliances are indicated and only if the tooth born expanders are not successful, then the use of a surgical appliance such as a maxillary skeletal expander is needed.
Maxillary skeletal expanders will produce more expansion of the max saw however the technique involves more risk and guarantees the need for braces and additional appliances after treatment.
Homeoblock and Dena appliances can promote growth, but much more slowly. The appliances can promote growth in three dimensions of directions and and certain cases can produce a complete result by themselves. Tooth born appliances often times do not require braces and more appliances after treatment. They are much less expensive and carry a lot less risk.
Some people have gotten poor results with the two born expanders including gum recession and, periodontal damage and unwanted movement of teeth. These Poor results are related to improper use of DNA and Homeoblock appliances and expansion of tooth born appliances too quickly. Dena and Homeoblock expanders will only grow bone in the very slow rate and treatment times with the appliances can take 1 to 3 years. There are a number of inexperienced providers and people using the appliances that are using them improperly and that has led to negative outcomes in certain cases.