Palate Expander or Sarpe?

[Sinuswhinus]

Hi, I'm new here and am glad to have found this community. I'm in my 30s and have always had a lot of nasal/sinus issues but in the last few years it's become worse. I had braces as a teen and fortunately no extractions but I can tell from pictures that it seems to have narrowed my smile. Also my overbite which was never corrected seems to have gotten worse with my mentalis (chin muscle) having become more and more strained. I have talked to a respected orthodontist who recommended a palate expander (the kind where the force is applied more up in the vaulted palate than in the teeth). I've also seen a surgeon who said the expander likely won't work on its own and my best bet is SARPE followed by lower jaw surgery to advance the mandible. I'm very confused and any help is appreciated.

[Collie]

Unfortunately palate expanders on their own won't do much on the adult palate, since the bones have fused already. At least that is the general consensus among orthos, a few people have had success expanding their palates as an adult without surgery but it seems to be quite the minority and who knows if there will be any relapse down the line for them. With SARPE you still get the lovely palate expander device but they sever the palate first so it's able to be moved.

[Nozzelnut]

If you have sinus issues due to narrow palate; you'd be better off with SARPE. The expander will move teeth; more tipping outward with slight movement in the bone. SARPE will actually increase volume.

[Sinuswhinus]

Thank you for your responses. The ortho who recommended the expander said that nearly every adult can be expanded as long as the expansion is done up at the roof of the mouth rather than just at the teeth. I'm not sure what kind of expander model he's speaking of and I'm wondering if anyone knows anything more about this?

[Sinuswhinus]

Also, is there any objective way to measure whether there is actual expansion of the maxilla or if it's simply pushing out and tipping teeth?

[Metalmouth33]

Ask the orthodontist what kind of expander he's using the next time you see him. An objective way to determine the viability of this method is simply x-rays of previous patients who have used the expander. With an xray you would see if it's just the teeth that moved or if the bone moved some. And by the way, palatal expansion through surgery isn't a pure expansion on the bone either. Somewhere like 40-80% will be bone movement, with the remainder simply being your teeth being pushed out. Like the other person said, most orthos/surgeons won't advocate for non-surgical expansion in adults, but I think both methods work. The only difference is the amount of expansion that can be achieved with non-surgical expansion obviously being the lesser of the two.

What's the sinus issues exactly? Trouble breathing through your nose? If so, I'd avoid the possibility of two jaw surgeries (expansion and mandible). Palatal expansion isn't guaranteed to help improve breathing through your nasal airways. It can for some, but it's not guaranteed to work (it didn't for me), so essentially you'd be undergoing an irreversible major surgery for only a chance at correcting the problem--not a very wise proposition considering the risks of these kind of operations.

I think you should have a consultation with a nose doctor instead of an oral surgeon when it comes to nasal stuff. One time I had a consultation with a nose surgeon about helping me breath through my nose instead of my mouth. I decided against it but at the time he said what they can do is cut out some material in your sinuses, essentially enlarging your airways that way.