Hi Everyone,
I've been following this forum for a couple of months and thought it's time I share my journey since I could use a bit of advice and see if anyone have had similar experiences.
I was a mouthbreather as a kid. This probably began due to my dustmite allergy, which was discovered later in my teens. I had all of my premolars extracted along with braces when I was 14 to correct some protrusion and minor crowding in upper and lower jaws. It's safe to say that my appearance did not change for the better after this. Neither did my issues with my poor nasal breathing, lip incompetence, or tall and high palate which got even worse. I also started having a lot of jaw joint problems around this time, with the joint clicking and locking painfully so that I was unable to close my mouth and I had to move it sideways manually in order to close it. This disappeared after a year or so.
Fast forward until my late teens when I started caring about my appearance more and as a result started forcing my mouth closed and chewing gum. This is way before I knew about anything related to orthotropics. During this period, I definitely noticed some changes in my facial appearance for the better. However, I always just thought this was a part of my natural growth pattern until a few months ago when I discovered orthotropics (I'm 29 at this point) and decided I needed to look into treatment because all my functional issues still remains. So, in April this year, I had an appointment at the LSFO with Dr. Mike Mew in order to see if I could begin fixing my problems with a palate expander of some kind.
During my consultation at the clinic, I found that my intermolar width was just 29mm. Because of this, Mike thought that a Myobrace would be better fit for me rather than the Biobloc which would take up too much tongue space because of my high and narrow palate. However, after trying out a Myobrace for just a few minutes at the clinic, my left jaw started clicking painfully upon opening and closing and it felt like it was going to dislocate at any second, just like it had done ten or so years ago when I had braces. This also excluded the Myobrace from my options of available treatments. The consultation itself was very thorough and I couldn't be more happy that I went. However, because of my problems, Mike told me I could try and looking into surgical palatial expansions as well. I'm wondering if anyone has gone through with this because no other options worked? It seems more risky, thats for sure, and I'm afraid this would just mess up my jaw joint for good more since it couldn't even handle a Myobrace. I'm very grateful for any advice at this point.
Btw, I've attached some before after after photos below since I thought it would be helpful to share, and also to show that change is possible, even though I've never been able to obtain a correct oral posture.
You could check out the FAGGA thread and see if there are any providers in your area. The FAGGA wouldn't create much transverse expansion, but with your description of temporomandibular joint dysfunction, you might need to focus on saggital expansion first to help take the pressure of the condyle off of the connective tissue in the joint. Then you could use oral posture, or (since your intermolar width is so narrow) other devices to expand in the transverse direction.
Thanks for sharing the story of your appointment with Dr. Mew! It is interesting to hear that he considers using the myobrace system in adult patients.
Thanks so much, this is incredibly helpful. I'll make sure to reach out to some FAGGA providers for consultations since surgery is really the last thing I want to do.
hope yuo will get a better situation for your health.
Do you have trouble breathing through your nose? You're a handsome guy, so I wouldn't consider surgery for cosmetic reasons. Your maxilla have great forward growth. Probably genetically blessed, there.
I doubt surgery carries much risk, but your face will probably change radically if you add 50% width to your palate. Have a chat with a doctor? This seems to have worried you for quite a while, so whatever you do, I suggest coming to a decision, and putting it behind you. Good luck! :)
Thanks for your replies everyone!
I decided to schedule a consultation with a reputable maxillofacial surgeon just to get a second opinion. Surgical palatial expansion is also out of the question at this point since my bite is perfect because of my previous orthodontic treatment. It would involve surgery to widen both the upper and lower jaw and then orthodontic treatment again afterwards. The surgeon instead recommended a lefort 1 and genioplasty in order to resolve my lip incompetence of 12mm.
I have looked into the FAGGA appliance as well but have yet to see enough case studies in order to jump on that. I think for now I might just leave things the way they are.
I think you should use MSE or MARPE instead as this would expand your palate without the need for surgery.
Can you post some front pictures? It doesn't look like your maxilla is recessed at all, perhaps your face just isn't wide from the front because you have a IM width of 29mm?
Skull and Jaw Correction
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