retard
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This is an informational post to anyone who is currently facepulling or is planning to facepulling, its longer but i suggest you read it if you dont want to develop an overbite and want faster results
If you are using Cope and Ropes infraoral appliance
STOP USE IMMEDIATELY, when pulling on the teeth it it causes both dento-alveolar changes, as well as maxillary changes, from an orthodontist's perspective it doesnt matter at all and that is why they frequently do use forces that mimic cope's design, HOWEVER ortho's are only concerned with getting proper occlusion and fixing the Class iii occlusion (people who get facepullers for orthodontic purposes of fixing an underbite). From the orthodontist's perspective it doesnt matter how the occlusion is fixed, either the alveolar ridge comes forward, or the maxilla comes forward doesnt matter to them; as long as the underbite is fixed they are satisfied.
However for us this is very bad, we want ONLY maxillary growth, because with that we can have our mandible come forward with the new maxillary growth
HOWEVER the lower arch its self has no inclination to follow the newly positioned upper ridge, meaning an overbite will happen if you use Cope's design due to both shifting forwards of the maxilla its self ( good) and our mandible can follow, and the forward shifting of the alveolar ridge itsself (bad) as the lower ridge will not follow and will be left behind resulting in an overbite
There are two types of facepulling, tooth borne pulling, and bone borne pulling
tooth borne is the most popularly used by ortho's and as the name implies wraps something around the teeth and pulls forward
bone borne is much more recent and is done by screwing a plate into the upper maxilla and pull forward from that. This is obviously not feasible for most people my self included.
Significant differences between the two groups were found in 8 out of 29 cephalometric variables (p < .05). Subjects in the tooth-borne facemask group had more proclination of maxillary incisors (OLp-Is, Is-SNL), increase in overjet correction, and correction in molar relationship. Subjects in the bone-anchored facemask group had less downward movement of the “A” point, less opening of the mandibular plane (SNL-ML and FH-ML), and more vertical eruption of the maxillary incisors. (https://progressinorthodontics.springeropen.com/articles/10.1186/s40510-015-0096-7)
This study shows that even tooth anchored pulling results in MUCH LESS maxillary protraction than bone anchored systems, it increases overjet correction more than in the bone borne group. meaning that if you use the teeth as an anchor, you will get undesirable upper ridge forward shifting not done by actual maxillary protraction which is BAD, however this can be avoided by bone anchored pulling
Now the question is how how the hell do we manage to facepull if we cant anchor anything to our bone?
Luckily for us @nelson solves this problem completely with his dowden appliance. The dowden applies force directly to the maxilla its self without the need for the teeth as a medium to conduct the force. Even though bone anchored protraction involves a screw drilled into the maxilla, and this is just a palate-mold that applies force; the way it manifests in maxilla change is all the same.
It really isnt complex, if the appliance applies a force by pushing on the bone it is bone borne, which both screws and the dowden appliance does, and if it applies a force by using the teeth as an anchor then it is tooth borne, not complex like i said
The dowden completely avoids all tooth contact and ONLY applies a force to the maxilla bone its self, eliminating the subsequent dento-alveolar changes that would cause an overbite in something like Copes appliance
It doesnt stop here though the dowden MOGS EVERY ORAL APPLIANCE TO LITERAL OBLIVION. There is an asterisk with bone anchored pulling, bluepilled orthos attach both screws to the maxilla and mandible and pull the maxilla downwards to the mandible, the screw failure rate is EXTREMELY high, due to pulling downwards the screw frequently gets ripped out of the maxilla, and as a result you can only use extremely minute forces with bone anchored pulling of around 250g a side to prevent the screws from coming undone, i am personally using 800g a side using a slight edit of the dowden
Since the dowden applies an upwards force, that force cements the appliance in the palate and you can use practically unlimited force, as much as you can handle without worrying about it messing up your teeth as it goes straight to the maxilla there are no repercussions, and you do not need to worry about the screws liability like in bone anchored protraction due to the design
The dowden mogs any oral appliance in the way that it distributes force, not to mention bone anchored results in MUCH faster results, compared to tooth anchored
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698016/ bone anchored also ensures the entire midface will be translated, while tooth anchored lets the rest of the midface out of the maxilla slack behind a little bit, when i first saw the dowden i thought cope's mogged it and i think most people thought that as well, it is extremely undervalued and now that i am more well versed in research, it is apparent that it doesnt just mog cope's it mogs literal surgical screws being drilled into the maxilla by miles
While the way the dowden applies force is ingenius, the way the force vectors work (needed 2 anchor points) isnt ideal for me so i slightly edited it so i can pull from a singular anchor point like the face bow from sandra khan that i have, premise is still the same
I think this needs a pin, tons of people will not see this and are under the impression cope's is superior and it will actually just give an overbite and slower results
get off your lazy ass's and start pulling this design is cheap as fuck and incredibly effective, better than MSE anchored pulling and you wont waste months/years waiting to get it
If you are using Cope and Ropes infraoral appliance
STOP USE IMMEDIATELY, when pulling on the teeth it it causes both dento-alveolar changes, as well as maxillary changes, from an orthodontist's perspective it doesnt matter at all and that is why they frequently do use forces that mimic cope's design, HOWEVER ortho's are only concerned with getting proper occlusion and fixing the Class iii occlusion (people who get facepullers for orthodontic purposes of fixing an underbite). From the orthodontist's perspective it doesnt matter how the occlusion is fixed, either the alveolar ridge comes forward, or the maxilla comes forward doesnt matter to them; as long as the underbite is fixed they are satisfied.
However for us this is very bad, we want ONLY maxillary growth, because with that we can have our mandible come forward with the new maxillary growth
HOWEVER the lower arch its self has no inclination to follow the newly positioned upper ridge, meaning an overbite will happen if you use Cope's design due to both shifting forwards of the maxilla its self ( good) and our mandible can follow, and the forward shifting of the alveolar ridge itsself (bad) as the lower ridge will not follow and will be left behind resulting in an overbite
There are two types of facepulling, tooth borne pulling, and bone borne pulling
tooth borne is the most popularly used by ortho's and as the name implies wraps something around the teeth and pulls forward
bone borne is much more recent and is done by screwing a plate into the upper maxilla and pull forward from that. This is obviously not feasible for most people my self included.
Significant differences between the two groups were found in 8 out of 29 cephalometric variables (p < .05). Subjects in the tooth-borne facemask group had more proclination of maxillary incisors (OLp-Is, Is-SNL), increase in overjet correction, and correction in molar relationship. Subjects in the bone-anchored facemask group had less downward movement of the “A” point, less opening of the mandibular plane (SNL-ML and FH-ML), and more vertical eruption of the maxillary incisors. (https://progressinorthodontics.springeropen.com/articles/10.1186/s40510-015-0096-7)
This study shows that even tooth anchored pulling results in MUCH LESS maxillary protraction than bone anchored systems, it increases overjet correction more than in the bone borne group. meaning that if you use the teeth as an anchor, you will get undesirable upper ridge forward shifting not done by actual maxillary protraction which is BAD, however this can be avoided by bone anchored pulling
Now the question is how how the hell do we manage to facepull if we cant anchor anything to our bone?
Luckily for us @nelson solves this problem completely with his dowden appliance. The dowden applies force directly to the maxilla its self without the need for the teeth as a medium to conduct the force. Even though bone anchored protraction involves a screw drilled into the maxilla, and this is just a palate-mold that applies force; the way it manifests in maxilla change is all the same.
It really isnt complex, if the appliance applies a force by pushing on the bone it is bone borne, which both screws and the dowden appliance does, and if it applies a force by using the teeth as an anchor then it is tooth borne, not complex like i said
The dowden completely avoids all tooth contact and ONLY applies a force to the maxilla bone its self, eliminating the subsequent dento-alveolar changes that would cause an overbite in something like Copes appliance
It doesnt stop here though the dowden MOGS EVERY ORAL APPLIANCE TO LITERAL OBLIVION. There is an asterisk with bone anchored pulling, bluepilled orthos attach both screws to the maxilla and mandible and pull the maxilla downwards to the mandible, the screw failure rate is EXTREMELY high, due to pulling downwards the screw frequently gets ripped out of the maxilla, and as a result you can only use extremely minute forces with bone anchored pulling of around 250g a side to prevent the screws from coming undone, i am personally using 800g a side using a slight edit of the dowden
Since the dowden applies an upwards force, that force cements the appliance in the palate and you can use practically unlimited force, as much as you can handle without worrying about it messing up your teeth as it goes straight to the maxilla there are no repercussions, and you do not need to worry about the screws liability like in bone anchored protraction due to the design
The dowden mogs any oral appliance in the way that it distributes force, not to mention bone anchored results in MUCH faster results, compared to tooth anchored
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698016/ bone anchored also ensures the entire midface will be translated, while tooth anchored lets the rest of the midface out of the maxilla slack behind a little bit, when i first saw the dowden i thought cope's mogged it and i think most people thought that as well, it is extremely undervalued and now that i am more well versed in research, it is apparent that it doesnt just mog cope's it mogs literal surgical screws being drilled into the maxilla by miles
While the way the dowden applies force is ingenius, the way the force vectors work (needed 2 anchor points) isnt ideal for me so i slightly edited it so i can pull from a singular anchor point like the face bow from sandra khan that i have, premise is still the same
I think this needs a pin, tons of people will not see this and are under the impression cope's is superior and it will actually just give an overbite and slower results
get off your lazy ass's and start pulling this design is cheap as fuck and incredibly effective, better than MSE anchored pulling and you wont waste months/years waiting to get it