Reversing Extractions of premolars with ortotropics & bioblok
Posted: Sun Feb 05, 2023 4:07 am
Hello guys,
I had bad retrusive ortho done to me in the past as an adult where I ended up having 4 premolars removed & gaps closed with elastic. I want to undo the damage done as much as possible. Currently I'm seeing a John Mew-trained orthodontist who rarely but in certain cases (like mine) works with adults. My case is quite severe in a sense that I have premolars removed, asymmetry, TMJD, a blocked airway, postural issues, and more. Some are direct impacts from retruded ortho, some were probably from badly developed jaw, traumas as a child etc. I can't tell for sure what was the cause and effect.
Anyway, The plan with ortotropics is the following : stage one biobloc to expand about 10mm ( i am about 30 mm in width right now). Rate of expansion 1/16 mm per day of the device which is very slow subtle movement. Besides expansion, this will open the gaps around all front 6 teeth and also form the gap where extraction occured (second premolar). This can take around 8-9 months if all goes well and give about 3mm forward growth. In addition, a reverse pull headgear overnight would gain about 2-3 mm forward if worn regularly and if I can tolerate it. On the lower we would also expand however it's doubtful that we can achieve so much to reopen spaces. In theory the lower is blocked by upper so when upper goes forward, the lower should also free up. The initially formed open bite at the end of stage one, at the front would be corrected using the catenary wire force on one side, and force of the lips, cheeks and tongue as far as I understand. This is a norm practice in children with biobloc, with adults also doable but the slower rate as far as I understand. This would then be followed by stage 3 appliance wherein the tongue function would be trained to rest in the proper position. myofunctional therapy would be done at the same time. a regular visits to osteopaths right from the beginning would also take place. The end result should give me alot of gaps between teeth and large gap ready for implant,( I know implants are invasive so Id only do it if everything else was spot on) I think the plan sounds good on paper. however in an adult case with no premolars, from first glance its almost too good to be true. I know there are many who believe tooth-borne devices are nothing more but teeth pushers or teeth flarers and favor mse or surgery. But I also know that some people have achieved success with tooth borne devices to reopen. I am no fan of mse because I think it's too invasive for me. And I don't think I could tolerate surgery neither even if i had the option to do it. Would be good to hear some people's opinions on this. A friend of mine proposed a sagitial device for me (y shaped) but just doing that and reopening spaces doesnt factor in the tongue function, which in my view is quite important as Is mewing, ortropics etc. However, saggital does seem to make sense too.
So my questions are:
Is ortropics and biobloc a good option to widen laterally and reopen spaces? Ive seen pics of adult expansion where there was good expansion in under a year acheived with much space formed enough for implants.
Wouldn't the expansion merely happen at the expense flaring the teeth out or moving it closed to the bone?
can ortotropics even work on adults or is it all big hoax?
How is biobloc compared to saggital Y shaped device?
Would be good to hear people's opinions on this.
thank you
I had bad retrusive ortho done to me in the past as an adult where I ended up having 4 premolars removed & gaps closed with elastic. I want to undo the damage done as much as possible. Currently I'm seeing a John Mew-trained orthodontist who rarely but in certain cases (like mine) works with adults. My case is quite severe in a sense that I have premolars removed, asymmetry, TMJD, a blocked airway, postural issues, and more. Some are direct impacts from retruded ortho, some were probably from badly developed jaw, traumas as a child etc. I can't tell for sure what was the cause and effect.
Anyway, The plan with ortotropics is the following : stage one biobloc to expand about 10mm ( i am about 30 mm in width right now). Rate of expansion 1/16 mm per day of the device which is very slow subtle movement. Besides expansion, this will open the gaps around all front 6 teeth and also form the gap where extraction occured (second premolar). This can take around 8-9 months if all goes well and give about 3mm forward growth. In addition, a reverse pull headgear overnight would gain about 2-3 mm forward if worn regularly and if I can tolerate it. On the lower we would also expand however it's doubtful that we can achieve so much to reopen spaces. In theory the lower is blocked by upper so when upper goes forward, the lower should also free up. The initially formed open bite at the end of stage one, at the front would be corrected using the catenary wire force on one side, and force of the lips, cheeks and tongue as far as I understand. This is a norm practice in children with biobloc, with adults also doable but the slower rate as far as I understand. This would then be followed by stage 3 appliance wherein the tongue function would be trained to rest in the proper position. myofunctional therapy would be done at the same time. a regular visits to osteopaths right from the beginning would also take place. The end result should give me alot of gaps between teeth and large gap ready for implant,( I know implants are invasive so Id only do it if everything else was spot on) I think the plan sounds good on paper. however in an adult case with no premolars, from first glance its almost too good to be true. I know there are many who believe tooth-borne devices are nothing more but teeth pushers or teeth flarers and favor mse or surgery. But I also know that some people have achieved success with tooth borne devices to reopen. I am no fan of mse because I think it's too invasive for me. And I don't think I could tolerate surgery neither even if i had the option to do it. Would be good to hear some people's opinions on this. A friend of mine proposed a sagitial device for me (y shaped) but just doing that and reopening spaces doesnt factor in the tongue function, which in my view is quite important as Is mewing, ortropics etc. However, saggital does seem to make sense too.
So my questions are:
Is ortropics and biobloc a good option to widen laterally and reopen spaces? Ive seen pics of adult expansion where there was good expansion in under a year acheived with much space formed enough for implants.
Wouldn't the expansion merely happen at the expense flaring the teeth out or moving it closed to the bone?
can ortotropics even work on adults or is it all big hoax?
How is biobloc compared to saggital Y shaped device?
Would be good to hear people's opinions on this.
thank you