Healthy_back (healthy_back) wrote,

Adult Palate Expansion

Я оформлю чуть поаккуратней пост http://william322.livejournal.com/12223.html

В США принято удалять все 8-е зубы. Всем. Здоровые. Просто так.

http://www.webmd.com/oral-health/guide/wisdom-teeth
Wisdom teeth present potential problems when they are misaligned - they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through or erupt through the gum.

Your dentist or oral surgeon may recommend that your wisdom teeth be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be done a few years later. Removal is easier in young people, when the wisdom teeth roots are not yet fully developed and the bone is less dense.

И после этого пидоры от "официальной медицины" имеют наглость наезжать на альтернативную медицину.

В двух словах основная мысль:

1) У примитивных народов ни кривых зубов, ни кариеса нет у 99% населения. Авторы связывают это с питанием, в частности, сахаром и пшеничной мукой у западных людей.

2) У тех, у кого уже кривые зубы есть, нужно выпрямлять их не сдавливающими челюсть устройствами, создавая пространство для зубов обтачиванием и удалением "лишних" зубов, а, наоборот, расширяющими нёбо и челюсть устройствами.

http://wholehealthsource.blogspot.com/search/label/dental%20health
And now, an example from the dental literature to motivate you. In 1976, Dr. H. L. Eirew published an interesting paper (http://www.ncbi.nlm.nih.gov/pubmed/1061607) in the British Dental Journal. He took two 12-year old identical twins, with identical class I malocclusions (crowded incisors), and gave them two different orthodontic treatments. Here's a picture of both girls before the treatment:



In one, he made more space in her jaws by extracting teeth. In the other, he put in an apparatus that broadened her dental arch, which roughly mimics the natural process of arch growth during childhood and adolescence. This had profound effects on the girls' subsequent occlusion and facial structure:



The girl on the left had teeth extracted, while the girl on the right had her arch broadened. Under ideal circumstances, this is what should happen naturally during development. Notice any differences?

http://www.ppnf.org/catalog/ppnf/price.htm



The Price-Pottenger Nutrition Foundation

CAPTION:
The "primitive" Seminole girl (left) has a wide, handsome face with plenty of room for the dental arches. The "modernized" Seminole girl (right) born to parents who had abandoned their traditional diets, has a narrowed face, crowded teeth, and a reduced immunity to disease.

CAPTION:
Good dental health begins with the diet of the parents. The Samoan girl on the left was born to parents who ate nutrient-rich native foods. The Samoan boy on the right was born to parents who had abandoned their traditional diet. He has crowded dental arches, and will be more susceptible to dental decay.


http://ryan-koch.blogspot.com/2010/03/adult-palate-expansion.html

I am deformed. I look nothing like my ancestors. As a child, I had braces. I was a frequent mouth breather. At age 16, I said bye to my wisdom teeth. I have only 24 teeth left. My dental palate is not broad and sweeping; my jaw isn't square; my nasal passage isn't wide. I'm a human being raised on a processed food diet, and this is the result. When I first read Weston A. Price's book, Nutrition and Physical Degeneration, it was hard to find out that I'm not developmentally optimal. I thought, "Well, crud, there's yet another thing that's wrong with me that can't be fixed." I began comparing photos of myself as a child with some of the photos from Price's book. Here's me next to a traditional Swiss gal:



See the lack of resemblance? Check out the overall roundness of the Swiss girl compared to my more narrowed facial structure. Compare my nasal passage to hers. Cheek bones? Jaw? And, wow, how about them teeth! This isn't due to genetics, as many of you know. It's all about nutrition during the developmental years, as Price discovered. Damn you, margarine, sugar, and white flour!

The other day I was thinking about how it might feel the have the facial features characteristic of the healthy cultures in Weston Price's studies as opposed to the narrow palate, brace-straightened teeth, weak jaw, narrowed nasal passage, and lackluster cheek bones that characterize my own facial structure. If I were all of the sudden blessed with an optimal facial structure and all the teeth the good Lord intended me to have, would I breath easier? Speak better? Smile more fully and more often? Have less tension in my jaws? Feel a heightened sense of well-being? While it's interesting -- if not somewhat depressing -- to imagine such a possibility, I never thought once that this would ever be achievable. I guess you can say that's why I've come to terms with my deformed self. I can't change it, can I? What other choice do I have besides acceptance of my not-so-optimal lot in life? Sigh.

The first website I came across, called Facial Development, is absolutely fascinating. It's authored by Theodore R. Belfor, DDS, who has a clinic in New York state that actually specializes in expanding adult palates using a dental appliance called a Homeoblock. From his website:

The Homeoblock™ appliance is a revolutionary patented oral device that is much like a retainer in looks, but the results go way beyond teeth straightening...The Homeoblock™ appliance works with the body, so that physiological changes occur naturally; developing the bones of the face and resulting in the strengthening of facial muscles. These changes occur due in large part to each person’s genetic potential Often, facial development does not reach its potential due to the food we eat, polluted air and poor dental care to name a few.

Wow. A dentist who acknowledges that facial development is influenced by diet? I wonder if he knows about Dr. Price. Browsing the website further, I came upon a paper that Dr. Belfor wrote called, "Facial Changes as a Result of Palatal Expansion in Adult Patients Using the Homeoblock Appliance." Check out this before and after 3d image taken of one of his patients who used a Homeoblock:



Look closely and notice the differences in the cheek bones, chin, and lips. Pretty incredible. So not only does palatal widening make for straighter teeth, it also induces significant changes in the overall facial structure -- even in adults. Dr. Belfor markets his work as a way of creating a more youthful appearance in addition to straightening teeth. An interesting effect of palatal widening is reduced wrinkles. But he's also very enthusiastic about other changes that occur with the procedure (emphasis mine):

I am experiencing the most incredible excitement on a daily basis. I routinely expand adult underdeveloped maxilla and mandible taking the teeth along for the ride. There are many different goals, as many as there are different patients. However, the result is always the same; more prominent cheekbones, wide smiles, and strong jaws!"

Prominent cheek bones? Wide smiles? Strong jaws? Is this guy Weston Price incarnate? So, wait a minute, how can any of this actually work if the bones are fused by age 18, as is commonly believed? Well, let's let Dr. Belfor answer that one:

Bone is essentially plastic in nature. Tension and intermittent pressure persuade the bones to redefine at any age. In fact, our typical patient is between 30 and 60 years old. In the upper dental arch nature has provided a suture line front to back between the two bones that form the palate. This allows for an easy widening process and as the palate expands, the cheekbones as well, creating more prominence.

Okay, so maybe there's a chance for a "deformie" like me to experience optimal facial structure after all! I would like a second opinion, though. I mean, isn't there a possibility of teeth relapsing or other complications happening? Let's see what one scientific study had to say about adult palatal widening procedures and the risks involved, in this case using an implement called a Haas expander:

Rapid maxillary expansion (RME) in the adult is thought to be an unreliable procedure with several adverse side effects and, consequently, surgically assisted RME is considered the preferred procedure...Rapid maxillary expansion using a Haas expander was examined in 47 adults and 47 children...The results indicate that nonsurgical RME in adults is a clinically successful and safe method for correcting transverse maxillary
arch deficiency.

This study had a follow-up time of an average 5.9 years, and the patients' teeth remained in place. Here's a dramatic before-and-after image from the study showing one case of palatal expansion, a 30-year-old female:



Now that's just amazing. 30-years-old and there's still room for correction of the dental arch. I wonder, though, are there any health benefits to having the palate expanded and the resultant craniofacial changes that take place? Dr. Belfor, what do you think?

Orthopedic jaw development, particularly arch expansion, allows for improved sinus drainage and widens airflow passages. This can result in snoring reduction and lessened symptoms of sleep apnea...Voice enhancement. Improved facial balance and skin tone. Arresting and reversing the premature aging of the face.

Sounds to me like it would be worth it. Only one problem, I have no idea how much the procedure actually costs. I'm sending an e-mail to Dr. Belfor to find out. Also, I'm going to ask him if he's influenced at all by Weston A. Price, as he seems right there with the 1930s dentist philosophically. If anybody out there has more information on the procedure, please leave your comments.

Here's one more link with an article and video on adult palate expansion: "Skull Stretching" http://www.dentalhealthcheck.org/index.php?m=11&y=07&category=1


http://ryan-koch.blogspot.com/2010/03/adult-palate-expansion-part-2-brief.html

As a follow-up to my last post on palate expansion in adults, I decided to give Dr. Theodore Belfor a call to find out more about his Homeoblock palate-widening appliance, as well his background and interest in the subject of craniofacial changes. What followed was a brief, yet fascinating chat that delved into many subjects. Here's a bulleted summary our conversation.


* The cost of the Homeoblock procedure: anywhere from $2600-6000, depending on your own personal facial structure, which can be evaluated at Dr. Belfor's clinic in New York through a catscan and 3d image analysis. He tries to keep the cost of the Homeblock close to the popular teeth-straightening product, Invisalign

* Human de-volution: Dr. Belfor acknowledges that human beings have rapidly devolved in a very short amount of time -- i.e. the last 100 years. While Darwin's theory of evolution recognizes changes in species over millenia, our rapid de-evolution is an indication that something we are doing externally is influences our physical deformities. He suggests diet and pollution as main causes.

* Epigenetics: (This is the changing of genes through influences other than DNA -- i.e. facial deformities) Dr. Belfor believes this is going to be the most important field in science in the 21st century as people come to realize that many of us are not expressing our genes fully and that we must find out why and do something about it.

* Sudden infant death syndrome: Recently, Dr. Belfor spoke with a doctor in Australia who connects craniofacial deformities with sudden infant death syndrome. With a lacking craniofacial development, the 9th (Glossopharyngeal) nerve in the head, which controls swallowing, gag reflex, and speech, could very well play a role in SIDs in that arterial blood flow to it may be be restricted, which could lead to a lack of signaling to baroreceptors, Belfor says. Baroreceptors signal the central nervous system to regulate blood pressure levels and with their malfunction could lead to possible cardiac arrest. (Hopefully I'm getting all of this right.)

* Weston A. Price, DDS: Dr. Belfor is familiar with Nutrition and Physical Degeneration and says that Price's research is the basis for the realization of our physical deformities and, thus, influences any dental work (including his) that seeks to restore the facial structure of the human genetic blueprint.

Unfortunately, Dr. Belfor had to leave the conversation somewhat abruptly because he had patients to tend to, but I'm extremely grateful that he was willing to speak and share what he did for the ten minutes we were on the phone. It seemed that if he was not busy, he would have talked to me for much longer, as he definitely has a passion for what he does and seems to enjoy very much sharing that passion with others -- even if they are some random blogger/independent health researcher like myself. What a great guy! If I was in the New York area, I would not hesitate to go in for a craniofacial evaluation.

http://ryan-koch.blogspot.com/2011/02/homeoblock-update-12711.html

In my way home from Arizona, I swung by Dr. Darlington's office for an appointment to fit my Homeoblock and take it home with me. Dr. Darlington, as usual, was very kind and accommodating to my needs as a patient living six hours away, scheduling the appointment for when it was most convenient for me. The Homeoblock fitting and insertion procedure took about a half-hour due to the upper palate device not fitting very well. It was a back-and-forth scenario with Dr. Darlington inserting the appliance and then me giving him feedback on how it felt. There was some discomfort around my gums, and he adjusted the Homeoblock with small pliers to fix it (similar to what is seen in this training video by Dr. Belfor). I was pretty surprised how easy and painless it all was. I was also relieved to find out that I would only be wearing the appliance at night, rather than all day and night for a few months as I initially thought.

The upper Homeoblock fit well enough, although I still felt that it wasn't optimal. Dr. Darlington said I could adjust the wiring as I needed to when I got home with my fingers, so I wasn't too worried about it and decided to get back on the road. The Homeoblock was given to me in a retainer-like case with an adjustment tool to advance the appliance a quarter turn each week. It's a pretty slick system.

At home, I made sure to take some "before" pictures to compare later down the line when I finally look like the Neanderthal that I've always wanted to. Kidding. But it will be interesting to see what changes occur, however subtle. Here's some of my mug shots to show you all what I'm working with. Please understand that I sacrificed a great beard so that my facial structure can be seen for what it really is -- all in the name of science. First face pictures:



Note the yellow line above that I drew on my face to illustrate its lack of symmetry. The left side appears to droop down, particularly noticeable by observing the eyes and lips. In the picture on the right, you'll notice that while smiling there is a definite natural face lift going on for me, but there is still marked asymmetry around the nose. Now let's take a look at my glorious upper and lower palate as they are now.

http://ryan-koch.blogspot.com/2011/01/palate-expansion-update-11011-first.html
I'm a few weeks away from being an official homie on the block. I recently took a trip to Flagstaff, AZ for my first Homeoblock appointment. The dentist, Scott Darlington, was very pleasant and shared his excitement about the procedure. It's rare that people come to him for adult palate expansion, which he thinks is unfortunate because the benefits are so great -- particularly in opening up the airways. I told him I was interested to see how my craniofacial structure would change and whether or not this procedure would provide any significant benefits for me.

For this initial appointment, I had a short dental check-up followed by my mouth being filled with plaster to make forms of my upper and lower palate -- all of which was completely painless. These forms are currently being sent to a lab where they will be used to manufacture my own custom Homeblock. This usually takes a few weeks. I plan on returning to Dr. Darlington's office in Flagstaff to pick up my appliance around mid-February on my way to Wintercount. For the first few months, Dr. Darlington recommends wearing the Homeoblock as much as I can, including daylight hours. After this, I will only have to wear it at night and it will be recreated every few months to continue optimal expansion. The cost for all of this -- appointments, new appliances, and all -- is $2000. I payed up front for a substantial discount of $250, so the final cost was $1750. I'm looking forward to looking like a retainer-wearing teenager for a short time -- maybe I'll even have a cool accent like Shelly from South Park.

http://www.facialdevelopment.com/papers.html
Facial Changes as a Result of Palatal Expansion in Adult Patients Using the Homeoblock™ Appliance

Introduction

Palatal expansion in adult patients is a relatively new concept. Ever since “Grays Anatomy” the “bible” for dental students studying anatomy, we all believed that the cranial sutures fuse solid when we become “non-growing adults”. In an interview for Dental Press Magazine of Orthodontic and Facial Orthopedics in 2002, Donald H Enlow, author of three books on Cranium Facial Growth and 170 scientific articles, Dr Enlow, when queried “Is there any craniofacial growth after 20 years of age?” Answered,“yes”. Futhermore, he states, “ A capacity for facial remodeling in adults is retained throughout life”. He also states,“We must utilize three-dimensional evaluation based on an individual’s actual growth and development.” The Homeoblock™ functional appliance produces noticeable facial changes in adult patients in four to six months. We have viewed these changes in three-dimensions using “stereophotogrammetry”. In an article published “Quantification of facial morphology using stereophotogrammetry--demonstration of a new concept.” It is concluded that “ stereophotogrammetry is a suitable 3-D registration method for quantifying and detecting developmental changes in facial morphology.” (1)

Abstract

Maxillary arch changes using the Homeoblock™ appliance have been reported and published in the Functional Orthodontist (2). The purpose of this paper is to look more closely at the facial changes that occur when we remodel the maxillary dental arch wider in the course of palatal expansion. To observe and understand these changes a review of the anatomy of the region is included.







Discussion

The issue of facial esthetics and functional orthodontics is very timely. There is a growing focus on esthetics, which needs to be balanced with good functional outcomes. The Homeoblock™ appliance has several components in combination, including a base-plate with a unilateral bite block and a mid-line expansion screw. We postulate that the unilateral bite block exerts cyclic, intermittent forces on the periodontium of the associated teeth during function (such as swallowing during sleep). These forces are detected by mechanoreceptors on the cell surfaces of the periodontal and periosteal cells. Due to signal transduction(3), a cascade of events is initiated, resulting in gene transcription and mRNA biosynthesis(4). Downstream, osteogenic cells are activated, and adapting to the axial forces, remodeling occurs. The change in vertical dimension (opening the bite) affects also the spatial relations of the contra-lateral teeth(5), which have lost their normal occlusal contacts. These changes are also detected by receptors in their periodontal and periosteal cells. Consequently, remodeling occurs due to signal transduction, adapting to decreased forces in accord with the functional matrix hypothesis(6-7).

The Homeoblock™ appliance has also a base-plate that does not contact the palatal vault. Consequently, swallowing of saliva creates a relative negative pressure between the palatal mucosa and the fitting surface of the device. As the dorsal surface of the tongue exerts forces on the polished surface of the device during swallowing, tension is exerted on the mucoperiosteum of the hard palate and the midpalatal suture is separated. Thus, the developmental mechanisms of sutural homeostasis are activated(8). Despite the fact that most osteogenic activity is normally observed during early to late childhood, it is now understood that palatal, maxillary and circum-maxillary sutures retain biosynthetic potential into late adulthood (9), and it is possible that mechanical stimuli up-regulate genes that are not typically expressed during normal development(10). It is postulated that the Homeoblock™ device maintains physiologic forces on the midpalatal suture, resulting in slow expansion (250µm per week). Recent research suggests that a sutural width >300µm results in bone deposition(11) while a sutural width <300µm is thought to arrest bone deposition and/or initiate bone resorption. Thus, Homeoblock-induced mechanotransduction may result in remodeling activities that affect facial morphology. The net results of this protocol are thought to evoke the maxillo-mandibular spatial patterning that is encoded for at the level of the genome.

According to the functional matrix hypothesis(12), the mandible and mandibular dentition form a spatial matrix(13) that is responsive to the maxillary complex. The unilateral bite-block of the Homeoblock™ appliance activates the lateral pterygoid muscles that displace the mandible anteriorly and inferiorly, providing space for putative condylar remodeling. Therefore, it is conceivable that during the correction of palato-maxillary structures the Homeoblock™ appliance will produce spontaneous correction of the mandible(14) due to neuromuscular activity. Simultaneously, the base-plate of the Homeoblock™ appliance displaces the tongue anteriorly and inferiorly, so that it contacts the lower anterior teeth intermittently. These neuromuscular responses may aid in relieving lower incisor crowding in conjunction with the mandibular expansion screw, while the flap springs aid in the correction of the spatial alignment of the mandibular dentition. Therefore, the ultimate result of the Homeoblock™ device is thought to evoke enhanced symmetrical dentofacial development(15-18) that is genetically encoded for each individual.



References

1. Ras F, Habets LL, van Ginkel FC, Prahl-Andersen B. Quantification of facial morphology using stereophotogrammetry--demonstration of a new concept. J Dent. 1996 Sep;24(5):369-74.
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2. Singh GD, Diaz J, Busquets-Vaello C, Belfor TR. Soft tissue facial changes following treatment with a removable orthodontic appliance in adults. Funct Orthod. 2004;21(3):18-23.
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3. Sandy JR. Signal transduction. Br J Orthod 1998; 25:269-274.
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4. Mao JJ, Nah HD. Growth and development: hereditary and mechanical modulations. Am J Orthod Dentofacial Orthop 2004;125:676-689.
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5. Iscan HN, Sarisoy L. Comparison of the effects of passive posterior bite-blocks with different construction bites on the craniofacial and dentoalveolar structures. Am J Orthod Dentofacial Orthop 1997;112:171-178.
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6. Moss ML. The functional matrix hypothesis revisited: The role of mechanotransduction. Am J Orthod Dentofacial Orthop 1997;112:8-11.
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7. Singh GD. On Growth and Treatment: the Spatial Matrix hypothesis. In: McNamara JA Jr (ed). Growth and treatment. Craniofacial Growth Series. Monograph 41. Ann Arbor: University of Michigan, 2004.
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8. Mao JJ, Wang X, Mooney MP, Kopher RA, Nudera JA. Strain induced osteogenesis of the craniofacial suture upon controlled delivery of low-frequency cyclic forces. Front Biosci 2003;8:A10-17.
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9. Kokich VC. The biology of sutures. In: MM Cohen Jr (ed). Craniosynostosis: Diagnosis, evaluation and management. New York: Raven Press, 1986.
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10. Mao JJ, Nah HD. Growth and development: hereditary and mechanical modulations. Am J Orthod Dentofacial Orthop 2004;125:676-689.
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11. Borke JL, Yu JC, Isales CM, Wagle N, Do NN, Chen JR, Bollag RJ. Tension-induced reduction in connexin 43 expression in cranial sutures is linked to transcriptional regulation by TBX2. Ann Plast Surg 2003;51:499-504.
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12. Moss ML. The functional matrix hypothesis revisited: The role of mechanotransduction. Am J Orthod Dentofacial Orthop 1997;112:8-11.
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13. Singh GD. On Growth and Treatment: the Spatial Matrix hypothesis. In: McNamara JA Jr (ed). Growth and treatment. Craniofacial Growth Series. Monograph 41. Ann Arbor: University of Michigan, 2004.
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14. Lima AC. Spontaneous mandibular arch response following rapid palatal expansion: a long term study on Class I malocclusion. MS thesis, Marquette University, Milwaukee, Wisconsin, 2004.
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15. Belfor TR, Singh GD. Developing facial symmetry using an intra-oral device. J Cosmetic Dent 2004;20:76-80.
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16 Belfor TR, Singh GD. Developing dental arch symmetry using the Homeoblock device. Int J Orthod 2004;15(3), 27-30.
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17. Singh GD, Diaz J, Busquets-Vaello C, Belfor TR. Soft tissue facial changes following treatment with a removable orthodontic appliance in adults. Funct Orthod. 2004;21(3):18-23.
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18. Belfor TR, Singh GD. Treating malocclusions and improving orofacial form and function in adults. J Amer Acad Gnathol Orthop 2005;22(1), 14-17.
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