Ron, I've seen some patients with severely asymmetrical post-DOME results in the past year (both vertical and horizontal asymmetries). I'm putting this out there as updated information and giving a fair warning for those considering DOME and/or MSE with a surgical assist. It seems many patients are not aware of this risk prior to surgery, don't know how to monitor for it, and/or take measures to minimize this unfavorable result.
@@borz55 From what I have seen: 1. the surgeon cuts on one side of the suture instead of directly down the center (in error or because the suture is not straight). 2. one side of the maxilla is already internally rotated and the other externally rotated so expansion forces are not received in the same way on one side of the maxilla vs the other.
If the skull is moving well, the upper jaw moves well at the same time. If the upper jaw moves well, the left and right sides are expanded at the same time no matter what treatment is performed. In most cases, asymmetrical expansion occurs when the movement of the skull does not move well in the three-dimensional direction. If there is a picture of the frontal face where the teeth are visible, it is judged to some extent how long it has been twisted, and the correct one can be known by palpation. Cutting the right bone to make it open is helpful for balanced expansion on both sides, but not for achieving a balance of the entire skull.
my oral surgeon does only a midline cut for MSE patients instead of doing a corticopuncture. He believes this is more effective at reducing the chance of assymmetric expansion.
Hey John! I want to find more information on this because I am going to try to get MSE but I fear asymmetry. Is there a name for only getting a mid-line cut or a way to ask for it? Do you know anywhere I can find info on this? I can't find much. Thank you for your time!
@@bobbyhill2438 I dont know where you can find more info. it’s just called Midline Osteotomy. I didnt get asymmetric expansion, but I couldnt get much expansion even with the midline cut because I’m a male in my 20s with thick bone structure, which is the most difficult MSE patient according to my doctor. He said DOME would be the better way to go, this is probably the case for most males in their 20s, and Ronald is an exception. I could only get 4mm expansion at the bone. there is a person in the comments saying that she saw asymmetry even in DOME patients, I wonder how. I guess the risk is there even for DOME and I dont know enough about the ways to address this, you might wanna ask her. Ashley Sommers is the name in the comments
What are the MSE arms even for? Something to do with stability for installation purposes? When you say 1 turn per day is that from the very beginning or AFTER the split? I thought you turn it more until the split?
@jawhacks I hope you read this ron. The bone borne asymmetry is caused due to difference in suture pressures in the skull hemispheres as described by postural restoration institute as the right TMCC pattern. You can decrease your chances of an asymmetrical expansion by leveling out the cant in your maxilla using PRI exercises before getting the MSE installed
You could possibly encourage an asymmetric split by very slightly angling the MSE appliance on the more recessed side. This would lead to the less recessed side pushing back, and the more recessed pushing forward. Ideally the backward pushing side would find more resistance as it is pushing against the skull. This would be pretty risky, though, as it may just induce more asymmetry. Could be modeled properly to accurately find the angle that would attain desired results.
@@skepticsphere5930 prolly no mandible movement possible unless ones facial structure is still developing. Maybe itd be a necessary mandibular osteotomy yo maintain the bite.
Hi Ron, do you know anything about the consequences of getting greater bone-borne expansion on one side? Would it be only the aesthetic asymmetry or do you think there are some functional consequences as well?
Fantastic video. One thing: I'm going to see an orthodontist for palatal expansion, and was wondering whether you have a preference toward the ALF appliance or the MSE. Thank you.
Hypothesis: Sleeping on your side or stomach may have caused your stubborn side to expand less? Explanantion: Sleeping on your right side (stubborn side) means there's slight pressure exerted on the right side of your face for around 6-8 hours every night. Especially true if you sleep on your stomach while your face lies on the right side.
@@JawHacks It may be interesting see if sleeping on the more expanded side all night would add enough resistance to help overcome things with the stubborn side. I am reaching out to Gelb Ortho for a consult. I definitely have a less expanded right side and would be game to test this theory if I move forward with MSE.
@FoolFaces A better alternative could be to add the criss cross bands that Ron currently has on WHILE you're expanding slowly with MSE. Bonus: Use the facemask during MSE expansion as well.
I’m current on MSE, I have a natural asymmetry from cross bite on my left side. And as expected, my left side was naturally slimmer and “caved in”, after turning for the 19th time, I noticed the right side expanded more than the left. It’s exactly the same thing what you have described in the beginning of your video. Could the crossbite and the way the Jaw was grown to accommodate the bite makes it harder for the MSE to push on the side thats caved in?😊
I have a class 3 maloclussion. I'm thinking about straightening my teeth with invisalign while I save up for a couple of years for MSE and facemask. Would you recommend that? Or am I wasting money?
My MSE provider says bc of my crossbite. My right side will expand more then my left but he says it will be corrected with aligners after MSE treatment is done. So hopefully all goes well
This study suggests MSE expands asymmetrical routinely link.springer.com/article/10.1186/s40510-018-0243-z Perhaps cortipuncture on the side you notice not expanding as much?
Ayye, all love but i have been watching all of your videos and hm.. do you know you can just have surgery ? I see you wearing all these appliance and doing all those thing and all the mewing and everything. I went to see my orthodontiste and there is surgery for your maxilla and your mandible who is covered by your assurance
You can just wear a 3d printed helmet that will add extra pressure or force to the side that is expanding faster... it should be adjustable in force on both sides. Or a rubber band that crosses both sides of the MSE? Hahaha. I just saw the rest of the video... we think alike
The doctor who did mse on me was trash and stealing money from my mom it literally cause asymmetric face one side expanded more than the other and and also a canted tilted smile where should I go to fix this
You should interview Won Moon
I'd be down. I'd also love to interview Dr. Ting. Dr. Marianna Evans or Dr. Newaz.
@@JawHacks Dr. Mahony in Australia?
Ron, I've seen some patients with severely asymmetrical post-DOME results in the past year (both vertical and horizontal asymmetries). I'm putting this out there as updated information and giving a fair warning for those considering DOME and/or MSE with a surgical assist. It seems many patients are not aware of this risk prior to surgery, don't know how to monitor for it, and/or take measures to minimize this unfavorable result.
Thank you for the information.
I wonder how severe asymmetry is possible even with DOME
@@borz55 From what I have seen: 1. the surgeon cuts on one side of the suture instead of directly down the center (in error or because the suture is not straight). 2. one side of the maxilla is already internally rotated and the other externally rotated so expansion forces are not received in the same way on one side of the maxilla vs the other.
I would be wary of DOME
Would you then just recommend old fashioned SARPE if your main goal is tongue space ? @ashleysommers
If the skull is moving well, the upper jaw moves well at the same time. If the upper jaw moves well, the left and right sides are expanded at the same time no matter what treatment is performed. In most cases, asymmetrical expansion occurs when the movement of the skull does not move well in the three-dimensional direction. If there is a picture of the frontal face where the teeth are visible, it is judged to some extent how long it has been twisted, and the correct one can be known by palpation. Cutting the right bone to make it open is helpful for balanced expansion on both sides, but not for achieving a balance of the entire skull.
And how do you make sure the skull moves well. Osteopathic manipulation? is it not true that alf can balance cranial distortions?
Isnt that the cae that people who need MSE, thei jaws dont move well simultaneously?
my oral surgeon does only a midline cut for MSE patients instead of doing a corticopuncture. He believes this is more effective at reducing the chance of assymmetric expansion.
Hey John! I want to find more information on this because I am going to try to get MSE but I fear asymmetry.
Is there a name for only getting a mid-line cut or a way to ask for it?
Do you know anywhere I can find info on this? I can't find much. Thank you for your time!
@@bobbyhill2438 I dont know where you can find more info. it’s just called Midline Osteotomy. I didnt get asymmetric expansion, but I couldnt get much expansion even with the midline cut because I’m a male in my 20s with thick bone structure, which is the most difficult MSE patient according to my doctor. He said DOME would be the better way to go, this is probably the case for most males in their 20s, and Ronald is an exception. I could only get 4mm expansion at the bone. there is a person in the comments saying that she saw asymmetry even in DOME patients, I wonder how. I guess the risk is there even for DOME and I dont know enough about the ways to address this, you might wanna ask her. Ashley Sommers is the name in the comments
What are the MSE arms even for? Something to do with stability for installation purposes?
When you say 1 turn per day is that from the very beginning or AFTER the split? I thought you turn it more until the split?
@jawhacks I hope you read this ron. The bone borne asymmetry is caused due to difference in suture pressures in the skull hemispheres as described by postural restoration institute as the right TMCC pattern. You can decrease your chances of an asymmetrical expansion by leveling out the cant in your maxilla using PRI exercises before getting the MSE installed
Continue to work sir I like your content🙏😁
Thank you Sir.
You could possibly encourage an asymmetric split by very slightly angling the MSE appliance on the more recessed side. This would lead to the less recessed side pushing back, and the more recessed pushing forward. Ideally the backward pushing side would find more resistance as it is pushing against the skull. This would be pretty risky, though, as it may just induce more asymmetry. Could be modeled properly to accurately find the angle that would attain desired results.
so do you think the mandible (or maxilla) on the recessed side will come forward more on the side that is expanded more?
@@skepticsphere5930 prolly no mandible movement possible unless ones facial structure is still developing. Maybe itd be a necessary mandibular osteotomy yo maintain the bite.
Hi Ron, do you know anything about the consequences of getting greater bone-borne expansion on one side? Would it be only the aesthetic asymmetry or do you think there are some functional consequences as well?
Curious as well
A little bit of aesthetic and functional. Functionally, I can tell my tongue is more stifled on the right side than the left.
Fantastic video. One thing: I'm going to see an orthodontist for palatal expansion, and was wondering whether you have a preference toward the ALF appliance or the MSE. Thank you.
ALF only expands and tilts teeth
Hypothesis: Sleeping on your side or stomach may have caused your stubborn side to expand less?
Explanantion: Sleeping on your right side (stubborn side) means there's slight pressure exerted on the right side of your face for around 6-8 hours every night. Especially true if you sleep on your stomach while your face lies on the right side.
Maybe but I didn't sleep on one side exclusively during treatment, or throughout my life.
@@JawHacks It may be interesting see if sleeping on the more expanded side all night would add enough resistance to help overcome things with the stubborn side. I am reaching out to Gelb Ortho for a consult. I definitely have a less expanded right side and would be game to test this theory if I move forward with MSE.
FoolFaces I encourage you to experiment with the sleep thing. 8 lbs of force 8 hours of night is not insignificant.
@FoolFaces A better alternative could be to add the criss cross bands that Ron currently has on WHILE you're expanding slowly with MSE.
Bonus: Use the facemask during MSE expansion as well.
@@JawHacks Ron, how do you plan on using your new face mask now that you've removed your MSE?
Face Mask needs to be anchored to your midpalatal suture
Didn't you say doing a slower expansion would make it less likely for asymmetry to take place?
I’m current on MSE, I have a natural asymmetry from cross bite on my left side. And as expected, my left side was naturally slimmer and “caved in”, after turning for the 19th time, I noticed the right side expanded more than the left. It’s exactly the same thing what you have described in the beginning of your video. Could the crossbite and the way the Jaw was grown to accommodate the bite makes it harder for the MSE to push on the side thats caved in?😊
I have a class 3 maloclussion. I'm thinking about straightening my teeth with invisalign while I save up for a couple of years for MSE and facemask. Would you recommend that? Or am I wasting money?
Face mask and MSE will definitely pull you in the right direction. The rest is details.
Yeah same sir,i have malocclusion class 3
So MSE and face mask first
@@JawHacks Thank you!
Where do you live? Or do you know how to find an mse provider locally
How does this mans not have 100k?
Would the Dome procedure eliminate a lot of the pain that comes from MSE?
Very good job! Could be possible mitigate MSE asymmetrical expansion by sleeping on the weaker side of skull?
What's your opinion of MSE vs DNA appliance?
I'd love to know this as well
Are there actual health/functional problems associated with asymmetrical expansion? Or is it mostly an aesthetic concern?
Mostly aesthetic
3:29 wouldn't you feel it if it the screws were dragging...?
Hey Ron - do you know if the DOME procedure is the same as regular surgically assisted MSE?
Watch his ‘How MSE works’ video, he mentions DOME in that video.
My MSE provider says bc of my crossbite. My right side will expand more then my left but he says it will be corrected with aligners after MSE treatment is done. So hopefully all goes well
I love the shirt, man! TB12!
Is there any point in getting imdo if the maxilla is still gonna be recesses? My bad too ik this the wrong video
Could MSE fix minor nasal septum deviation?
yes
can MSE correct a unilateral posterior cross bite?
I have the same problem
unilaterial crossbite is usually corrected with MSE and if needed with a follow up bimax surgery.
I wonder if bone smashing the sutures could aid in the stubborn sides.
use wooden mallet with flat head
Any ideas to shorten midface
what about SARPE?
Maybe proper supplementation would help, like vitamin K2, calcium, magnesium and vitamin D
What is MSE
This study suggests MSE expands asymmetrical routinely
link.springer.com/article/10.1186/s40510-018-0243-z
Perhaps cortipuncture on the side you notice not expanding as much?
Im no expert, but as a mech eng, it seems to me just by looking at the device that asymmetry is a feature of it.
Face mask risks and benefits
Ayye, all love but i have been watching all of your videos and hm.. do you know you can just have surgery ? I see you wearing all these appliance and doing all those thing and all the mewing and everything. I went to see my orthodontiste and there is surgery for your maxilla and your mandible who is covered by your assurance
You can just wear a 3d printed helmet that will add extra pressure or force to the side that is expanding faster... it should be adjustable in force on both sides. Or a rubber band that crosses both sides of the MSE? Hahaha. I just saw the rest of the video... we think alike
Aber der hat ein anderes Gerät eins das nicht an den Zähne befestigt ist
This is why surgical cut is superior. You dont have to worry about asymmetry.
sup gigachad
you mog barrett and chico
The doctor who did mse on me was trash and stealing money from my mom it literally cause asymmetric face one side expanded more than the other and and also a canted tilted smile where should I go to fix this
The men who did mine told to turn it twice in the morning and twice in the night wtf
I also have deviated nose
@@camino9651 Did you find any help to fix it? I am currently experiencing the same problem.
@@ItsKroov no yet still looking
@@camino9651 i’m having this problem now, did you ever find a solution?