Is Facemask worth doing along with MSE at age 27?

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Hello,

My original plan was to do MSE first (with a midline cut, and possibly another cut at the edges of the nose, forgot the name of the place) and 6 months after this do MMA surgery to bring both jaws forward. My mandible has enough bone to move the teeth outward, so I most likely will not need MSDO, orthodontic expansion of the lower arch will be enough. My maxilla needs to come forward about 8mm and mandible 7mm.

So my question is can I achieve 8 mm of forward protraction of the maxilla if I use a Facemask with the MSE (at age 27), let's say if I wear this almost 24/7 for 6-7 months? And what about combining Facemask with "intraoral protraction with skeletal anchorage"? If this works then I would only do a BSSO after this instead of MMA. I prefer the Facemask method rather than Le Fort 1 because the Facemask would bring the cheeks and orbital rims forward as well (if it works), but if it is a futile effort I will go with the original plan and just do LeFort 1 after the MSE, and then maybe get some implants for the orbital rims/cheeks.

My surgeon said that there is a possibility the MSE will fail even with these 2 cuts, and a LeFort 1 line cut might be necessary, making it a DOME procedure, in which case upper midface/cheekbone expansion would not be possible.

My case also does not require impaction of the maxilla (already compact) or CCW rotation (already low occlusal plane angle). Only issues are narrow maxilla and retruded maxilla&mandible.

Comments from anyone is appreciated. @Sergio-OMS If I can get your opinion as well it would be great. Thanks.
 
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I’ve never seen before/after of someone getting 8mm growth
 
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greycels continue to outdo rotters on this site jfl
 
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.

So my question is can I achieve 8 mm of forward protraction of the maxilla if I use a Facemask with the MSE (at age 27), let's say if I wear this almost 24/7 for 6-7 months?
I doubt it
 
take that 6-7 months to 10 months and that is realistic
 
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are you really going to wear that mask at least 8 hours a day?
 
Of course. It's worth at any age.
 
Hello,

My original plan was to do MSE first (with a midline cut, and possibly another cut at the edges of the nose, forgot the name of the place) and 6 months after this do MMA surgery to bring both jaws forward. My mandible has enough bone to move the teeth outward, so I most likely will not need MSDO, orthodontic expansion of the lower arch will be enough. My maxilla needs to come forward about 8mm and mandible 7mm.

So my question is can I achieve 8 mm of forward protraction of the maxilla if I use a Facemask with the MSE (at age 27), let's say if I wear this almost 24/7 for 6-7 months? And what about combining Facemask with "intraoral protraction with skeletal anchorage"? If this works then I would only do a BSSO after this instead of MMA. I prefer the Facemask method rather than Le Fort 1 because the Facemask would bring the cheeks and orbital rims forward as well (if it works), but if it is a futile effort I will go with the original plan and just do LeFort 1 after the MSE, and then maybe get some implants for the orbital rims/cheeks.

My surgeon said that there is a possibility the MSE will fail even with these 2 cuts, and a LeFort 1 line cut might be necessary, making it a DOME procedure, in which case upper midface/cheekbone expansion would not be possible.

My case also does not require impaction of the maxilla (already compact) or CCW rotation (already low occlusal plane angle). Only issues are narrow maxilla and retruded maxilla&mandible.

Comments from anyone is appreciated. @Sergio-OMS If I can get your opinion as well it would be great. Thanks.
8mm is very ambitious, considering that the facemask becomes very inefficient after 3-6 months due to ossification. If you use multiple elastics and wear it 24/7 for the entire time and maybe throw in a day every few weeks where you turn the mse twice a day to increase the mobility along the sutures you could get 5-6 mm
 
8mm is very ambitious, considering that the facemask becomes very inefficient after 3-6 months due to ossification. If you use multiple elastics and wear it 24/7 for the entire time and maybe throw in a day every few weeks where you turn the mse twice a day to increase the mobility along the sutures you could get 5-6 mm
8mm is not ambitious, it's impossible with just a facemask.
 
So my question is can I achieve 8 mm of forward protraction of the maxilla if I use a Facemask with the MSE (at age 27), let's say if I wear this almost 24/7 for 6-7 months?

Typically, 8mm is on the order of what is possible in children but not adults. I've been very diligent with my facemask. So far, I think I've gotten a couple millimeters of forward expansion. After completing all the turns on my 10mm MSE, I'm trying some weeks alternating with contraction in the hope that it will prolong the efficacy of the traction and maybe further mobilize perimaxillary sutures. So far this hasn't given me dramatic results, but it's too soon to say if it is helping. I don't have current imaging, but I think I need another 2-3mm of forward expansion (for a total of around 5mm) to correct my class III skeletal relation, and even more would be welcome. However, I'm starting to doubt it is possible at my age.
 
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In an adult patient there is no way you are going to get 8mm of maxillary protraction non-surgically (or anywhere near it) no matter what protocol you use.
 

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