If one has already straightened out a canted and yawed maxilla, what is the problem with pulling ones face for forward development? Not sure i wanna spend so much on AGGA if i can just face pull.
The problem is that most of the force is concentred on your teeths and that the sutures are really stiff in adults. You will most likely have problems with your teeths before loosening even a little bit your sutures. The MSE combined with a Facemask doesn't have those issues. It is bone anchored and because of the rapid palatal expansion your sutures are loosened, therefore making it easier to protact the maxilla and as i said, it's bone anchored so no problems for the teeths.
But there are a few cons.
1. It's expensive. Not really more than FAGGA tough.
2. you can't protract indifinetly (5-8mm)
3. you must convince your ortho that you need one. "I want a chad maxilla" isn't enough.
4. How is your mandible going to catch up with that much expansion? there is no """midmandibular"""" suture like the midpalatal suture. Mandibular expanders only have limited effects.
So the benefit of agga over face max is that you dont need MSE with agga?
Where have you seen face pulling giving any results? Plus how do you plan to attach the mask to your upper jaw if you do not have braces or an expander installed in your upper jaw?
my story: http://www.aljabri.com/blog/my-story/
I dont know what the mask even is, I am just learning about it now.
How about Plato from the facepulling website, are those bad results?
I dont know what the mask even is, I am just learning about it now.
How about Plato from the facepulling website, are those bad results?
I've spoken to Plato; He still does facepulling (in even more extreme and strange ways, like using a pulldown machine) but his development doesn't seem to be any better than his pictures from years ago. Dr Dean Howell (Who was doing Plato's endonasal/NCR therapy) developed the FaceMax appliance to combine with endonasal. Face pulling, essentially
/community/community/main-forum/dean-howell-facemax/
There doesn't seem to be any update about the appliance. I know Dr. Howell is in contact with Dr. Mew, so if there were any promising developments I think we should have heard of them by now - through either of the doctors.
I'll contact Dr. Howell again soon to ask how it's going
any reason mentioned why he started using the pulldown machine instead?
The "issues" with face pulling as far as getting it done "professionally" are that a lot of orthos (most?) don't want to do it on adults. Take my case:
-My maxilla is obviously recessed (I have an underbite)
-My upper arch can use expansion
When I consulted with a doc who co-authored papers alongside Won Moon himself on MSE, MSE+ Face Mask, and MSE + Face Mask in Adults, the guy told me "in cases with face mask in adults the results weren't very satisfactory... I'd recommend surgery for you."
TAKE NOTE:
A) I myself am not saying it's impossible to protract the maxilla in adults through a face mask; I'm saying many ortho's will say so. I'll link a study on tooth-anchored face mask in adults where the underbite was corrected...HOWEVER the before and after ceph tracings don't seem to show the maxilla itself moving forward: http://www.kravitzorthodontics.com/assets/pdfs/Expansion-Facemask-Treatment-of-an-Adult-Class-III-Malocclusion.pdf
There was a Won Moon study on MSE + Face Mask in an ADULT underbite case that used to be publicly available but now I can only find the abstract, so I can't say whether or not with bone-anchorage (through MSE) Face Pulling works.
B) I haven't mentioned AGGA at all because imo I don't think it provides enough force for the actual maxilla to be disrupted.
IF Face Mask protraction anchored to MSE, which literally disarticulates the maxillary sutures and is bolted into your maxilla, doesn't produce satisfactory maxillary advancement (I don't mean to imply it doesn't, read point C) then I don't see how any form of AGGA would- the logic being that bone anchored pulling is a far greater force, and that's the case isn't it?
C) The doc I consulted with might have just not wanted to take me on as a patient because he didn't think the hassle of trying MSE with Face Mask on an adult was worth it, and that's understandable. The most "experimental" and knowledgeable docs who provide MSE in my limited opinion are Sylvain Chamberlain and Richard P. Ting. So maybe they'd be capable of trying MSE + Face Mask in adults. I haven't read all of @varbrah 's thread (only glanced at it) so I don't remember if he used a face mask, if the face mask was approved by the ortho, and if protraction of the maxilla itself occurred, etc... so I can't say but maybe his ortho would do it as well.
-Melius
There was a Won Moon study on MSE + Face Mask in an ADULT underbite case that used to be publicly available but now I can only find the abstract, so I can't say whether or not with bone-anchorage (through MSE) Face Pulling works.
-Melius
This case study?
https://sci-hub.tw/10.1186/s40510-015-0083-z
any reason mentioned why he started using the pulldown machine instead?
More force.
I uh... don't recommend it.
There was a Won Moon study on MSE + Face Mask in an ADULT underbite case that used to be publicly available but now I can only find the abstract, so I can't say whether or not with bone-anchorage (through MSE) Face Pulling works.
-Melius
This case study?
No, I'm afraid. That's a study based on simulations of different approaches to MSE + Face Mask in an adult male, BUT, as noted in this thread of mine on that same paper:
/community/community/main-forum/theoretical-question-regarding-mse-fm/#post-19068
those simulations seem to be just that, simulations, and were probably only intended to show what would happen if the bones were still as pliable as a child's. Coincidentally, the ortho I went to see is credited on this same paper! I'd completely overlooked that and only realized after I saw him, if not, I definitely would've asked him about it!
The study I was referring to was far more recent; a man of Asian descent in the 19-25 year age range, with an underbite that is corrected afterwards, and includes before and after photographs and scans showing superimposition of bone change, including in the zygomatic region. I'm also pretty sure by the time at least studies were written, MARPE was no longer the abbreviation used as Won Moon had already coined, "MSE" as he realized it actually expanded much more than the maxilla.
Update: Here's a link to the abstract, if you can find the whole thing that'd be awesome.
Class III treatment by combining facemask (FM) and maxillary ...
If anyone also has the entire version of the below paper (just about MSE in adults not MSE + FM), I'd greatly appreciate if you can share it; I also remember being able to find it online easily just a few months ago... should have saved it :/
The problem with fagga is that instead of MOVING your maxilla forward it just lengthens it in an horizontal direction. Then the back teeths are moved forward to make your bite how it's supposed to be. YES this allows the mandible to come more forward which improves your lower third. It also allows you to adopt a natural head posure and to put your tongue on the roof of your mouth without obstructing your airway but it has no effects on the cheekbones. Yes it can give the illusion of more proeminent cheekbones (when i jut my lower jaw forward, my cheekbones seems a lot more apparent but my maxilla didn't move at all) But it doesn't change their place. Some FAGGA practitioners say that they will follow the rest of the maxilla a bit later (could be up to 2 years of treatement) but i've never seen a single before after showing something like that, let assides x-rays etc.
To illustrate what i am saying, take your hand, palm facing the ground and put a random object on your wrist. This object is your cheekbones and the hand your maxilla ok? now immagine it's recessed and you need to move it more forward. Put your other hand in a vertical position in front of the hand representing your maxilla and consider that as the point where your maxilla should be. MSE plus facepulling would be more like moving your whole hand (maxilla) until your fingers reach the palm of your other hand. The FAGGA approach would be more like growing your fingers until they reach the palm of your other hand. Sorry i struggled a bit to explain, i hope it was clear enough.
The problem with fagga is that instead of MOVING your maxilla forward it just lengthens it in an horizontal direction. Then the back teeths are moved forward to make your bite how it's supposed to be. YES this allows the mandible to come more forward which improves your lower third. It also allows you to adopt a natural head posure and to put your tongue on the roof of your mouth without obstructing your airway but it has no effects on the cheekbones. Yes it can give the illusion of more proeminent cheekbones (when i jut my lower jaw forward, my cheekbones seems a lot more apparent but my maxilla didn't move at all) But it doesn't change their place. Some FAGGA practitioners say that they will follow the rest of the maxilla a bit later (could be up to 2 years of treatement) but i've never seen a single before after showing something like that, let assides x-rays etc.
To illustrate what i am saying, take your hand, palm facing the ground and put a random object on your wrist. This object is your cheekbones and the hand your maxilla ok? now immagine it's recessed and you need to move it more forward. Put your other hand in a vertical position in front of the hand representing your maxilla and consider that as the point where your maxilla should be. MSE plus facepulling would be more like moving your whole hand (maxilla) until your fingers reach the palm of your other hand. The FAGGA approach would be more like growing your fingers until they reach the palm of your other hand. Sorry i struggled a bit to explain, i hope it was clear enough.
it lengthens it? You mean it actually adds bone mass to your maxilla and that its "bigger" than it was before?
How is that even possible lol
The problem with fagga is that instead of MOVING your maxilla forward it just lengthens it in an horizontal direction. Then the back teeths are moved forward to make your bite how it's supposed to be. YES this allows the mandible to come more forward which improves your lower third. It also allows you to adopt a natural head posure and to put your tongue on the roof of your mouth without obstructing your airway but it has no effects on the cheekbones. Yes it can give the illusion of more proeminent cheekbones (when i jut my lower jaw forward, my cheekbones seems a lot more apparent but my maxilla didn't move at all) But it doesn't change their place. Some FAGGA practitioners say that they will follow the rest of the maxilla a bit later (could be up to 2 years of treatement) but i've never seen a single before after showing something like that, let assides x-rays etc.
To illustrate what i am saying, take your hand, palm facing the ground and put a random object on your wrist. This object is your cheekbones and the hand your maxilla ok? now immagine it's recessed and you need to move it more forward. Put your other hand in a vertical position in front of the hand representing your maxilla and consider that as the point where your maxilla should be. MSE plus facepulling would be more like moving your whole hand (maxilla) until your fingers reach the palm of your other hand. The FAGGA approach would be more like growing your fingers until they reach the palm of your other hand. Sorry i struggled a bit to explain, i hope it was clear enough.
it lengthens it? You mean it actually adds bone mass to your maxilla and that its "bigger" than it was before?
How is that even possible lol
Looks like it's causing growth at the premaxillary suture (which is where you get the gaps)
@melius https://sci-hub.tw/10.1053/j.sodo.2018.01.009
and
https://sci-hub.tw/10.1016/j.ajodo.2015.04.043
That second paper - Wow. Absolutely massive changes
Before
After
Couple years later:
Even with virtually no forward growth he looks completely different.
then again he was 19, and the face still changes quite drastically in the early 20s.
2. you can't protract indifinetly (5-8mm)
Why would we be limited to 5-8mm of forward growth in the case of the Facemask + MSE combo?
The problem with fagga is that instead of MOVING your maxilla forward it just lengthens it in an horizontal direction. Then the back teeths are moved forward to make your bite how it's supposed to be. YES this allows the mandible to come more forward which improves your lower third. It also allows you to adopt a natural head posure and to put your tongue on the roof of your mouth without obstructing your airway but it has no effects on the cheekbones. Yes it can give the illusion of more proeminent cheekbones (when i jut my lower jaw forward, my cheekbones seems a lot more apparent but my maxilla didn't move at all) But it doesn't change their place. Some FAGGA practitioners say that they will follow the rest of the maxilla a bit later (could be up to 2 years of treatement) but i've never seen a single before after showing something like that, let assides x-rays etc.
To illustrate what i am saying, take your hand, palm facing the ground and put a random object on your wrist. This object is your cheekbones and the hand your maxilla ok? now immagine it's recessed and you need to move it more forward. Put your other hand in a vertical position in front of the hand representing your maxilla and consider that as the point where your maxilla should be. MSE plus facepulling would be more like moving your whole hand (maxilla) until your fingers reach the palm of your other hand. The FAGGA approach would be more like growing your fingers until they reach the palm of your other hand. Sorry i struggled a bit to explain, i hope it was clear enough.
it lengthens it? You mean it actually adds bone mass to your maxilla and that its "bigger" than it was before?
How is that even possible lol
yeah sorry, i just wanted to keep thigns simple for the other ppls in this discussion who seemed to be newbies. TGW explained it well.
what shows us that moving it forward is superior to growing it forward?
i don't know if you are talking about aesthetic or about health. But moving the maxilla forward as a whole would affect your cheekline, it will move the skeletal part of the maxilla too while fagga just seems to move the dento alveolar part. Both will allow your lower third to come forward though
2. you can't protract indifinetly (5-8mm)
Why would we be limited to 5-8mm of forward growth in the case of the Facemask + MSE combo?
I don't exaclty now why but the info comes form won moon himself. I guess that it will take time and that you can' keep your mildpalatal suture open enough time to get more protraction than that.
I dont know what the mask even is, I am just learning about it now.
How about Plato from the facepulling website, are those bad results?
I've spoken to Plato; He still does facepulling (in even more extreme and strange ways, like using a pulldown machine) but his development doesn't seem to be any better than his pictures from years ago. Dr Dean Howell (Who was doing Plato's endonasal/NCR therapy) developed the FaceMax appliance to combine with endonasal. Face pulling, essentially
/community/community/main-forum/dean-howell-facemax/
There doesn't seem to be any update about the appliance. I know Dr. Howell is in contact with Dr. Mew, so if there were any promising developments I think we should have heard of them by now - through either of the doctors.
I'll contact Dr. Howell again soon to ask how it's going
I dont know what the mask even is, I am just learning about it now.
How about Plato from the facepulling website, are those bad results?
I've spoken to Plato; He still does facepulling (in even more extreme and strange ways, like using a pulldown machine) but his development doesn't seem to be any better than his pictures from years ago. Dr Dean Howell (Who was doing Plato's endonasal/NCR therapy) developed the FaceMax appliance to combine with endonasal. Face pulling, essentially
/community/community/main-forum/dean-howell-facemax/
There doesn't seem to be any update about the appliance. I know Dr. Howell is in contact with Dr. Mew, so if there were any promising developments I think we should have heard of them by now - through either of the doctors.
I'll contact Dr. Howell again soon to ask how it's going
Did you find anything out?
It's not going. I don't think he has any active cases right now with the device. I've learned that he's not technically a licensed medical doctor / dentist, so that may be the reason why - you can't put devices on patients without the prerequisite medical training in most of the US. Also remember that the 1cm of forward growth that he had claimed was never backed up by anything other than Plato's opinion.
Still, I won't discount the idea that using a balloon to loosen up the nasomaxillary complex and then keeping it in traction could pull it forward. Maybe Plato's friend was a one-off case where that's specifically what he needed to release the maxilla.
2. you can't protract indifinetly (5-8mm)
Why would we be limited to 5-8mm of forward growth in the case of the Facemask + MSE combo?
I don't exaclty now why but the info comes form won moon himself. I guess that it will take time and that you can' keep your mildpalatal suture open enough time to get more protraction than that.
Expand, open sutures, protract, sutures fuse, expand more
2. you can't protract indifinetly (5-8mm)
Why would we be limited to 5-8mm of forward growth in the case of the Facemask + MSE combo?
I don't exaclty now why but the info comes form won moon himself. I guess that it will take time and that you can' keep your mildpalatal suture open enough time to get more protraction than that.
Expand, open sutures, protract, sutures fuse, expand more
Suture doesn't fuse but closes. and btw you can't expand to 70mm of IMW just to have enough time for protracting the maxilla up and forward. That being said, don't underestimate what 5-8mm of forward growth can change in your face, both health and aesthetic wise.
2. you can't protract indifinetly (5-8mm)
Why would we be limited to 5-8mm of forward growth in the case of the Facemask + MSE combo?
I don't exaclty now why but the info comes form won moon himself. I guess that it will take time and that you can' keep your mildpalatal suture open enough time to get more protraction than that.
Expand, open sutures, protract, sutures fuse, expand more
Suture doesn't fuse but closes. and btw you can't expand to 70mm of IMW just to have enough time for protracting the maxilla up and forward. That being said, don't underestimate what 5-8mm of forward growth can change in your face, both health and aesthetic wise.
I agree on the suture’s not fusing. But didn’t UCLAnewbie and others already claim that forward protraction doesn’t equal to 5-8mm of actual visible protraction that can be seen via aersthetics changes? Or did I misinterpret that?
I dont know what the mask even is, I am just learning about it now.
How about Plato from the facepulling website, are those bad results?
I've spoken to Plato; He still does facepulling (in even more extreme and strange ways, like using a pulldown machine) but his development doesn't seem to be any better than his pictures from years ago. Dr Dean Howell (Who was doing Plato's endonasal/NCR therapy) developed the FaceMax appliance to combine with endonasal. Face pulling, essentially
/community/community/main-forum/dean-howell-facemax/
There doesn't seem to be any update about the appliance. I know Dr. Howell is in contact with Dr. Mew, so if there were any promising developments I think we should have heard of them by now - through either of the doctors.
I'll contact Dr. Howell again soon to ask how it's going
Did you find anything out?It's not going. I don't think he has any active cases right now with the device. I've learned that he's not technically a licensed medical doctor / dentist, so that may be the reason why - you can't put devices on patients without the prerequisite medical training in most of the US. Also remember that the 1cm of forward growth that he had claimed was never backed up by anything other than Plato's opinion.
Still, I won't discount the idea that using a balloon to loosen up the nasomaxillary complex and then keeping it in traction could pull it forward. Maybe Plato's friend was a one-off case where that's specifically what he needed to release the maxilla.
As always, thanks for your response.
2. you can't protract indifinetly (5-8mm)
Why would we be limited to 5-8mm of forward growth in the case of the Facemask + MSE combo?
I don't exaclty now why but the info comes form won moon himself. I guess that it will take time and that you can' keep your mildpalatal suture open enough time to get more protraction than that.
Expand, open sutures, protract, sutures fuse, expand more
Suture doesn't fuse but closes. and btw you can't expand to 70mm of IMW just to have enough time for protracting the maxilla up and forward. That being said, don't underestimate what 5-8mm of forward growth can change in your face, both health and aesthetic wise.
I agree on the suture’s not fusing. But didn’t UCLAnewbie and others already claim that forward protraction doesn’t equal to 5-8mm of actual visible protraction that can be seen via aersthetics changes? Or did I misinterpret that?
I am talking about protraction (forward growth). UCLANewbie was talking about transverse expansion. If you succesfully protract 5-8mm forward, your lower jaw will be able to come 4-7 mm forward which will make your lower third look completly different compared to now (and thus allowing your masseter and temporal muscle to work in balance as i said in the MSE thread). In terms of cheekbone projections idk how much you can exactly except, maybe 5-8 mm too because of where the growth occurs.
2. you can't protract indifinetly (5-8mm)
Why would we be limited to 5-8mm of forward growth in the case of the Facemask + MSE combo?
I don't exaclty now why but the info comes form won moon himself. I guess that it will take time and that you can' keep your mildpalatal suture open enough time to get more protraction than that.
Expand, open sutures, protract, sutures fuse, expand more
Suture doesn't fuse but closes. and btw you can't expand to 70mm of IMW just to have enough time for protracting the maxilla up and forward. That being said, don't underestimate what 5-8mm of forward growth can change in your face, both health and aesthetic wise.
I agree on the suture’s not fusing. But didn’t UCLAnewbie and others already claim that forward protraction doesn’t equal to 5-8mm of actual visible protraction that can be seen via aersthetics changes? Or did I misinterpret that?
I am talking about protraction (forward growth). UCLANewbie was talking about transverse expansion. If you succesfully protract 5-8mm forward, your lower jaw will be able to come 4-7 mm forward which will make your lower third look completly different compared to now (and thus allowing your masseter and temporal muscle to work in balance as i said in the MSE thread). In terms of cheekbone projections idk how much you can exactly except, maybe 5-8 mm too because of where the growth occurs.
Thanks for your response. So, UCLAnewbiee said that protraction doesn’t work in adults to create CCW rotation. Not saying this is true as I still don’t think he’s credible enough to give any advice out the way he does. But that’s what I believe he has said on the main thread for MSE+FM.
Not sure if you still need the article, but it's attached here.
Skull and Jaw Correction
Join hundreds who are Tensegrity Mewing, enhancing the good results of mewing and reversing damage. Free Newsletter and Classes
Your email is safe with us, we don’t spam