One fatal flaw that has come to my attention, is that the definition of success, being described as "a split of the mid-palatal suture", is that whenever you successfully perform these type of osteotomies, i.e. midpalatal and midline osteotomies, there should be a slight opening at the mid-palatal suture. This may be a very minor gap, like a fraction of a millimeter. HOWEVER, just because you get this split, it doesn't mean the expansion will be successful, I have seen cases where it then fails as the resistance to expansion is too much for the expander to overcome. This is either due to the circummaxillary sutures being too strong, the TADs not engaging well enough into the bone, i.e. there isn't enough "grip", or the TADs bend. SO, one could fail to expand and yet the provider considers it a success. This is something I am very concerned about, when we are on the topic of "100% success rates". We need to differentiate between a successful surgical-assist, and a successful treatment. After researching this topic a lot more, I have noticed a few things though that could raise the successful expansion rate. 1. The osteotomies are of course going to increase the success rate. 2. The FME expander is quite promising at least to me, maybe in a bit of the same way in that it should increase the success rate. One of the most important factors I have noticed is that the FME has six TADs, which the number doesn't matter so much but what matters more is the configuration and position of them. One of the differences between the FME and MSE is that the FME has a "middle screw" in it's configuration. If you look at CBCT, there is a lot of "thicker bone" more anteriorly, especially at the level of the premolars and more anterior to that. So, if you have a middle screw that engages into the bone around the premolars, you now have a middle screw and a anterior screw that are engaging into this "good bone", as opposed to only anterior screws engaging into it. So, even though the FME has 6 TADs vs 4 TADs, you might argue that actually, it has twice as many TADs engaging into the "good bone" (4 vs 2). It also has these two layers to it's design, which I'm guessing would help with bending. Meaning I believe the FME will "grip" better, and it will "bend" less than the MSE.
Will this method prevent you from splitting your maxilla the maximum amount on the top half of it? Like causing it to split more in a triangle /\ where the bottom half expands more than the upper maxilla?
@@jawley I know many guys who share that same trait who think doing anything to the MPS in order to weaken it (because it's somehow where the resistance is and not in the cheekbones) is just useless. The MPS is relatively easy to separate, the zygomatic bones are cut during DOME. I know of cases where the MPS split and the patient had a diastema but were unable to expand any further due to the fact that the sutures higher up in the maxilla refused to become loose. It isn't really shocking that disinformation of this magnitude continues to be pushed, I mean these are still very new techniques with a relatively tiny amount of research, especially in the realm of how the bone actually reacts with these forces.
@@matttzb my brother in Christ you realize the whole point of piezo is to prevent the MSE from literally failing to split the mps? Which it’s notoriously known to struggle with? The true use for MSE is to increase the airway, the facial changes are just a bonus. Not to mention the price of DOME is at least x3 MSE treatment and it’s only being provided by strictly one person to my knowledge… the zygomatic sutures are weakened from expansion but if you’re looking for the benefits from DOME in MSE then just get DOME….
Hey Ron, Could I get your opinion real quick? Does asymmetry affect mewing progress/position? I found it very difficult to mew when I first started. Despite wrestling to find correct tongue posture, it feels like I’m mewing harder on the left than the right because of a recession/Imbalance… intake? Id be much obliged! I’m Also still waiting for available 1 on 1’s!
I am doing the swallow thing for getting proper tounge posture but in the end there is some part of my tounge still not up there and when i push it up it blocks my airway...what i think that it could be 2 thing happening here either am trying to push too much back or i dont have sufficient volume for my tounge..as in the case of sufficient volume when i open my mouth while my tounge touching the pallette it just fits fine according to me as well as i am able to keep it up while sleeping...can u plz tell whether i am lacking volume or trying to push too back ?
what is the oldest patient to undergo this type of Jaw expansion - I am 58 and being told I need SARPE plus double jaw surgery with about 3+ years of treatmen
Hey There! Just wanted to let you know how much your videos have helped me through my own process. I just started my M.A.R.P.E. journey this week, also with Dr. L. He is the best!
Ron, nothing in medicine is "guaranteed". I can almost guarantee that there are several scenarios (outlandish as they may be) that could come-up that would prevent...umm.."could" ;-) prevent MSE split. Using "absolutes" in medicine is almost never used--Unless your're talking about the guarantee of death for us all. I would suggest throwing in "nearly" or "almost" before the word "guarantee" in the title. But I understand...to say "GUARANTEES" is more dramatic ;-)
One fatal flaw that has come to my attention, is that the definition of success, being described as "a split of the mid-palatal suture", is that whenever you successfully perform these type of osteotomies, i.e. midpalatal and midline osteotomies, there should be a slight opening at the mid-palatal suture. This may be a very minor gap, like a fraction of a millimeter. HOWEVER, just because you get this split, it doesn't mean the expansion will be successful, I have seen cases where it then fails as the resistance to expansion is too much for the expander to overcome. This is either due to the circummaxillary sutures being too strong, the TADs not engaging well enough into the bone, i.e. there isn't enough "grip", or the TADs bend.
SO, one could fail to expand and yet the provider considers it a success. This is something I am very concerned about, when we are on the topic of "100% success rates". We need to differentiate between a successful surgical-assist, and a successful treatment.
After researching this topic a lot more, I have noticed a few things though that could raise the successful expansion rate.
1. The osteotomies are of course going to increase the success rate.
2. The FME expander is quite promising at least to me, maybe in a bit of the same way in that it should increase the success rate. One of the most important factors I have noticed is that the FME has six TADs, which the number doesn't matter so much but what matters more is the configuration and position of them. One of the differences between the FME and MSE is that the FME has a "middle screw" in it's configuration. If you look at CBCT, there is a lot of "thicker bone" more anteriorly, especially at the level of the premolars and more anterior to that. So, if you have a middle screw that engages into the bone around the premolars, you now have a middle screw and a anterior screw that are engaging into this "good bone", as opposed to only anterior screws engaging into it. So, even though the FME has 6 TADs vs 4 TADs, you might argue that actually, it has twice as many TADs engaging into the "good bone" (4 vs 2). It also has these two layers to it's design, which I'm guessing would help with bending. Meaning I believe the FME will "grip" better, and it will "bend" less than the MSE.
Sounds like great progress
This is how you do it! Great provider!!
Will this method prevent you from splitting your maxilla the maximum amount on the top half of it? Like causing it to split more in a triangle
/\ where the bottom half expands more than the upper maxilla?
Dang, wish this was thought of when i first tried. Ive been thinking of round 2 lately.
Confused as to why the face mask wouldn’t be designed to pull up for those with a downswing? Wouldn’t forward or down just exacerbate that problem?
I would love for someone’s experience with this and how it was like for them, thinking about getting this.
Hello doctor, was MSE brought into action as a superior technique to SARPE ? But why is a bone split still done in MSE ? Looking forward for a reply
If you could go back which provider and treatment would you begin with?
1:50
Thats not the biggest resistance for expansion. Its the zygomatic bones lol.
Idk I trust the guy who’s done over 500 MSE cases
@@jawley I know many guys who share that same trait who think doing anything to the MPS in order to weaken it (because it's somehow where the resistance is and not in the cheekbones) is just useless. The MPS is relatively easy to separate, the zygomatic bones are cut during DOME. I know of cases where the MPS split and the patient had a diastema but were unable to expand any further due to the fact that the sutures higher up in the maxilla refused to become loose. It isn't really shocking that disinformation of this magnitude continues to be pushed, I mean these are still very new techniques with a relatively tiny amount of research, especially in the realm of how the bone actually reacts with these forces.
@@matttzb my brother in Christ you realize the whole point of piezo is to prevent the MSE from literally failing to split the mps? Which it’s notoriously known to struggle with? The true use for MSE is to increase the airway, the facial changes are just a bonus. Not to mention the price of DOME is at least x3 MSE treatment and it’s only being provided by strictly one person to my knowledge… the zygomatic sutures are weakened from expansion but if you’re looking for the benefits from DOME in MSE then just get DOME….
nah the palatine suture is what holds the maxilla from expanding. the zygomatic suture holds zygomatic from widening.
Hey Ron, Could I get your opinion real quick? Does asymmetry affect mewing progress/position? I found it very difficult to mew when I first started. Despite wrestling to find correct tongue posture, it feels like I’m mewing harder on the left than the right because of a recession/Imbalance… intake? Id be much obliged! I’m Also still waiting for available 1 on 1’s!
Ron, can you give the name of the German MSE provider you mentioned in a live stream? I forgot
I’m trying to fill out the form for a 1:1 chat with you Ron, the website won’t let me. Can you help? Really need to talk with you asap
I am doing the swallow thing for getting proper tounge posture but in the end there is some part of my tounge still not up there and when i push it up it blocks my airway...what i think that it could be 2 thing happening here either am trying to push too much back or i dont have sufficient volume for my tounge..as in the case of sufficient volume when i open my mouth while my tounge touching the pallette it just fits fine according to me as well as i am able to keep it up while sleeping...can u plz tell whether i am lacking volume or trying to push too back ?
what is the oldest patient to undergo this type of Jaw expansion - I am 58 and being told I need SARPE plus double jaw surgery with about 3+ years of treatmen
Hey There! Just wanted to let you know how much your videos have helped me through my own process. I just started my M.A.R.P.E. journey this week, also with Dr. L. He is the best!
Does this method cut off zygomatic expansion like other methods?
I am wondering the same.
No, this just helps split the mid palatal suture
Great informations
Once i get money i get this to myself
does anyone know whether the sutures that cause anterior/posterior maxilliary growth are loosened if you get a surgical assist?
Seriously, if you’re like a 25-year-old adult male, just get a SARPE or something with actually guaranteed outcome.
😂
@@JawHacks The reality is there are many cases where MSE/MARPE fails and patients would have to go back to the surgical route anyway.
Does Dr.Yousefian use PIEZO ? And is he aware of the placement of tads?
yes
Wait so if you use the Piezo knife you do NOT need the MSE?
Piezo is prior to installation of MSE, it is used to help assist the MSE to split the suture
Do you think mse could help reduce breath per minute ?
Yeah
Is he saying if you're a male over 25 you can't get this?
No, if you are a male over 25 you SHOULD get this.
@@JawHacks ahhh I see
Ron, nothing in medicine is "guaranteed". I can almost guarantee that there are several scenarios (outlandish as they may be) that could come-up that would prevent...umm.."could" ;-) prevent MSE split.
Using "absolutes" in medicine is almost never used--Unless your're talking about the guarantee of death for us all. I would suggest throwing in "nearly" or "almost" before the word "guarantee" in the title. But I understand...to say "GUARANTEES" is more dramatic ;-)
Does the MSE hurt when you first get it or turn it or just regularly wearing it?
Yes. The first few days are definitely not comfortable but definitely very worth it. After about two weeks you tend to forget it’s there
@@jawley can I get more user eye support from this by getting the maxilla more forward!?!
goes why dont u chew mastic gum, why need to spend $20K on appliance which do same thing as a $10 mastic gum would do
@@InsaneRG4172what?
@@dariusjohnson5648 what u not understand?
29 here is not helpful ahh.
Did you fail
@jawhack, Mate I have texted regarding something ultra urgent. Please check.