Heads-up people!! This video is just for information and isn’t medical or dental advice-I’m not a doctor, dentist or licensed healthcare provider of any kind. Always check with a qualified professional for your health questions. Use this info at your own risk-it’s not meant to diagnose, treat, or recommend specific providers, products or procedures.
BRAVO !! I love when I hear discussions that make perfect sense, and coincide with what I consider “logical” Thanks SO much guys for putting this together !! 👍 It baffles me that an epidemic, such as narrow growth pattern, can be so unknown by so many professionals (and non-professionals)
You spoke against the DOME procedure as it hindered aesthetic gains in your previous videos. Is that going to be addressed? Isn't there a case then against the surgical split?
Dr. Ting first said that the cut is only through a layer of the bone, in contradiction of what Dr. Vaughn just said. Also, Dr. Ting said you still get mid face expansion with surgical MSE / DOME which shouldn't be true if the cuts are through all layers of bone and all the way behind the molars, as Dr. Vaughn described. Maybe there is an option to only surgically split the midpalatal suture without cutting the sides.
@@david_tovar How was it a success? I think you posted a comment earlier that the MSE screws bent and had to be removed, and you will have a new MSE in September.
@@stefm5640 Well, the first MSE was a failure, but the splitting assisted by surgery was a success. I consider that a success as at least the treatment can actually be carried out.
@@david_tovarYou don't know if the treatment can be carried out successfully this time. The resistance can be in the midface and the screws can bend again.
Im probably thinging of doing SARPE just because it seems like thats the only available thing near Vancouver unless someone can tell me otherwise. Hopefully theres nothing with this expansion method.
Very interesting interview. Is there any mention at some point of the benefits of doing MSE and then a standard LeFort surgery vs. just doing one three-piece-segmental surgery to expand both directions at once?
Unknown as of yet. Before MSE was a thing, transverse expansion gained by multi-piece LeFort osteotomy was shown to be more stable and to relapse less than transverse expansion with SARPE, so it wasn't recommended to do SARPE just for the sake of avoiding multi-piece LeFort (2 invasive surgeries w/ general anesthesia risk instead of just 1 for little marginal benefit). With the advent of MSE, there is some suspicion that we may be able to get earlier adaptation of the taut, palatal soft tissue to a new expanded dimension, decreasing the relapse tendency following later, further expansion accomplished with surgery. But I don't necessarily think many see it as a *replacement* for surgical expansion if surgery is deemed necessary for antero-posterior correction anyway.
In short, no. First off, a quad helix is tooth-borne and so ends up with a higher proportion of dentoalveolar than skeletal expansion. The other main difference is that a quad helix uses lighter force with the aim of activating sutural growth, similar to using a jackscrew expander with a "Slow maxillary expansion" protocol. Once the midpalatine/intermaxillary suture begins to fuse/interdigitate around age 11-13 though, the only real way to widen the maxilla is by splitting that suture either with high force (via jackscrew expander w/ "rapid" protocol) or surgery.
Thank you Evan. I've been reading and watching videos for the last couple of hours trying to understand a bit more about the different procedures. For what I understand there are 2 main groups: MARPE and SARPE MARPE doesn't involve an osteotomy, the expander/device itself is anchored to the palate/bone with mini-screws and the pressure breaks the palatine suture and expands the palate. SARPE involves an osteotomy, and also uses a device/expander anchored to the palate to expand it. If that's correct then DOME and MSE (as described in this video) and EASE are all different forms of SARPE. Then I just need to understand what are the main differences between these different SARPE methods. There is a lot more I need to know but clarifying this would be at least a starting point. There is a video from Dr Li regarding EASE where he says that his procedure creates a parallel expansion and its better for opening nasal cavity/improving airflow than other procedures that create a V shape expansion. THANK YOU so much for your input and feedback. Being alone in this research/quest, reading, watching and trying to understand procedures, I really appreciate it. Cheers
@@tonato17 you're welcome. MSE does not use an osteotomy. MSE is just a specific brand name of MARPE. also, just fyi, corticopuncture doesn't count as surgical assist.
Heads-up people!! This video is just for information and isn’t medical or dental advice-I’m not a doctor, dentist or licensed healthcare provider of any kind. Always check with a qualified professional for your health questions. Use this info at your own risk-it’s not meant to diagnose, treat, or recommend specific providers, products or procedures.
BRAVO !!
I love when I hear discussions that make perfect sense, and coincide with what I consider “logical”
Thanks SO much guys for putting this together !! 👍
It baffles me that an epidemic, such as narrow growth pattern, can be so unknown by so many professionals (and non-professionals)
You spoke against the DOME procedure as it hindered aesthetic gains in your previous videos. Is that going to be addressed? Isn't there a case then against the surgical split?
Which video is that one? (Just found this channel and see 117 videos.. 😅)
@@celtic5yamum No idea this is an old comment. The thing is that DOME does a lefort 1 cut which makes the upper midface not protract.
Great discussion
Dr. Ting first said that the cut is only through a layer of the bone, in contradiction of what Dr. Vaughn just said. Also, Dr. Ting said you still get mid face expansion with surgical MSE / DOME which shouldn't be true if the cuts are through all layers of bone and all the way behind the molars, as Dr. Vaughn described. Maybe there is an option to only surgically split the midpalatal suture without cutting the sides.
Personally I received only a central osteotomy when my MSE failed. They didn't cut on the sides and it was a success.
@@david_tovar How was it a success? I think you posted a comment earlier that the MSE screws bent and had to be removed, and you will have a new MSE in September.
@@stefm5640 Well, the first MSE was a failure, but the splitting assisted by surgery was a success. I consider that a success as at least the treatment can actually be carried out.
@@david_tovarYou don't know if the treatment can be carried out successfully this time. The resistance can be in the midface and the screws can bend again.
@@stefm5640 I'm optimistic cause the magnetic resonance imaging file shows the midpalatal suture is fully opened. Let's see what happens.
Im probably thinging of doing SARPE just because it seems like thats the only available thing near Vancouver unless someone can tell me otherwise. Hopefully theres nothing with this expansion method.
How much cost for MSE procedure?
Is bone borne expansion SARPE? I’m confused
Very interesting interview. Is there any mention at some point of the benefits of doing MSE and then a standard LeFort surgery vs. just doing one three-piece-segmental surgery to expand both directions at once?
Unknown as of yet. Before MSE was a thing, transverse expansion gained by multi-piece LeFort osteotomy was shown to be more stable and to relapse less than transverse expansion with SARPE, so it wasn't recommended to do SARPE just for the sake of avoiding multi-piece LeFort (2 invasive surgeries w/ general anesthesia risk instead of just 1 for little marginal benefit). With the advent of MSE, there is some suspicion that we may be able to get earlier adaptation of the taut, palatal soft tissue to a new expanded dimension, decreasing the relapse tendency following later, further expansion accomplished with surgery. But I don't necessarily think many see it as a *replacement* for surgical expansion if surgery is deemed necessary for antero-posterior correction anyway.
Important question! Can Quad Helix be an alternative to MSE?
In short, no. First off, a quad helix is tooth-borne and so ends up with a higher proportion of dentoalveolar than skeletal expansion. The other main difference is that a quad helix uses lighter force with the aim of activating sutural growth, similar to using a jackscrew expander with a "Slow maxillary expansion" protocol. Once the midpalatine/intermaxillary suture begins to fuse/interdigitate around age 11-13 though, the only real way to widen the maxilla is by splitting that suture either with high force (via jackscrew expander w/ "rapid" protocol) or surgery.
Very informative 👍👍
Mewing intensifies 🤣😵💫
What about Marpe?
MSE is a specific MARPE device.
@@evanlavizadeh4032 is it accurate that MSE/MARPE is likely to expand in a V shape whilst EASE would expand anterior and posterior palate equally?
@@tonato17 no I think you're confusing MARPE with DOME. DOME (any SARPE with lefort 1) creates v shape.
Thank you Evan. I've been reading and watching videos for the last couple of hours trying to understand a bit more about the different procedures.
For what I understand there are 2 main groups: MARPE and SARPE
MARPE doesn't involve an osteotomy, the expander/device itself is anchored to the palate/bone with mini-screws and the pressure breaks the palatine suture and expands the palate.
SARPE involves an osteotomy, and also uses a device/expander anchored to the palate to expand it.
If that's correct then DOME and MSE (as described in this video) and EASE are all different forms of SARPE. Then I just need to understand what are the main differences between these different SARPE methods.
There is a lot more I need to know but clarifying this would be at least a starting point. There is a video from Dr Li regarding EASE where he says that his procedure creates a parallel expansion and its better for opening nasal cavity/improving airflow than other procedures that create a V shape expansion.
THANK YOU so much for your input and feedback. Being alone in this research/quest, reading, watching and trying to understand procedures, I really appreciate it.
Cheers
@@tonato17 you're welcome. MSE does not use an osteotomy. MSE is just a specific brand name of MARPE. also, just fyi, corticopuncture doesn't count as surgical assist.