The MSE Expander - Dr. Derek Mahony & Dr. Isabel Drewling part 2
2021 ж. 21 Қыр.
22 617 Рет қаралды
The MSE Expander Developed by Prof. Won Moon is used to expand the palate and move bone in adult cases. Here we are following Olivia's case, her progress and feelings over the treatment so far.
This interview with Olivia, will explain how it works and what people can expect from this treatment option. Make sure you see the first part here:
• The MSE Expander - Dr....
For more information email: info@derekmahony.com
It’s been over a year, so I’m curious why there’s not been an update yet on this young lady. Excited to see her end result! ☺️
Her smile now is so beautiful! I want that! As a child, I was one of those they pulled four permanent first molars out, put braces on me, and drew my face back toward my neck, destroying my face structure and smile.
Brilliant . . . just brilliant! I've been researching the heck outta trying to find something suitable to expand my son's palate w/o surgery and THIS seems to be the ticket! Thank you so kindly for both videos thus far . . . . looking forward to # 3. I'm in the USA and just found PHELPS & COHEN Orthodontics in San Jose, CA . . . and they offer both the MSE and DAMON braces and I'm thrilled! Now to find out if they recommend the 4 turns each day to begin with as you're advising, Dr. Mahony.
Strangely there is no part 3. Suspicious.
Can you explain how far these pictures were taken from each other? Specifically how long until the suture split, how long until the teeth closed out naturally, and how long until the teeth became leveled with the braces? It’s nice to get perspective
Brilliant, inspiring. When comparing the photos please shift and size the photos so the eyes are the same space apart. I hope you do this type of video again with an adult male with drilling to weaken the sutures.
It’s good to see it’s slowly forming into a healthy smile. I wonder, does she have any allergies that made her a mouthbreather while growing up?
Hi Dr Mahony, do you have recommended professionals to perform this procedure in Asia ? I live in Hong Kong and would like to get this done as well.
Hi Dr Mahony, I have a very similar upper teeth/jaw situation as Olivia however, I also have a recessed lower jaw that has caused me to have sleep apnea for the last few years. I am on a quest to find an alternative treatment to cpap that will not just mask my problems but correct them so that I have no breathing issues and secondly a must nicer jawline/profile. My question to you is where do I start? Can I have both the upper jaw fixed with MSE and the lower fixed with surgery? I need advise and help please.
I see after the MSE expansion there is anterior open bite. I would think you would want to use TADS again to intrude posterior teeth in order to correct anterior open bite. Am I correct? She probably has a tendency to be a vertical grower. “Impacting” teeth, versus “extrusion” of teeth to level the arch seems like it would make more sense.
Dear Derek, massive well done for what you have all achieved together, seeing the massive expansion in Olivia as well as the fact that her cant is treatable is extremely inspiring. At some point, if it would be possible, I wonder if, with Olivia's permission, we could see the change in her resting front profile then compared to now, the one we see at 10:31? It would be really great to see how the MSE changed Olivia's facial width and height. Derek, although not very helpful as I don't have any pictures on here to show you, I did want to ask, my face is aymmetrically twisted to the right with my left side being underdeveloped (cheekbones not nearly as wide, palate more narrow on that side that led to a crossbite), would anything like TADS, skeletal anchorage, MSE (surgically assisted if need be) all be able to contribute to evening out the face and reducing said asymmetry? No worry if it's too complex without pictures but I did want to ask as I'm 24 currently and am looking to sort this lifelong issue as, although everyone has a degree of natural asymmetry, everyone has twists and turns, mine are a lot more pronounced and combined with the underdeveloped left side, leave a lot to be desired for me. Thank you again, very impressive work.
Asymmetric expansion is something we lived with since it happens 100% of the time with a wide range of magnitude...much like root resorption in orthodontics. This is the case with all expanders. Here are some of the facts/logical assumptions/observations: 1. All expanders produce equal reciprocal force between left and right hemi-maxilla at the skeletal level. A tooth-borne expander with an uneven number of anchor teeth can produce asymmetric dentoalveolar expansion; however, the force transferred to the basal bone is equal on both sides. 2. Human skull is never perfectly symmetric, varying in shape, size, density, etc. The equal and reciprocal expansion force by all expanders against the asymmetric human skull can only produce an asymmetric expansion. 3. Although this phenomenon is true for all expanders, some results will be more notable. Those with a larger magnitude of skeletal expansion will reveal the asymmetric results more prominently, by the larger displacement. As long as the expander produces reciprocal force, asymmetric expansion is expected; however the magnitude of this asymmetry is clinically manageable (see the attached article). I cut off the arms on the side with more expansion, and dentally compensate. 4. Some of the cases illustrated in the link are misleading because of the mandibular shift immediately after the expansion due to dental interferences. After orthodontic decompensation, the mandible returns to the functional position. Asymmetric expansion should be evaluated against the cranial base, preferably with CBCT (see the article). Also the MSE position is important. If it is positioned anteriorly (NOT recommended!!!), the pattern of expansion becomes more V-shaped with much larger changes anteriorly, magnifying the asymmetry. 5. Asymmetric expansion is a result of an asymmetric skull rather than the appliance design in most of the cases, assuming that the appliance was fabricated correctly. Predicting which way the expansion will occur is difficult because there are many variables in play (see the article). 6. Weakening the buttress bone on one side (unilateral corticotomy) can promote more expansion on that side, but you may end up with uneven buccal corridors. The majority of unilateral crossbite cases is due to asymmetric mandibles. I prefer to have relatively even expansion and orthodontically compensate the mandibular teeth. I hope this clarifies the myth related to asymmetric expansion.
@@derekmahony4334 when you say “much larger changes anteriorly”, are you referring to malar projection?
@@derekmahony4334 Dear Derek, does cutting the arms off mean that when you further expand, the side with the arms cut off doesn't expand at all or does it mean it's just stable so that the other, less expanded side, is able to expand given that it still has the arms? Thank you so much.
People who have a narrow pallate are usually coupled with a recessed/underdeveloped jaw. How can one adress the recessed jaw in a safe manner (please adress your opinion on AGGA) and then receive MSE to reap the benefits from that too? Please respond, thank you
Can't wait for part 3. Hope she has changed her mouth breathing face cos MSE is my last hope to get a regular face :(
God bless man, MSE has helped me a ton but my face is still assymetrical ngl
@@spiscold50 i believe if you chew correctly on both side in few months you can fix your asymmetrical face. Is there and place i can see your before/after pics? I'm from Brazil there isn't MSE over here. To get this treatment i got to make sure it i will work properly
Dr. Mahony, I have small teeth and want cosmetic bonding to fill in the spacing. Is it stable to get bonding done after the suture split to fill in gaps instead of getting braces?
Search the EASE procedure and Dr Kasey Li for sleep apnea related maxillary expansion. He has videos on KZhead and lot of people talking about him on the sleep apnea reddit.
Really important to do your research on the different procedures as there are quite a few out there with different amounts of improvement, especially for sleep apnea
Hey Derek!! How long after getting a frenectomy/gum graft can I do something like getting an expander?? Cheers
Can you treat TMJ without orthodontics. Like with a orthotic splint? How does Dr Mahony treat TMJ. Thankyou
What is the difference between DNA,ALF and AGGA?
I wonder how long her treatment has lasted since her first appointment visit until now and how many months she had the device (expander) in her mouth?
12 months with 4 months of expansion
Doc, have you fixed severe sleep apnea with this? What is the price range on this MSE surgery, i read invisaline is $5k to $7k but not sure about MSE range
Hi guys, I need a second opinion. I have a class II problem, 10mm overjet, and also overbites with a convex face profile, 27 years old. I decided to go for orthodontic treatment (Damon braces) recently. My ortho recommended me for both 1st premolar extraction on my upper jaw for retraction space. unfortunately for me that I find about all of this information (risk for sleep apnea, etc) after I wear the braces. I have discussed this problem with my doctor, but He didn't see another solution outside of extractions as my by overjet and the convex profile that I have, he saw it as a match to go for extractions. He also told me about molar distalation but He thought that I didn't need it as the solution requires my upper jaw to be moved backwards hence the same thing as extraction (reducing he thought). so now I'm in a dilemma of whether to go for the extraction or what because this also costs me financially. any suggestions?
Extraction retraction is just a fucking disaster, In hindsight it's not worth losing bicuspids, only to allow for excess retraction, And worsened bite. if the teeth overlap again it's in a now smaller arch, and worse than before. upper bicuspid extraction/retraction if the top is retracted too far back, can cause the lower jaw to be set held further back, causing TMD, and muscle strain, and your lower jaw may "want to come forward" DR BILL HANG has a video about "mandibular entrapment" as he calls it. Also doing extraction retraction, increases the risk of severe root resorption of the incisors, overjet of approx 10 mm? Did you ask about BSSO surgery, or did the orthodontist bring up surgery as an option? Any orthodontist who pushes extraction/retraction as the only option, really doesn't know what's best for their patient. Best to be done once, and done properly, Better be safe than sorry!
@@luke14946 Hi Luke, any journal that indicated the risk of severe root resorption of the incisors that you addressed? I have tried to address the sleep apnea problem, the airway, and then he tried to address more factors that could contribute to it such as tonsils. He also said that the extraction followed up by retraction does not decrease the size of the oral cavity and his patient does not experience such a thing to prove that the extraction-retractive procedure is safe. but still, I'm in doubt. I didn't ask about BSSO, but he did say that I didn't need a surgery to be done because it's not that severe. that's why I stopped asking further even about BSSO. Btw, I personally prefer to do palatal expansion compared to surgery anyway. When I try to bring up about maxillary skeletal expansion (MSE) option, he instead addressed me to RME / SME treatment, a much different and more conventional approach, and again he said that I didn't need such procedure to be done because the expansion could not cover such 10mm overjet. I'm starting to see how limited my options are for the lack of face-focused and airway-focused orthodontics practitioners in my country (Indonesia), and the closest provider to MSE is in Sidney (Dr Derek Mahony), and Kuala Lumpur.
@@rupiahman I had an OPG taken recently, (OPG is a panoramic dental X-ray, of the jaws/teeth from behind) Showing that for someone who had orthodontic treatment once, I had the upper incisor root resorption, comparable to someone who had braces atleast TWICE, when you have gaps made by extractions, closing them via retraction, increases the amount that the teeth are moved, basically more movement, and force = more resorption. (braces on the top only + both upper bicuspids extracted, when I was 14 I agreed "top first, bottom after", but I wasn't in the mood after, it's left me with a terrible bite, and I should have sued for malpractice) I'm 21 ½ now, the shitty "treatment" I had took place when I was 14-16, And in Ireland. (I Currently can't even find MSE here) Believe me, You have less to lose, by NOT getting shitty substandard orthodontic treatment, Get it done ONCE, but more importantly get it done RIGHT. Orthodontists aren't infallible, and don't always know what's best for people, so be real careful. Look up karinbadt.medium.com, "Extracting Premolar teeth for orthodontic treatment: the risks", ...it also mentions some people who made the grave mistake of trusting an orthodontist, and getting teeth pulled out for braces, and how their quality of life has been impacted.
@@luke14946, I can see why now. I read a journal indicating that the risk for resorption increases when you have braces for at least 3 - 6 years. Do you happen to experience side effects such as sleep apnea, TMJ, etc? I can only assume that your doctor indicated that you needed room for spaces similar to my case, 4 bicuspids are just too many healthy teeth. Now that I know all of these, I can't pretend to not know about the consequences, I already lost 1st mandibular molar 10 years ago, so I can tell the reason why my doctor told me that He will utilize the empty space in my mandible to "correct" my erupting mandible incisors. I can only imagine that he will extract 4 of my bicuspid too if not for the empty space available in my mandible. What do you plan on doing now then that you're left with the bite? I'm currently trying to get a second opinion from dr. O from e&s ortho. Still preparing the files required. I hope I can make my case.
Who dos this in the US?
Hey Dr Mahony how much does these procedure cost from start to finish? ballpark figure*
the MSE is the same cost as a septoplasty and then there is the cost of braces. If you live in Sydney or Melbourne feel free to send your photos for an opinion to info@derekmahony.com Best Wishes
I just have one question… how much does this full treatment cost? I’m in the US and I plan on getting this done ASAP but I’m poor as fuck. Is there any hope, can you make payments or do I have to pay this all up front? There’s no way this is a cheap procedure if it takes a year?
Dr. Ting from California does this and Also there's another doctor in New York that does this, I forgot his name Search MSE expander and it'll show all the doctors that offer these treatments.
$10K 😬
Here in Houston TX my otho is charging me $6500 for MSE/ MARPE & braces afterwards.
Don't you come to Melbourne, Doctor? ☹️
He does! I saw Derek recently and he's a godsend!
@@clown7169hey can u tell me a bit more abt him?
If anyone knows an orthodontist that can do this in New Zealand please let me know. It costs $800 just for the opinion of this Orthodontist to look at your mouth and see if the work can even be done. Insane!
Hello! Can you talk about the bottom expander. My orthodontist put a bottom and upper expander. I have a cross bite, why some people only get one upper expander, and other like me get both? Thank you.
The fact that this doesn’t have 50k views is irritating, it should have billions😂
Not to be rude but I dont think she looks better in the after picture.
I disagree.