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The first ever LIVE JawCast episode with Ron's own orthodontist, Dr. Ilya Lipkin DDS, who has done over 500!!! MSE cases and claims 100% success rate splitting adult males since incorporating ONE very important new technique.
1-on-1 Consultation Chat with Ron
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00:00 Introduction!
00:16 How many MSE cases has he done?!-
00:46 Complications/failure to split
01:31 Lipkin’s opinion on DOME 🤨
02:01 What is PIEZO? How does it work?
03:17 Lipkin’s Success rate of MSE ?🤯
03:33 How PIEZO has revolutionized MSE/MARPE
04:41 CBCT’s necessity for success
05:19 Importance of MSE placement? & Learning from failures.
06:35 Should you turn MSE slower or faster? & How frequently should you turn?
07:52 Do you need a surgeon for PIEZO?
08:38 What does PIEZO feel like😳
10:04 SARPE vs MARPE what costs more $ ???
10:53 How long until the suture splits after PIEZO?
11:38 Does PIEZO help asymmetry?
12:31 CBCT’s necessity for success pt. 2
13:00 Cause of MSE asymmetry?
15:41 How labs have helped Lipkin’s success rate
15:59 The sad absence/scarcity of MSE providers😔
16:30 PIEZO downsides? (Necrosis? Nerve damage?)
18:56 Mandibular Expansion?
19:24 Are tooth borne expanders enough to expand the lower arch?
20:19 Dr. Ting’s suture split at WHAT AGE??? & MSE on steroids
21:40 Future of MSE
22:11 Should you wait until the MSE field progresses to get MSE?
23:12 Lipkin’s PIEZO
24:18 PIEZO before or after installation
24:45 Any patient freakout stories?
26:05 Lipkin did MSE how long ago???? 👴🏻& What set him apart from the rest in dental school
27:01 Lipkin’s FIRST MSE case 👀 & trying MSE in older patients
28:36 How MSE sparked Lipkins interest in MSE’s correlation with the airway
29:38 Turning MSE backwards?
30:12 MSE + Face Mask ❤️
33:11 Determining the bite with CBCT
33:28 Bite discrepancies (jutting jaw forward) & How AGGA makes this worse
34:58 MSE + Face Mask pt. 2 ❤️
37:32 Ideal angle for Face Mask pulling is… Wait what??? - วิทยาศาสตร์และเทคโนโลยี
Hey Ron, will you do consultations again after your 3 month pause?
Thanks for all the work you do i'll watch the video now ;)
I decided to open up one last day of chats, this Saturday, Jan 28th. THIS will be my last day until May. Link in the description to sign up.
Enjoy the video.
@@JawHacks I’d love to get on again when you open back up in May in hopes of spreading positive news in regards to my asymmetry/bite issues, take care Ron and thank you for all that you do
@@TheCrossfitter I saw ur video, you had a lot of great expansion done. If you don’t mind me asking, what did u decide for your mandible treatment ? There’s so many different options
@@marissa7680 as of right now have just done dental alveolar expansion via Invisalign. I have a follow up in a few weeks so will discuss adjunct treatment options then. Will also take another CBCT to see where things are at. Best, Ryan Warkentin.
@jawhacks Please open up a few more spots for consultations before the pause !
Ting, Lipkin, and you should commission a 10 episode podcast for the benefit of humanity.
Would love that.
This is such an awesome chat! It is pure gold
Ron! the quality of your videos has improved so much👍🏼 keep up the good work man!
Brother! Appreciate that. Stay buff 💪🏼
I’m amazed at how far this channel has come🙌
Ron thanks for taking the time to interview professionals and letting us get that benefit of viewing good info. Still waiting to start my own mse journey, starting it now doesn’t work for me unfortunately. I really hope that u continue making health related videos in the future and I hope more ppl wake up and start to take this stuff more seriously.
Ron you are amazing! Thank you for everything you do for orthodontic knowledge.
Dude I wish I had this information before my two MSE’s. Hindsight 20/20. Can only educate others now :)
this one was great man
He seems very knowledgeable. This was very educating
Great questions, Ron. Thank you!!
Glad it was helpful!
I love it. Awesome interview. I see MSE as addressing the fruit of the problem of jaw development, and the roots might be something like allergies, tonsils, tongue position due to mouth breathing due to nasal resistance. Do you plan on doing any interviews on how to reduce / avoid the causes of these problems like exposure to allergy or some kind of screening process for kids?
I LOVE THIS WORK! It is so rewarding! I wish i could do this treatment but my son will
im on day 10, 1 turn a day. no pezo. ill be sure to enquire on my next visit. i have fibromyalgia, so i register pain at a higher level than average, but i am also used to being in pain. it took me 8 days to get up and going again. thank you for all the great info, and the dedication.
Good implementation of the expansion device is key 😬💡
Nicely done Ron great info!!!
Everyone should watch Mike's interview with Dr. Lipkin too!! 👆🏼👆🏼
Ron, I’m a fan and had no idea we share the same ortho! I had my MSE installed by Dr Lipkin six weeks ago. I’m 57 years old and so far, so good. Dr Lipkin’s patient care and attention is second to none, let alone his cutting edge expertise.
How much is the treatment?
@@junior17medval that varies greatly from person to person
So im assuming you got the split and using the piezo knife?
@@MA-dm4xy I did, yes.
@@lilyvega7450 ok then how much are you paying then?
This is epic Ron. I plan to start my MSE consultation this year so seeing this is perfect.
Hi, do you know how long MSE treatment is? How long it stay in your mouth after expansion? Thanks
@@carlgadoury6092 tbh not sure
@@submarooo4319 ok thanks
I'm in the beginning and right away you answer a question I had. If the suture does not split just do it manually and continue on with the expansion.
He’s doing me in March. Thanks for posting this. Very confident.
Good luck!
Thank you!
@@timothyquinn4040 how has it went? What benefits have you seen so far?
Did you split..? Any improvement !?!
hey man, any update?
This is insane. I am a 41 year old female. Started mewing yesterday. Actively swallowing when mewing today. And I heard a clicking sound several times when swallowing already!
I’m not sure if that’s a good sign , clicking please watch the video of Ron and Dr yousefian he explains why clicking isn’t a good thing actually if I’m not wrong , it can be dangerous too
Expand the maxillary arch from within, along with MANY other benefits, by headloading and using purging breath in wuji posture, daily practice.
39:11 - 39:21
About the face mask angle pulling, I think the angle should change based on each patient's face individual face structure and their needs. For someone who is vertically deficient, pulling down is good, as it balances the face. However this is not the case with everyone. I am the opposite, so I would have to change the angle of pull to more up to create more of a balance in my face. Moral of the story there is no "one angle is best", its based off each patients needs and problems.
I believe Dr Lipkin was talking only about Class 3 cases. He mentioned it a few times however, I could be wrong
What are the odds... I was planning on calling up Dr Lipkin's office this week for a consult. Great interview as always Ron you're changing lives and I can't wait for my life to be transformed. If I mentor Jaw Hacks at the office will I get 10% off my treatment? ;)
I wish!
The MSE is old technology - a one size fits all solution. The newest and best MARPE expanders are now 3d printed customized for each patient to go through as much bone as possible. The bone where the MSE goes is usually very thin.
Dr. Lipkin custom designs his MARPEs as you describe
@@JawHacksmy ortho doesn’t use the piezo knife but does do 3d custom marpe, how’s the chances of asymmetry with that
Thanks for the video, quite informative. Even I myself would not use MSE, I do not doubt it can help many people out there. I will also first think on mewing as an option.
Glad it was helpful!
Hi Ron, i have a big doubt about the last point of the interview, for those patients who has a vertical Growth class 3 with longer face (no underbite but skeletal class 3, a mandibule more developed than maxila with an horarium Growth ) instead short face like Dr said... do you use face mask pulling upwards instead downwards if that's the case?
My only local MSE provider is Dr. Eric Howard... I heard he helped educate Dr. Bokow, (maybe spelled incorrectly) whom has been on the channel. Does anybody have any experience with him?
Will expanding the upper jaw also expand the lower and correct recessed chin?? Or is the lower jaw a complete separate issue? Thank you 😊
I would really like to know if there are complications or the process of MSE when you have a joint “displacement”? Every time I open my jaw the right side pops out. It does not cause pain and other dentists have told me now to worry. I’m wondering what future complications would be to expand the upper jaw.
Curious about this too. I have a similar issue
I recentrly had a new kind of surgery which helped my MSE to split: "Single-incision mini-invasive surgery for miniscrew-assisted rapid
palatal expansion".
Hungry for an MSE facemask adult case outcomes interview with Dr. Lipkin.
For sure 🤙🏻
Can you use Facemask with Invisalign? Or does it have to be with MSE?
As I've had nose diaphragm surgery, what kind of complications are we talking about with mse?
I would never have expected him to suggest a downward force on the maxilla to move it forward. I wonder if that would make the smile more gummy and undesirable. It makes a lot of sense though the way he explained it. Also he sounds like he would recommend it on older patients too, which means it is an effective treatment for bringing the upper jaw forwards.
Remember, he only uses facemask on underbite patients, and underbite patients tend to already have very short midface.
Pulling down is appropriate in class 3 patients for all the reasons he lists.
In a non growing patient it shouldn't become more gummy really. There's no LeFort so it will just rotate, swing along.
My somewhat silly non educated question is... If one were to do bilateral zygomatic osteotomies... Could you swing it even further?
whre do we go and how much is it to get these procedure done ?
Ron looks especially handsome here. Thank you for releasing more info about MSE yet again!
That's very kind, thank you.
I have a class 2 overbite, can mse fix this? Most videos only talk about class 3 underbites
10:10 all about the money!
Hi Ron, when Dr. Lipkin calls it a successful split, what does this actually mean? There seems to be evidence that a split with a diastema doesn't necessarily translate to increased nasal floor width. The expansion can be localized to the dentoalveolar segment. This would minimize nasal improvement. I can see this happening to older males where the bones superior to the maxilla are exerting resistance, since the piezo only weakens one suture, not the rest. Thoughts?
How does his procedure compare to Kasey li ease when trying to improve breathing sleep and airway nasally???
He said his method is superior to EASE, but realistically from what I've seen, EASE is pretty much the gold standard. You're paying significantly more though, so you get what you pay for. Best case scenario his method is equivalent. I've seen EASE cases where someone is like 30M+ and they expand like a teenager with MSE. So really impressive results.
Very interesting video, didn't even notice the time.
How to get this treatment when you live in the UAE 😢 any recommendations of trusted orthodontists ?!
this doctor knows what's he's talking about.. too bad im from europe, are there any doctors doing Marpe in Europe? any suggestions?
What if your lower palete is also not ideal? I need this done my face was not meant to be as narrow as it is, my breathing is compromised
Lower jaw is tough. SFOT or, even better, DAME/MSDO.
There is only one palate. The roof or your mouth.
But, If you are talking about your lower arch, and the fact that IT is narrow, then most of the time orthodontics will be all you will need to correct the problem. If its severely narrow, orthodontics alone cannot solve, you may need surgery.
I just had SFOT on my lower jaw.
Was put asleep for procedure. Was so painful...for like almost 3 wks. Was nothing like I imagined. Also, at my age 50 there are more risks.
I think having a face bow that rests ANYWHERE on the face is a bad idea. (Unless you want the rest positions to be pushed backward).
If there is a force pulling the midface foward, there HAS TO BE an equal and opposite amount of force pushing backward…why would you have that backward force be place ANYWHERE on the face? Ie. Dr Lipkin mentions sometimes he uses it placed on the chin…which would force the jaw back. A backward direction for the jaw is a bad direction in most cases.
True and obviously he knows that but "politics is the art of the Possible." The more minimalist, basic facemask that pushes on the chin is so much lower profile than the bow or crane and gets higher rate of patient compliance for that reason.
@@JawHacks , Maybe attaching the maxilla to a rope, that is attached to a spring, that is attached to a beam on the ceiling above your bed; may be the best option. I just hope you sleep on your back and don't move too much ;-)
@@JawHacks can you cut out the MSE's legs and still can pull MSE appliance with facemask? I want to do Ting's Spider power chain too.
At 33:10 Dr Lipkin states that when a person postures his jaw forward, (because they are more comfortable in that position) he says “that’s not a position we can treat-to”
But how do you know the person isn’t posturing their jaw forward into an ideal position?
It may have been too far back in the skull, and the patient’s moving the jaw forward places the jaw joint into ideal relationship…??
Although from my knowledge, the lower jaw position ideally should be located as far back and up into the skull as possible; so any anterior posturing would be a bad thing from “conventional teaching” standpoint. Ie Moving the jaw forward would normally make the top of the jaw, where it articulates with the skull, impinge on the nerves in the joint itself (which are located in the anterior portion of the joint “socket” itself)
This is why I believe Dr Lipkin may not want to set final position of teeth that pushes jaw too far forward…(to match the patient’s forward jaw posturing habit)
Speaking from my own experience, it's very easy to fall into the trap of posturing the lower jaw too far forward and thinking that is home.
Happens to many AGGA patients during the honeymoon period of that treatment.
@@JawHacks but what about post retraction? Dr. Quintero told me the Temp Mand Joint adapts relatively easy to new positions, and that muscle memory will always be there.
I do agree some people over jut their mandible for a “desirable jawline” but for those who’ve been extr/retr jutting 3-7mm could be their old normal and help tmj, airway, aesthetic,biting forces and could possibly help protract the mid face in the zygomatic area due to the pressure from the ramus (assuming the sutures are disrupted from MSE)
@JawHacks When your mandible has been set back for most of your life the muscles are shorter and tighter hence posturing your mandible forward will be hard to hold (no different to pulling your shoulders back in order to get correct body posture but of course the tight muscles will just pull them forward again once you relax). That's why you have to TRAIN the muscles to remain in the forward posture (no different to what the Stage 3 appliance that John Mew uses which is a mandible retraining posture appliance). I moved my maxilla forward 5mm using a DIY Class 3 setup and my mandible repositioned forward to meet that new position. I have now held that new jutted position for over two years and could EASILY come another 5mm forward if not a lot more. You just have to TRAIN your muscles to be forward. Also I remember a top Miami jaw surgeon in a webinar saying that having the condyle set perfectly in the joint may not actually be optimal and he would actually do his surgeries to keep the condyle forward out of the joint same as if you were jutting your jaw forward.There's a very good reason why jutting the jaw feels good and alleviates TMJ pain - cause it's where the mandible wants to be.
It wasn't a trap Ron - you were correct at the time just as the AGGA patients are likely correct now. Over-jutting your mandible to your absolute maximum right off the bat may be too much, but doing it incrementally as the maxilla slowly moves forward is different altogether. It's all about retraining those mandible muscles to stay forward just like with correcting forward head or forward shoulder posture. I encourage you not to dismiss this avenue.
Does mse help with crossbite and asymmetrical face/maxilla?
Can every orthodontist do this procedure? I live in Canada.
Yes. And no, not every orthodontist is trained with MSE.
Victor, private message me, i'm from canada too and am getting MSE+facemask and SFOT
Good luck fellas. I hear good things about Joel DeSouza in Toronto area.
People come from Canada to see Lipkin
I have Already asymmetrical maxilla ,is it possible to widen and make it symmetrical at the same time?
That's a big ask. But you could definitely get dental correction of that asymmetry!
About the piezo guys, keep in mind and this is very important, if they just do a mid-palatal osteotomy with a piezo that doesn't necessarily mean it's the same as what Dr. Lipkin is showing here. The fact that he is cutting THROUGH the incisors and up into the anterior nasal spine, is very important. It is also very difficult from a technical skill perspective, because if the physician has shaky hands they can nick the roots of the incisors and then now you need a root canal or lose the tooth. So lots of providers will be hesitant to try such a procedure (I wouldn't recommend being their first). Frankly I didn't expect Dr. Lipkin to even attempt it.
Before I thought he probably was avoiding that area. Now that he explains how he is doing this osteotomy, plus his slow turn protocol (which interestingly enough Kasey Li's protocol is way slower, the equivalent of like half a turn every other day, but that's after he gets 1 mm diastema during surgery), makes it super plausible that the failure rate is dramatically reduced using this method. Maybe not 100% success rate long-term but it could be a lot better.
Edit: After rewatching, I think maybe Dr. Lipkin is taking extra care to avoid the area between the roots of the incisors. Just not cutting so close to that area. You can hear he says "entering in above the roots of the incisors". I think that's a wise choice. No reason to risk getting too close to the roots when the MSE can likely just split that area.
Edit 2: Another thing I realized is that, even though Dr. Lipkin shows cutting up to the ANS on the model, I'm not sure how he would be cutting that high, since you would need to perform an incision like they do during LeFort 1, so that you can expose the bone. Otherwise, it's above the lip near the base of the nose area, it's not accessible. You can see animations of LeFort 1 to see what I mean. I think only an OMFS can do that. Maybe you can just do a puncture above the incisors without exposing the bone?
Amen bro.
How many turns you did to get the split/ gap with the MSE ?
LEGENDSS
That's you my guy
@@luke14946 very punny Luke
EDIT: I believe I am wrong about what is said below. I misunderstood the vertical forces above the pulling angle and pulling along the already existing plane
Pulling downward with a facemask seems wrong. His explanation for justifying a downward pull as opposed to horizontal seems odd. Intuitively, it just doesn't make sense. Yes, if you had a class 3, any forward pull in the upper jaw would help, but pulling down would just make the midface longer.
Think about it. Anyone with a class 3 and a long lower third of their face would need the upper jaw to be pulled horizontally if not upward to some degree. For patients with class 3 and long faces, a correction would mean counter clockwise mandibular rotation with anterior upper jaw movement to facilitate bringing the jaws back to their normal relationship.
For the patients he's speaking about that are deficient in vertical, a long midface is not deficient, rather its excessive.
iLLWiLL shots fired
Will, I thought the same thing. He had me scratching my head. Most people that would benefit from MSE would probably have excessive vertical growth and narrow face; most benefiting from DECREASING vertical, expanding the midface and COUNTER-CLOCKWISE rotation of lower jaw (thus decreasing vertical)…Pulling the midface DOWN and FORWARD is usually the opposite of what you’d desire. That would be CLOCKWISE rotation of the lower jaw, which INCREASES vertical and concomitantly constricts the airway by making the lower jaw drop down and back, closer to the neck.
Normally a person with a horizontal jaw, breathes better than a person with a highly angled jaw. By rotating the jaw clockwise, you are creating a higher angle, which usually has the effect of restricting airway (relative to horizontal jawed person)
@@tjam4229 Yes, you explained it better than I did. I see your comments all over youtube, did you by chance have a background in anatonmy, or craniofacial studies?
@@will6751 , yes. Graduated top of my dental class in both clinical and didactic studies. As far as orthodontic related issues, I was inducted into honorary societies for occlusion and TMJ studies. The reason I mention that is not to puff up my chest, but to fortify my opinion here...But that only matters to those whom are interested 🙂
How about you Will? Seems you have knowledge "above normal" here as well...
@@tjam4229 oh cool. Did you study in the US? Congrats on that, honorary societies for occlusion and TMJ is amazing. Definitely be proud of that!
As for me, i'm just a kid who found an interest in anatomy and wants to fix his face
Did he say how he deals with expanding the mandible does he do tht
"I wouldn't call it a planet" Okay now this is epic!
@@luke14946 because its flat :)
I think he meant in a humble way he’s not the best on the planet
@@jawley of course
@@luke14946 I trust him more because of him saying that tbh and I'm not even a flat earther
I think he was nervous and mean to say “I wouldn’t say I’m the best on the planet”. I think he was trying to show humility and it came out wrong.
Lipkin is amazing!
📠
So do you get an even longer face after mse+facemask in class 3 patients?
you should follow the same facemask angle that used to treat class 3 children, it's a bout the bite, not just the face
the incorrect install is such a relief to hear.
Do you know of any MSE providers out in Tennessee?
Craig Starling in Nashville/Brentwood
Justin Trisler in Oakridge
@@will6751 are they solid? Because I looked at Craig Starling and it says on his website he only does TADS
@@acemanley111 TADS are the device used to install the MSE, i've never been to him though, i only know of him
What’s the device called, a ‘piso’?
Has anyone had MSE experience with Dr. Nick K. Nguyen DDS from Orange County, California?
I've heard okay things about him, nothing negative. He's the only San Diego guy I know so def worth a consult.
What is the typical cost?
I'm from the Philippines can someone please help me locate anyone that can help me with MARPE.
Thought you used Dr. Newaz?
This is basically engineering
I literally called this doctor today. Please help me understand this new procedure he’s doing with the knife. I am not following. Thanks! Also, you recommended a website on another video I commented on last night, and I found a local person to do it. So, I’m torn. Dr. Lipkin with the knife procedure or Dr. Koval in Boca Raton, Florida (local)?
Regine, think “oscillating tool”…it’s basically the same concept.
th-cam.com/video/jYqp7vLzig0/w-d-xo.html
Any one can give a rough estimate on how much this treatment with this orthodontist cost? I’m willing to pay for a treatment.
what is PIEZO?
The doctor doesn’t seem to have had the procedure in hisself. Why is that?
Do you know if dr Derek Mahoney uses PIEZO?
I do not know, but I hear good things about him.
Send him an email, he's usually very quick to respond. If you do let us know his response.
Ron, I feel that these orthodontists never really have satisfying answers on the question of asymmetry. It always seems like an after-thought that is hand-waved away. With how confidently they dismiss asymmetry being an issue with MSE, you would think they would be able to better elaborate on some of the common theories and exactly why they are incorrect or not. They also have inconsistent answers. Dr. Ting said asymmetry is only an issue when there is a cant, and here Lipkin says it is only an issue with poor planning/installation.
I understand that this is a sensitive subject that can be hard to navigate, but I cant help but express disappointment with answers like that.
Are you not satisfied with Lipkin's theory that asymmetry is caused by fabricating and/or installing the appliance asymmetrically?
Asymmetry is already present before MSE but gets more evident once you split the suture and that expansion occurs. It’s caused by cranial asymmetries. Some orthos use splints on patients to balance the cranial bones that may be causing any distortions or cants. Once this is stabilized you can expand. It’s safer this way but requires a lot of knowledge, and is a slow and tedious process.
Ron, I actually think that his explanation of careful planning is a big piece, and the fact that Lipkin addresses this is commendable. Though I don’t think it’s the full story. There was a paper that used computational techniques to predict asymmetry given bone density and placement of expander. They then used this same technique to minimize asymmetry by optimizing placement of the expander and making certain cuts to the bone to compensate for density differences. I can’t seem to find the paper. On a similar note, I recall other papers suggesting that the number one thing that predicts asymmetric expansion is whether or not pterygomaxillary disjunction is achieved on both sides of the palate - thus certain practitioners cutting these sutures.
My main beef with ortho’s is that they don’t refer to any of this literature. It does appear Lipkin at least addresses some of the issue and offers a fairly reasonable solution, which is more than people typically get from MSE practitioners.
How much in mm is one turn on mse
Are there any skilled MSE people in North Carolina
Nope 👎
jk idk just don’t go to gladwell
Joseph Dastrup
Clay VanderWall
Ron, at 20:20 , you started down a certain thought pathway, but it seemed your pathway was a bit trampled-on by Dr Lipkin. Would you be able to recall exactly what you were going to say? I feel like I was hanging on your every word and got ripped-off. Lol.
More on this later!
Did Dr. Lipkin mention if he has gotten an MSE himself?
He has Not had MSE.
Does Mse solve the problem of mewing at night?
Certainly helps.
How young is too young to do this? Is it easier if done on young kids? How much does this cost?
He said men over 25 women over 30 get the piezo 🪚
So one per day even without having done pizo?
MSE without piezo is gambling 🎰
@@JawHacks but he said he only does it for men over 25. Can you request piezo if you're below 25?
For those of you a little foggy on the piezoelectric “knife”….think “oscillating tool”…it’s basically the same concept.
th-cam.com/users/shortsVi0YQW1-6as?feature=share
Curious why no one is using the KLS TPD expander. I had EASE done by Dr Li and when he swapped it out for an MSE the screws bent. Once he put a new TPD back in at a different spot my breathing improved immensely with no significant O2 desaturation when I sleep now.
It is expensive from what I understand. The device itself is expensive. Also, the flow of information that caused this video to exist all stems from Dr. Kasey Li. A bunch of people wanted a cheaper option to EASE and went to Dr. Ting asking him to cut them and do MSE. Ting was already on the MSE wave and just applied the two. I think the next evolution is to ditch the MSE and go with the KLS.
It's a lot harder to install, it's more expensive, different sizes as well, and they can deal a lot of damage to the alveolar bone especially if you don't release all the sutures. Probably not a good idea unless you do a really good mid-line/palate osteotomy and the pterygomaxillary osteotomy Dr. Li does to release all the resistance.
@@shuikai272 eh, i disagree. sure Li has had damage. Sure he cuts the midline, but whos to say what his specific technique is as he is fuzzy on it for monetary purposes, he makes 30k a pop. ofc he will be fuzzy. whos to say what his exact technique is, and if these guys here are getting close to it. His cuts take 50 min, these guys take a little longer. Maybe these guys cut more than li?
@@ekim051084 Not fuzzy at all. He shared the entire surgical notes with someone which went into complete detail.
EASE:
Local anesthesia:
Local anesthetic was injected in the palatal region at the premolar/molar region bilaterally, the mid palatal suture, posterior tuberosity bilaterally.
Limited bilateral pterygomaxillary osteotomies:
Incision was made at the posterior tuberosity and subperiosteal dissection made to identify the pterygomaxillary suture. Piezoelectric blade used to perform limited pterygomaxillary osteotomy and wound irrigated and sutured with 4-0 chromic sutures. Similar procedure performed bilaterally.
Oral mid-palatal & midline osteotomies:
Using a Piezo electric blade, two small midpalatal osteotomy was done just 2 mm into the bone. Next, using a thin osteotome, midline osteotomy was made to connect the two small osteotomies and expand to the PNS. Using the same thin osteotome, osteotomy was made between the maxillary central incisors between the roots aiming towards the vomer from the labial aspect of the maxilla. A tiny diastema was noted.
Installing the KLS Martin RPE expander:
Incision was made at the palatal aspect of the second premolar/first molar area about 10 mm above the CEJ. Subperiosteal dissection was done to create a small pocket and the footplates of the TPD were inserted into the pocket and stabilized with a 2x5 mm screw on each side and TPD was expanded to fully engage the bone. The washer was tightened. The small maxillary labial wound was sutured with 4-0 chromic suture.
So I mean you compare that with what Dr. Lipkin is explaining here (essentially the same type of oral mid-palatal & midline osteotomies that Kasey Li describes in his notes) you know exactly what cuts they're doing.
I’m in the UK who can do this for me
Mary Lo
Sunil Hirani
Richard Cousley
Can anyone comment on even older patients?
Creating Chads
MSE is a total Chadmaker.
What’s sfot?
FYI it's unclear if SFOT really works for widening the molars. It's like you try it and hope for the best. MSDO/DAME can expand the molars a little bit, but due to the expansion pattern it's not much. Theoretically if a mandibular expansion was invented which has a parallel expansion pattern (like the natural growth pattern) you could expand a lot more.
Suprised Lipkins response to complications after nasal surgery was “I don’t know.” If he’s truly done as many procedures as he claims, he has had to come across multiple people who are post nasal surgery. It’s an airway treatment after all and nasal surgery was the original go to. Appreciate Ron asking this but disappointed in the answer.
I personally think he was holding on info because I’m assuming he wants people to buy his course
I don't really see it being an issue. I know one woman who did EASE and had a 25 mm aperture, which is above average, and she had it undone because she didn't like how much air she was getting through her nose. So potentially if you over-expand beyond the norms it could not be recommended.
Big dick chad. Love the regular uploads. You’re the only active mewTuber. thanks for giving us a show with the homguy. We know it was a setup between you. Too ridiculous on both parts to be real
Alll the money i get from hbg will be donated to ron. This is for your bro!
Have you heard from hbg and/or “dev” yet? Neither have been communicating. Last I spoke to hbg on the internet he said he had spoken to doctors near and that they were pissed by your upload. He’s gone
Man you didn't ask how much of mm can an adult get with face mask
2-4 around. Varies depending on age, sex, and patient compliance of course
@@will6751 and how many hours of wearing the facemask would you say to get about 3-4 mm of forward growy
@@bhavyanegi6602 the more the merrier. I've planned out my treatment so that I can make money without having to leave the house, so I'll be able to wear it for 22-23hours a day
@@will6751 damn wearing it for 22-23 hours Is almost impossible for me . I have college and other stuff . Btw which facemask will you be using ? Bow crane or traditional one . I also do part time work so , it would be very difficult for me to wear the headgear. Only during night i can wear it . Willing to share your home earning method?😂
@@bhavyanegi6602 I'll be wearing crane. Bow is very inconvienent and there is virtually no negative impact of the resting forces against the forehead in terms of anterior pulling.
I understand if that's not possible for you, it varies depending on your schedule. Just know that wearing less will affect your results.
I organize guns and drug trades online.
just kidding lol, I trade stocks
Amazing, so I’ve been waking up early as hell expecting to bring down the guys hating on these appliances for no reason. Now the guy behind it all dips. Welp ronald you got docs coming at you.
bro can you update on hbg and the friend? Where have they gone? I believe in his case but he’s disappeared after the video was posted. I’ve only gotten a message saying “He has bad karma coming 👨⚕️”
what more do you want? It's just drama
yo will you give us updates in your lawsuit with the doctors after the video with the appIiance? We know it’s happening don’t hide it away from us.
Did he sue the doctor in the video or a different doctor?
so 31 years old is to late ?
According to Lipkin “too late” is pretty much a thing of the past.
In the advent of piezo, "too late" has gone the way of the Horse and Buggy.
Did you get an editor or something whats with these click bait thumbnails and effects 💀
made you click
You were right we’ve been told by some guy to make hbg look bad and hurt people hurting appliances like dna/homieobIock. This guy is threatning to share images of me if I didn’t comply. Sorry man
If you “steal” from a jeweler who’s a terrorist it isnt stealing it’s just setting the orders in balance. Why should a guy like him have money but me working 9-5 have null? Lets all make a group.