Maxillary Expansion: Not All Are Created Equal
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- เผยแพร่เมื่อ 15 ก.พ. 2022
- Sleep Apnea Surgery Center
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Please do an EASE giveaway lol
Cope
This is cutting-edge treatment for OSA. We just need to take the best of several procedures and combine them into a predictable treatment.
I'd like to see this doctor. Where is he?
I'd like to see this doctor. Where is he?
amazing. some had no teeth movement at all.
Thank you. Do you have references showing dental mouth expansion does not improve sleep apnea? Vivos just got FDA clearance to show it does help with sleep apnea.
why do the other surgeons not start to do it the EASE way? it is so sad
Dr Li, you claim there’s no change in position of teeth after your treatment…but if you are moving the foundation (bone) on which teeth are anchored, there SHOULD be bodily movement of tooth position. 🤔 (I'm guessing you mean to say "no change in tooth position RELATIVE to the bone in which they are anchored")
im wondering the same thing, seems the dr is making the impossible possible, although if you look a lot of these people have braces on afterwards
The bone is expanded but tilted inwards. Thus the teeth are tilted but the tips are not moved.
He means what you state at the end of your comment
Does anyone know if this can be worn with a Facemask the Bow by Forwardontics?
I'm wondering how much of the "gap" that we see in post-op images, is from "surgical removal of bone"; and not from the two halves of the maxilla moving apart from each other.
To help answer this question, I would like to see a radiograph JUST AFTER SURGICAL CUTS, to see how much of the gap is from removal of bone during the "cutting" process.
There is no surgical removing of bone.
@@DivadMick , yes there is. Try cutting a piece of wood without creating sawdust. There is ALWAYS a bone removal when cutting bone…that’s what forms a certain “gap” when cutting through most material. It’s not like using scissors and cutting thru paper.
It's miniscule
Is it just me or does EASE create a larger space between the eyes in the before and after?
Yeah. Wider nose gives you greater distance between the eye.
Thanks for the informative lecture. Am wondering if after mma surgery, an orthodontic pallete expansion is possible? What is the name of the preferable expansion option and who would provide these?
Nope.IMO once the maxilla and mandible are fixed with plates and screws,transverse skeletal expansion is no longer possible.
The expansion is "on the bone" baby
I cannot for the life of me find an animation or video that shows what this surgery actually is
Dr. Li is the only surgeon that does this, and he hasn’t made an animation/video showing how it’s done so you won’t find one.
@@DivadMick I see he cuts at the mid palatel suture, but what are those other two red lines indicating? Those are cuts but which bones/sutures are cut there?
pterygoid bone probably
@@SecretMountainTroll
I would also LIKE to see a diastema form. A diastema doesn’t “guarantee” that there is an “entire” anterior to posterior expansion…but I think one would “always” see a diastema in cases with true anterior to posterior expansion. (Ie. It is a sign that there is at least anterior palatal split/expansion.
Maybe there should be a hybrid treatment: EASE surgical cuts accompanied by standard MSE appliance (placed adjacent and parallel to palatal suture). Using standard MSE appliance distributes the expansive forces equally along the palatal suture. I question the single expansive screw, which appears to place the expansive force in one area at the alveolus…pushing that particular molar tooth buccally. You don’t see this single tooth displacement with standard MSE appliance.
do you know maybe if His procedure makes cuts, or is surgically assisted? or is it just an TPD appliance without any surgical cuts?
@@CroElectroStile, it seems to me that the surgical component is done from the interior of the nose. I’m guessing at least a midpalatal suture split and maybe splitting the ptyergo-maxillary sutures
@@tjam4229 midpalatal suture split, is that done with drilling small holes? and i'm not sure hoe the ptyergo maxilary sutures are cut? so it's not similar to SARPE with a TPD instead of MARPE
@@CroElectroStile, I haven’t seen any details on the EASE procedure. For some reason I t seems to be kept a secret. I’m guessing it might be an ultrasonic instrument to make the split, but I’m not sure. It could just be a regular orthopedic bone saw.
Dr. Li does use MSE on some patients who have compromised alveolar bone, and the results are not as good. What he is doing with the KLS distractor is the best way of doing it. It delivers more force to overcome the zygomatic buttresses and other points of resistance, and is not attached to the teeth like MSE. It’s also not at risk of dragging through the bone or breaking/bending like MSE. MSE also creates more rotational expansion, lower down in the jaw because it’s attached to the molars. And MSE DOES displace single teeth because it’s attached to the molars on each side. I had this happen to me with MSE. A diastema does form with EASE, it’s just not as big as with DOME, which Dr. Li explains in this video. You can see very clearly in all the scans that it achieves perfectly parallel expansion from ANS to PNS, so I’m not sure what your criticisms are even based on. No form of MSE, surgical or non-surgical achieves results this good.
Do you have references show rapid palatal expansion in children improves airway and that the opening of the suture does become filled with bone?
He lists some of the research papers in the vid.
What about the new knife for front and back used by Ilya lipkin ? For mse
Kasey Li does the exact same thing for splitting the palate, same piezotome, if anything he might be a bit more daring with going between the roots. The difference with Kasey Li's method are the limited pterygomaxillary osteotomies, which are cuts to the back of the maxilla to reduce chance of failure to expand, and the fact he uses the KLS expander.
The other difference with Dr. Lipkin and Dr. Coppleson as well, both seem to be doing basically the same thing, and have a so-called "100% success rate". Now... Even Kasey Li doesn't have a 100% success rate, and he is having a VERY hard time successfully expanding with MSE, and from my experience his success rate is the highest out of anyone by far. So, I'm pretty sure their definition of success is carefully worded, and I have some info about Coppelson's definition of success which led me to speculate on how they achieved their 100% rate.
My guess is that their definition of success is:
- Separation at the mid-palatal suture.
Now, the issue here, is that it appears to me that whenever a surgeon successfully performs a mid-palatal and mid-line osteotomies, like what all these providers are doing, the suture is obliterated and there is a slight separation. Therefore, the definition of success could very well be tied to whether the surgical-assist is done correctly. The issue, is that once the surgery is complete and you turn the appliance, it could still fail to overcome the resistance of the expansion, however if your definition of success is any separation at the mid-palatal suture then even though the treatment was a failure it would qualify as a success under that definition. This is how I believe they achieve their 100% success rate.
So, if you undergo a treatment with one of these guys, I would get it in writing or on tape that they agree, that once the surgery is done it is your expectation that the expander overcomes the resistance and successfully expands. I mean if they're not willing to acknowledge that, I think it'd be really sus.
@@shuikai272 Is there a difference between using a TPD or MSE device with the EASE procedure? Does MSE result in less expansion even if the EASE cuts are made?
How much is this treatment? Is he the only Dr doing this in the USA? Thanks
$30,000 cash, LA
@@lambbanb8106 not LA. It’s in the Bay Area.
How to expand the lower jaw to match the upper jaw expansion ??
they use orthodontics to expand the bottom jaw, I think he told me he no longer does lower jaw distraction because the results were too unpredictable.
Why do the faces looks narrower after if you are expanding?
They definitely aren't narrower. Judging photos of faces is pointless.
Maybe due to expansion mid face expand but lower face doesnot
Maybe due to expansion mid face expand but lower face doesnot
@@DivadMick No. You have an unscientific mind.
@@saileshjoshi5422 The whole face seems narrower.
so what to do in adults whose CBCT show not favorable candidate for MSE? 38 year old male, nor is EASE affordable at $20k
Why would you not be a favourable candidate for MSE? EASE would be similar to MSE candidates except if your bite can’t allow for much expansion, EASE would be better because it doesn’t move the teeth much. EASE is also $30K+. If you can’t do that, then you’re kind of just out of luck. There aren’t any good alternatives…except maybe some kind of surgical MSE, but the result won’t be as good as EASE.
@@DivadMick my CBCT results show I'd unlikely split.. not true. Someone in my group mentioned doing ease plus minimal surgical cuts similar to Dr. Li, hers was 13k as well but quite far away sadly.. so there is some in
Between of EASE and MSE, I still don't know how much DOME costs as well
@@DivadMick how do u know EASE is 30k+? Is there a source you can link?
@@SecretMountainTroll same question. It's seems super expensive
@@SecretMountainTroll Because I've done it, and I know several others who have as well. I think the price is actually rising as the demand is becoming greater. Dr. Li can only manage so many patients.
Does it also move the cheeks outwards tho?
@@rob8694 Wrong. EASE will move the cheeks outwards the same as MSE. But it will probably only be around 5mm so it's not usually noticeable. Everyone commenting on facial changes with MSE and EASE are usually fooling themselves.
Yes, the expansion affects the zygomata (my CT scan is featured in this video)
@@ChuckMoyes I'd like to speak to you personally
@@TheChuckster402 Thanks!
@@Smozzle19 Yes.
A lot of the after pics of your patients from the expander looks worse. Maxilla is more downward and some even have asymmetry in the bones for the ones you did surgery on
It's true. They do look worse for some reason.
@@hamidoshatara5910 wtf are you talking about? “Severe destruction??” It’s barely even noticeable lol.
@jawhacks