What about the removal of, say, the mandibular third molars following maxillary expansion with third molar maxillary already removed. In other words, following the diastema and anterior migration of the teeth, where the maxillary second molars once contacted the mandibular third molars, they now no longer do. Is it better to pull or leave the otherwise healthy mandibular third molars?
Too much valuable information to miss!!…some cheap clip-on microphones would be awesome. Wait…I just saw they are wearing clip-on mics…I’m thinking they might not be turned on. It sounds like conversation is echoing, like the mic from the camera is picking up the sound.
Other then improve nasal breathing, isn t jaw surgery with ccw superior when it comes to enlarging the actual airway? The narrow upper airway seems like a forward groeth problem as opposed to tranversal problem.
This is a great question. You are correct that jaw surgery with counterclockwise rotation is generally the most powerful and capable method to produce physical gains in upper airway dimension. However, it is also important to treat the scope of the problem as it presents on an individual level, and to do so in layers. What I mean by that is that perhaps someone's primary problem is nasal resistance, or perhaps ONE of their problems is nasal resistance, and addressing that may have the potential to solve at least some bit of that patient's challenges, subjectively and objectively, and can often be a sensible precursor to then later embarking on more invasive treatment IF it is otherwise not a slam dunk that the individual needs jaw surgery. I.e., they may get enough benefit from a lesser intervention before doing the biggest intervention, unless it is absolutely known that they need the bigger intervention. Hope this helps!
@@thepeoplesorthodontist thanks for the response, can fme or mse be used after the surgery? Even with lefort cuts ?Also wpuld need to remove the titanium plates for expansion ?
It could be both. What if someone isn't recessed, but their palate is really narrow, they can't breathe through their nose, they mouth breathe at night, and their tongue won't fit onto the roof of their palate? So I think it might depend on the person, not a one size fits all approach. I also think that looking at it from the perspective that the pharyngeal dimensions are the only relevant factor might not quite be the right idea. In order to breathe well at night it seems that the entire system needs to be working properly. You want to be breathing through your nose, your lips should be closed, your tongue should be in the normative position, on the roof of the palate, you don't want excessive negative pressure sucking the tissues such as the soft palate backwards, like from nasal resistance. What about the soft palate, the tensor muscles, etc. you don't want your tongue falling backwards, low tongue posture seems to be somewhat correlated to that, common causes are an open mouth and insufficient intraoral volume, inability to posture the tongue properly, tongue tie? If the tongue does collapse, then the dimensions in the cbct would not be indicative of the dimensions at night. What about the epiglottis? So there are just all of these other factors aside from the pharyngeal dimensions found on a CBCT. When the patient relaxes their muscles all of that could change. So by stretching all the muscles apart by moving the bones, their airway could stay open easier despite the muscles relaxing.
@@shuikai272 do you think transverse appliance work after djs? Would i need to remove my plates to do so? I know they cant widen the zygomas because of the lefort, but i dont really care about that.
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Dr we would appreciate if you share cases
Will FME be available in EU anytime soon?
Can you guys discuss lower arch (not jaw) expansion in adults, if it's possible and if so how?
They're the best
What about the removal of, say, the mandibular third molars following maxillary expansion with third molar maxillary already removed. In other words, following the diastema and anterior migration of the teeth, where the maxillary second molars once contacted the mandibular third molars, they now no longer do. Is it better to pull or leave the otherwise healthy mandibular third molars?
Too much valuable information to miss!!…some cheap clip-on microphones would be awesome.
Wait…I just saw they are wearing clip-on mics…I’m thinking they might not be turned on.
It sounds like conversation is echoing, like the mic from the camera is picking up the sound.
Definitely had some technical difficulties with the mics, won’t happen again! 💜
Yeaaaa Buddyyy
YA BUDDY 😸
Other then improve nasal breathing, isn t jaw surgery with ccw superior when it comes to enlarging the actual airway? The narrow upper airway seems like a forward groeth problem as opposed to tranversal problem.
This is a great question. You are correct that jaw surgery with counterclockwise rotation is generally the most powerful and capable method to produce physical gains in upper airway dimension. However, it is also important to treat the scope of the problem as it presents on an individual level, and to do so in layers. What I mean by that is that perhaps someone's primary problem is nasal resistance, or perhaps ONE of their problems is nasal resistance, and addressing that may have the potential to solve at least some bit of that patient's challenges, subjectively and objectively, and can often be a sensible precursor to then later embarking on more invasive treatment IF it is otherwise not a slam dunk that the individual needs jaw surgery. I.e., they may get enough benefit from a lesser intervention before doing the biggest intervention, unless it is absolutely known that they need the bigger intervention. Hope this helps!
@@thepeoplesorthodontist thanks for the response, can fme or mse be used after the surgery? Even with lefort cuts ?Also wpuld need to remove the titanium plates for expansion ?
@@kichki777 can be but generally not ideal if we have a choice in the matter
It could be both. What if someone isn't recessed, but their palate is really narrow, they can't breathe through their nose, they mouth breathe at night, and their tongue won't fit onto the roof of their palate? So I think it might depend on the person, not a one size fits all approach.
I also think that looking at it from the perspective that the pharyngeal dimensions are the only relevant factor might not quite be the right idea. In order to breathe well at night it seems that the entire system needs to be working properly. You want to be breathing through your nose, your lips should be closed, your tongue should be in the normative position, on the roof of the palate, you don't want excessive negative pressure sucking the tissues such as the soft palate backwards, like from nasal resistance. What about the soft palate, the tensor muscles, etc. you don't want your tongue falling backwards, low tongue posture seems to be somewhat correlated to that, common causes are an open mouth and insufficient intraoral volume, inability to posture the tongue properly, tongue tie? If the tongue does collapse, then the dimensions in the cbct would not be indicative of the dimensions at night. What about the epiglottis?
So there are just all of these other factors aside from the pharyngeal dimensions found on a CBCT. When the patient relaxes their muscles all of that could change. So by stretching all the muscles apart by moving the bones, their airway could stay open easier despite the muscles relaxing.
@@shuikai272 do you think transverse appliance work after djs? Would i need to remove my plates to do so? I know they cant widen the zygomas because of the lefort, but i dont really care about that.