Yesterday a user on reddit made a post challenging the notion that extractions and braces damage faces. He posted a link to another post where a young lady provided before and after pictures of her orthodontic treatment.
The orthodontist extracted 4 of her pre-molars and then pulled the front teeth back to improve her facial profile.
I thought the post was good and was worth debating but for some reason it was deleted.
I am posting the links here along with the pictures.
https://www.reddit.com/r/orthotropics/comments/biobfj/what_do_you_think_of_this_results_some_say/
From my perspective this is a good example where extractions and retractive braces provide improved facial esthetics but on the expense of tongue space.
Her orthodontist extracted her pre-molars to create spaces and pull the front teeth back. This eliminated her bi-dental protrusion but did nothing to increase her forward growth.
In fact, it made it worse, which means her tongue will be fighting back against those front teeth to move them forward.
I suspect in the long term she will start developing restricted airway symptoms and possibly tmj pain.
One thing for sure is she is going to need to use her retainer for the rest of her life, which she already confirmed.
my story: http://www.aljabri.com/blog/my-story/
The after pic looks about as aesthetic as the before pic.
From a health perspective she got worse.
Imagine if they had focused on expansion. I bet her palate was quite narrow already.
I dont understand how this is possible while pulling the teeth back.
her mandible has swung up so heavily and her face is so much shorter on the right.
I dont understand why her face shortened, and her mandible has swung up and her chin is more projecting because of braces and headgear that moves your teeth backwards?
It makes zero sense to me
I dont understand how this is possible while pulling the teeth back.
her mandible has swung up so heavily and her face is so much shorter on the right.
I dont understand why her face shortened, and her mandible has swung up and her chin is more projecting because of braces and headgear that moves your teeth backwards?
It makes zero sense to me
The head is smaller and a little higher in the after picture which is giving the illusion that it swing up, but it didn't.
It mainly moved a small amount forward because she was wearing class 2 elastics for 1 year.
The biggest change is in her lips moving backward, especially the lower. That's what made the chin become prominent.
She could have had a similar result with geno plasty without needing any extractions though that would have not helped with her upper lip.
my story: http://www.aljabri.com/blog/my-story/
I still dont understand. How moving teeth/maxilla/mandible backwards gives you a more PROMINENT chin.
It still makes zero sense to me.
Anyways, if its this easy to turn a convex profile into something that resembles a decent looking human, why does not everyone do it?
I still dont understand. How moving teeth/maxilla/mandible backwards gives you a more PROMINENT chin.
It still makes zero sense to me.
Anyways, if its this easy to turn a convex profile into something that resembles a decent looking human, why does not everyone do it?
Here is a gif where I resized and rotated the pictures to match. Notice how the lower jaw moves a little forward and lips move allot backward creating a more prominent chin.
my story: http://www.aljabri.com/blog/my-story/
Many reasons to not do this. Such as a very narrowed archway that makes breathing difficult. Or the fact that the TMJ will be stressed.
I had extractions and experienced tinnitus, asthma attacks, back problems, forward head posture (to compensate for narrow airway), and on top of that a horrifying midface ratio.
There is never. Ever. A reason to pull teeth. The aesthetics can be achieved with better ways. Maybe a genioplasty. Or heck widen the damn arch. Most if not all bimax cases feature a very narrow arch with teeth tipping and weak intercanine distance.
Many in China are lip incompetent. I don’t know her race, but I know that the tongue size must be considered. I have read s personal account of a woman who had extraction and she liked her results. She had a forward & blocky face to begin. Lowering the minute chin and stuff helped her appearance, she indicated. Also, she gets lots of compliments on her smile now. Now she considers it one of her best features. There are cases.
Aesthetics of extractions aren't worth the complications. Expansion is both more functional and aesthetic
Aesthetics of extractions aren't worth the complications. Expansion is both more functional and aesthetic
In her case expansion will not bring esthetic results. She would need her skeletal maxilla moved forward and then the alveolar ridge and teeth brought back int the empty spaces that develop.
There is currently no way to do this with an adult patient. Her next best option is to have le fort 1 surgery and afterwards some how manage to pull all the top teeth back to where she can reduce her nasolabial angle.
my story: http://www.aljabri.com/blog/my-story/
"There is currently no way to do this with an adult patient".
Not even MSE + FM?
"There is currently no way to do this with an adult patient".
Not even MSE + FM?
I haven't seen a single case where this was done on an adult. I only read about varbrah attempting it. The only cases available from Won Moon are for teenagers with class 3 malocclusion.
my story: http://www.aljabri.com/blog/my-story/
Something is wrong with the forum. I cant quote anymore.
What about these though?
https://www.hindawi.com/journals/crid/2014/270257/
https://www.angle.org/doi/full/10.2319/090308-462.1
Honestly, if not even a aggressive treatment like MSE + FM can do anything for an adult, why do we even bother with mewing.
Something is wrong with the forum. I cant quote anymore.
What about these though?
https://www.hindawi.com/journals/crid/2014/270257/https://www.angle.org/doi/full/10.2319/090308-462.1
Honestly, if not even a aggressive treatment like MSE + FM can do anything for an adult, why do we even bother with mewing.
Yes, for the last few days, I am quoting you manually.
Thanks for sharing those. I will read them once I am free, but glancing through them they seem all to be for class 3 malocclusion and very young adults.
MSE does it's job in the transverse plane, it's just the sagittal expansion that's questionable.
Correct tongue posture and function works differently to rapid expansion. It's not about applying so much force as much giving stimulation.
To clarify this look at FAGGA. If you do not tap the pad lightly you won't get any expansion even if the springs are tensioned constantly.
That's the same concept, you want to stimulate your system with constant correct posture and function and the body will respond to the message.
One last thing, allot of people have over expectations for what correct tongue posture and function can achieve.
my story: http://www.aljabri.com/blog/my-story/
I mean, what do you consider very young adults?
The first case report is of a 19 year old female.
Unfortunately, i misunderstood the second one. It said "young adults" but they are actually teenagers.
Well the assumed forward growth comes from the Facemask, no?
"One last thing, allot of people have over expectations for what correct tongue posture and function can achieve."
I guess alot of people are just very frustrated to be stuck with facial deformities for the rest of their lives, knowing it would have been so extremely easy to prevent it.
Personally, i am alot more frustrated, now that i know what caused my recessed face, knowing i could have looked alot better with a few simple tricks.
Its frustrating to know ill be stuck with this for the rest of my life, and having the "what could have been" in the back of my mind.
I was happier thinking my genetics made me look like this and that i cant do anything about it.
Now i think (and alot of other people too) that theres still "hope". People are grasping for straws and hope theres a chance they can undo everything. And the more we learn just how hard (or even impossible) it is for adults, the worse the mental impact of this whole mewing concept becomes. Or anything that revolves around it.
After months of dwelving into this topic and finding not a SINGLE case of a adult who achieved even slight maxillary forward growth, i just think it would be better to drop this whole subject alltogether.
It seems to me thats what you have already done. So im wondering, what are you trying to achieve on your "journey" if you believe maxillary displacement is not possible in adults?
Very interesting perspective @bundfalke. I always felt some people argued over "mewing" from a stand point of desperation. Your comment confirms this and I thank you for your courage and honesty in expressing it.
It seems to me thats what you have already done. So im wondering, what are you trying to achieve on your "journey" if you believe maxillary displacement is not possible in adults?
Over the time I have made many posts that give an idea of what my expectations are for correct tongue posture and function. But to save you the effort of going through previous posts I will add this reply I made on reddit just today about a very similar question.
In a best case scenario and over a 3-5 years period, one should be able to (with correct tongue posture and function):
relieve mild crowding and malocclusion
increase inter molar width and correct some teeth angulation
experience mild increase in facial width and under eye support
reduce facial muscles size which inversely makes the face look wider
gain a more prominent lower jaw line due to better muscle tone
improve neck and body posture
All of those things combined will make you a better version of your self but will not change you like multiple cosmetic surgeries would.
One good way to envision this is to look at the twin results of Quintin and Ben:
I would like to add that there are additional benefits to correct tongue posture and function including a stronger tongue that a)stays out of the airway while sleeping and b)supports an expanded palate from relapsing after treatment is finished.
Those two alone make learning and practicing correct tongue posture and function a worthwhile journey.
my story: http://www.aljabri.com/blog/my-story/
In this girl’s case...her lower jaw is notably shortened. It doesn’t look so healthy. It may be better to get some dystalization of molars. That’s just after 2 years! What will happen going forward?
Oh people definetely do that. Personally, im a emotionally and mentally very stable person. I can take things in life that makes other people suicidal. This whole mewing/melting face story is one of the very few things in my life that managed to take such a toll on my mental health. Nothing has ever come close to this. So i think other people may "suffer" even more than i do when they dwelve into this topic. So i can very well imagine that people argue over mewing because its maybe the only thing that prevents them from giving up on life as a whole.
I try to avoid that because i think that would make things even worse for me. Its better to accept the cold hard truth and learn to live with it, then to live in delusion and never actually achieve what you dream of. As extremely depressing as that is, unfortunately.
Your point make alot of sense, apart from "reduce facial muscle size".
Meaning, reducing facial width? But how does that link to correct tongue posture?
Anyways, in my opinion, for alot of people these things will be trivial. As rude as it sounds, its like pouring water over a flesh wound and placing duct tape on it, for some people. Very exagerated but you get my point.
Your point make allot of sense, apart from "reduce facial muscle size".
Meaning, reducing facial width? But how does that link to correct tongue posture?
It links to tongue function. As you strengthen your tongue and start using it for functions such as swallowing, your facial muscles will be used less, become weaker (dystrophy) and shrink in size. This will make your face look wider because the lower part of your mid face (cheeks) will look narrower relative to the higher part (cheek bones).
Anyways, in my opinion, for alot of people these things will be trivial. As rude as it sounds, its like pouring water over a flesh wound and placing duct tape on it, for some people. Very exagerated but you get my point.
Plus allot of those people have a very strange standard of beauty. I often see pictures of ugly people posted as examples of facial esthetics just because they have well developed jaws. It's like they have an obsession with jaws and bony landmarks while forgetting that soft features comprise half the face esthetics.
my story: http://www.aljabri.com/blog/my-story/
Facial aesthetics isn't even about bone or soft tissue but how there is harmony between the eyes, nose, and mouth. This can also apply to ratios between facial regions.
Anyway, why wouldn't expansion help with bimax? As can be seen here, bimax happens when the arch is narrow between the molars and canines, while the incisors are proclined. This means that opening those spaces would allow the mandible to come forward, decrease the overjet, and cause the chin to be in the ideal position.
Look:
You saying expansion can't benefit this person????
The reason nasolabial angles are acute in bimax cases is because the palate is triangulated and Only the incisors poke out. This increases the overjet which causes the lips to pout. If her canines were further forward this problem would be non existent. DNA appliance maybe?
This case is not as severe as the original case. Notice how the lower lip position (mentolabial angle) is good. That means you can focus on the upper lip only, which is not too bad either.
If expansion of the arch provides enough space to pull the central incisors back then her dental protrusion is solved and she can have a normal nasolabial angle without extraction.
Otherwise her orthodontist would have to extract pre molars to make that space, but again I don't think that is needed in this case.
By the way the nasolabial angle is dependent on the central incisor position. To reduce it you always have to bring the central incisors back not the lateral incisors forward.
Doing otherwise will make the lip uniformly pouted out instead of just in the middle. It will improve the look of the lip but will not change its angle relative to the nose.
my story: http://www.aljabri.com/blog/my-story/
looks like probably she had the same problem I have
alveolar prognathism in the jaw...
which is a prognathism where the jaw is not overdeloped but only the teeth and bone that support the teeth.
when closing the mouth I am obligated to push the jaw backwards, if I could remove two teeth in the jaw the jaw would move forward and benefit profile.
i created a post about this
Skull and Jaw Correction
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