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u/HugeIntroduction8707

▲ 2 r/UARS

Ortho proposed a "10-15 day MARPE trial" before surgical assist. Thoughts on this plan?

Context: 29M, breathing issues, fatigue, recessed jaws. My upper arch is severely narrow due to childhood ortho (extractions + headgear), but my lower jaw is also very narrow and missing teeth.

The Proposed Plan: The ortho looked at my CBCT and confirmed my midpalatal suture is completely fused. However, she proposed the following:

  1. The MARPE Trial: Install MARPE and start a very conservative expansion protocol to see if we can get airway benefits.
  2. The 10-Day Check: Evaluate at day 10-11. If the suture pops, great.
  3. Plan B: If there's no skeletal movement by day 11, stop immediately to avoid tipping/bone damage, and switch to surgically assisted expansion or expand along with the jaw surgery.
  4. Conservative Goal: Limit the expansion amount to avoid a scissor bite, since my lower jaw is narrow and my bite is fine.
  5. Phase 2: Double Jaw Surgery (Advancement) once the arch is ready.

My Questions:

  1. Has anyone in their late 20s/30s tried this 10-day "wait and see" MARPE approach before pulling the trigger on surgical assist?
  2. Does this sound like a safe, realistic plan given my fused suture, or should I just go straight to jaw surgery?

Would love to hear your experiences!

reddit.com
u/HugeIntroduction8707 — 21 hours ago
▲ 1 r/UARSnew

Ortho proposed a "10-15 day MARPE trial" before surgical assist. Thoughts on this plan?

Context: 29M, breathing issues, fatigue, recessed jaws. My upper arch is severely narrow due to childhood ortho (extractions + headgear), but my lower jaw is also very narrow and missing teeth.

The Proposed Plan: The ortho looked at my CBCT and confirmed my midpalatal suture is completely fused. However, she proposed the following:

  1. The MARPE Trial: Install MARPE and start a very conservative expansion protocol to see if we can get airway benefits.
  2. The 10-Day Check: Evaluate at day 10-11. If the suture pops, great.
  3. Plan B: If there's no skeletal movement by day 11, stop immediately to avoid tipping/bone damage, and switch to surgically assisted expansion or expand along with the jaw surgery.
  4. Conservative Goal: Limit the expansion amount to avoid a scissor bite, since my lower jaw is narrow and my bite is fine.
  5. Phase 2: Double Jaw Surgery (Advancement) once the arch is ready.

My Questions:

  1. Has anyone in their late 20s/30s tried this 10-day "wait and see" MARPE approach before pulling the trigger on surgical assist?
  2. Does this sound like a safe, realistic plan given my fused suture, or should I just go straight to jaw surgery?

Would love to hear your experiences!

reddit.com
u/HugeIntroduction8707 — 21 hours ago
▲ 1 r/jawsurgery

Ortho proposed a "10-15 day MARPE trial" before surgical assist. Thoughts on this plan?

Context: 29M, breathing issues, fatigue, recessed jaws. My upper arch is severely narrow due to childhood ortho (extractions + headgear), but my lower jaw is also very narrow and missing teeth.

The Proposed Plan: The ortho looked at my CBCT and confirmed my midpalatal suture is completely fused. However, she proposed the following:

  1. The MARPE Trial: Install MARPE and start a very conservative expansion protocol to see if we can get airway benefits.
  2. The 10-Day Check: Evaluate at day 10-11. If the suture pops, great.
  3. Plan B: If there's no skeletal movement by day 11, stop immediately to avoid tipping/bone damage, and switch to surgically assisted expansion or expand along with the jaw surgery.
  4. Conservative Goal: Limit the expansion amount to avoid a scissor bite, since my lower jaw is narrow and my bite is fine.
  5. Phase 2: Double Jaw Surgery (Advancement) once the arch is ready.

My Questions:

  1. Has anyone in their late 20s/30s tried this 10-day "wait and see" MARPE approach before pulling the trigger on surgical assist?
  2. Does this sound like a safe, realistic plan given my fused suture, or should I just go straight to jaw surgery?

Would love to hear your experiences!

reddit.com
u/HugeIntroduction8707 — 21 hours ago
▲ 2 r/MARPE

Ortho proposed a "10-15 day MARPE trial" before surgical assist. Thoughts on this plan?

Context: 29M, breathing issues, fatigue, recessed jaws. My upper arch is severely narrow due to childhood ortho (extractions + headgear), but my lower jaw is also very narrow and missing teeth.

The Proposed Plan: The ortho looked at my CBCT and confirmed my midpalatal suture is completely fused. However, she proposed the following:

  1. The MARPE Trial: Install MARPE and start a very conservative expansion protocol to see if we can get airway benefits.
  2. The 10-Day Check: Evaluate at day 10-11. If the suture pops, great.
  3. Plan B: If there's no skeletal movement by day 11, stop immediately to avoid tipping/bone damage, and switch to surgically assisted expansion or expand along with the jaw surgery.
  4. Conservative Goal: Limit the expansion amount to avoid a scissor bite, since my lower jaw is narrow and my bite is fine.
  5. Phase 2: Double Jaw Surgery (Advancement) once the arch is ready.

My Questions:

  1. Has anyone in their late 20s/30s tried this 10-day "wait and see" MARPE approach before pulling the trigger on surgical assist?
  2. Does this sound like a safe, realistic plan given my fused suture, or should I just go straight to jaw surgery?

Would love to hear your experiences!

reddit.com
u/HugeIntroduction8707 — 21 hours ago
▲ 1 r/UARS

Is MARPE/SARPE necessary before jaw surgery? Narrow arch vs. Normal nasal base dilemma

Hey everyone, looking for some insights on my pre-surgical planning. I'm trying to figure out if pre-surgical palate expansion is actually the right move for my specific anatomy.

My Context:

  • Age: 29M.
  • Symptoms: Breathing issues, chronic fatigue, recessed jaws with a steep mandibular plane. I'm not 100% sure if my breathing problems are primarily caused by my tongue dropping back and blocking my throat, but my airway is definitely narrow.
  • History: Had old-school ortho as a kid (extractions + headgear), which severely collapsed my upper arch.
  • Surgical Plan: Double Jaw Surgery (DJS) with advancement and CCW rotation. My maxilofacial surgeon hasn't confirmed the exact mm of advancement yet.

The Expansion Dilemma: My upper dental arch is extremely narrow, leaving zero room for my tongue. However, my CBCT scans show a major structural discrepancy:

  1. Nasal cavity (piriform aperture): 24mm (which seems to be completely normal).
  2. Suture status: My ortho confirmed my midpalatal suture is tightly fused. Pure MARPE is off the table; if I expand beforehand, it has to be SARPE

My Questions for the community:

  1. Since my actual nasal cavity width (24mm) is already normal, is pre-surgical expansion (SARPE/MARPE) still necessary to get breathing benefits? Or would expanding risk over-expanding my nose just to fix a dental-level collapse?
  2. Would it make more sense to skip pre-surgical expansion entirely, treat my baseline allergies (because turbinates are enlarged), and rely on the DJS advancement (plus maybe a 3-piece segmented LeFort during the DJS to widen the dental arch) to fix my breathing?

Would love to hear if anyone has navigated a similar setup or skipped expansion in a case like this. Thanks!

u/HugeIntroduction8707 — 9 days ago
▲ 2 r/UARSnew

Is MARPE/SARPE necessary before jaw surgery? Narrow arch vs. Normal nasal base dilemma

Hey everyone, looking for some insights on my pre-surgical planning. I'm trying to figure out if pre-surgical palate expansion is actually the right move for my specific anatomy.

My Context:

  • Age: 29M.
  • Symptoms: Breathing issues, chronic fatigue, recessed jaws with a steep mandibular plane. I'm not 100% sure if my breathing problems are primarily caused by my tongue dropping back and blocking my throat, but my airway is definitely narrow.
  • History: Had old-school ortho as a kid (extractions + headgear), which severely collapsed my upper arch.
  • Surgical Plan: Double Jaw Surgery (DJS) with advancement and CCW rotation. My maxilofacial surgeon hasn't confirmed the exact mm of advancement yet.

The Expansion Dilemma: My upper dental arch is extremely narrow, leaving zero room for my tongue. However, my CBCT scans show a major structural discrepancy:

  1. Nasal cavity (piriform aperture): 24mm (which seems to be completely normal).
  2. Suture status: My ortho confirmed my midpalatal suture is tightly fused. Pure MARPE is off the table; if I expand beforehand, it has to be SARPE

My Questions for the community:

  1. Since my actual nasal cavity width (24mm) is already normal, is pre-surgical expansion (SARPE/MARPE) still necessary to get breathing benefits? Or would expanding risk over-expanding my nose just to fix a dental-level collapse?
  2. Would it make more sense to skip pre-surgical expansion entirely, treat my baseline allergies (because turbinates are enlarged), and rely on the DJS advancement (plus maybe a 3-piece segmented LeFort during the DJS to widen the dental arch) to fix my breathing?

Would love to hear if anyone has navigated a similar setup or skipped expansion in a case like this. Thanks!

u/HugeIntroduction8707 — 9 days ago
▲ 1 r/MARPE

Is MARPE/SARPE necessary before jaw surgery? Narrow arch vs. Normal nasal base dilemma

Hey everyone, looking for some insights on my pre-surgical planning. I'm trying to figure out if pre-surgical palate expansion is actually the right move for my specific anatomy.

My Context:

  • Age: 29M.
  • Symptoms: Breathing issues, chronic fatigue, recessed jaws with a steep mandibular plane. I'm not 100% sure if my breathing problems are primarily caused by my tongue dropping back and blocking my throat, but my airway is definitely narrow.
  • History: Had old-school ortho as a kid (extractions + headgear), which severely collapsed my upper arch.
  • Surgical Plan: Double Jaw Surgery (DJS) with advancement and CCW rotation. My maxilofacial surgeon hasn't confirmed the exact mm of advancement yet.

The Expansion Dilemma: My upper dental arch is extremely narrow, leaving zero room for my tongue. However, my CBCT scans show a major structural discrepancy:

  1. Nasal cavity (piriform aperture): 24mm (which seems to be completely normal).
  2. Suture status: My ortho confirmed my midpalatal suture is tightly fused. Pure MARPE is off the table; if I expand beforehand, it has to be SARPE

My Questions for the community:

  1. Since my actual nasal cavity width (24mm) is already normal, is pre-surgical expansion (SARPE/MARPE) still necessary to get breathing benefits? Or would expanding risk over-expanding my nose just to fix a dental-level collapse?
  2. Would it make more sense to skip pre-surgical expansion entirely, treat my baseline allergies (because turbinates are enlarged), and rely on the DJS advancement (plus maybe a 3-piece segmented LeFort during the DJS to widen the dental arch) to fix my breathing?

Would love to hear if anyone has navigated a similar setup or skipped expansion in a case like this. Thanks!

u/HugeIntroduction8707 — 9 days ago
▲ 3 r/jawsurgery

Is MARPE/SARPE necessary before jaw surgery? Narrow arch vs. Normal nasal base dilemma

Hey everyone, looking for some insights on my pre-surgical planning. I'm trying to figure out if pre-surgical palate expansion is actually the right move for my specific anatomy.

My Context:

  • Age: 29M.
  • Symptoms: Breathing issues, chronic fatigue, recessed jaws with a steep mandibular plane. I'm not 100% sure if my breathing problems are primarily caused by my tongue dropping back and blocking my throat, but my airway is definitely narrow.
  • History: Had old-school ortho as a kid (extractions + headgear), which severely collapsed my upper arch.
  • Surgical Plan: Double Jaw Surgery (DJS) with advancement and CCW rotation. My maxilofacial surgeon hasn't confirmed the exact mm of advancement yet.

The Expansion Dilemma: My upper dental arch is extremely narrow, leaving zero room for my tongue. However, my CBCT scans show a major structural discrepancy:

  1. Nasal cavity (piriform aperture): 24mm (which seems to be completely normal).
  2. Suture status: My ortho confirmed my midpalatal suture is tightly fused. Pure MARPE is off the table; if I expand beforehand, it has to be SARPE

My Questions for the community:

  1. Since my actual nasal cavity width (24mm) is already normal, is pre-surgical expansion (SARPE/MARPE) still necessary to get breathing benefits? Or would expanding risk over-expanding my nose just to fix a dental-level collapse?
  2. Would it make more sense to skip pre-surgical expansion entirely, treat my baseline allergies (because turbinates are enlarged), and rely on the DJS advancement (plus maybe a 3-piece segmented LeFort during the DJS to widen the dental arch) to fix my breathing?

Would love to hear if anyone has navigated a similar setup or skipped expansion in a case like this. Thanks!

u/HugeIntroduction8707 — 9 days ago
▲ 2 r/MARPE

My Dr. told me that MARPE won't work. Are these other options viable?

• Need for expansion: The upper palate must be expanded; attempting to align the upper molars in their current position would result in a reverse or crossbite.

• Suture status: Given your age (30 years old), the palatal suture is quite closed and fused.

• Ruling out simple MARPE: A conventional MARPE expander (which relies on teeth or micro-screws without bone cuts) will not have sufficient force to open the suture in this case.

• Option 1: It is recommended to plan for a SARPE-type appliance (or surgically assisted variants such as “mis-marpe” or BAME), which requires cuts (corticotomies) in the bone to release resistance and allow for actual expansion in adults.

• Option 2: Orthognathic surgery: This involves undergoing a comprehensive procedure in which the upper jaw is impacted to correct bone density and asymmetry, with expansion performed simultaneously in the operating room to avoid subjecting the patient to two separate surgeries.

What do you think? Is sarpe good?

reddit.com
u/HugeIntroduction8707 — 10 days ago
▲ 2 r/PerfumesArgentina

Qué hace que un perfume tenga estela / proyeccion? Realmente una empresa de imitaciones puede lograrlo tambien?

Mi pregunta va mas que nada por el tema de si realmente estas empresas como extracto importado, yves d'orgeval, leduft, etc pueden lograr la misma calidad de perfume como los originales. Tambien proyectan y dejan estela como los originales?

En teoria los originales no usan materia prima mas "exclusivas"?

Igual soy conciente de que muchos de los originales muchas veces tambien dejan mucho que desear a la hora de duracion / proyeccion

reddit.com
u/HugeIntroduction8707 — 11 days ago
▲ 4 r/MARPE

My Case:

  • 29M. steep mandibular plane, recessed jaws, and very narrow airway (chronic fatigue).
  • Had old-school ortho as a kid (extractions + headgear), which retracted my jaws and severely collapsed my dental arch.

MARPE vs. 3-piece LeFort I My upper arch is so narrow that my tongue drops and blocks my throat. But my CBCT shows a huge discrepancy:

  1. My piriform aperture (nasal base) is completely normal (24.0 mm).
  2. My intermolar width is severely narrow (27.8 mm).

I'm consulting with specialists before locking in a surgical plan. Ortho #2 told me that since my nasal base is normal, doing MARPE/SARPE might unnecessarily over-expand my nose just to fix a dental issue. She suggested skipping MARPE and doing a DJS with a 3-piece Segmented LeFort I to only widen the dental horseshoe. (Note: I'm still waiting for Ortho #1's final feedback on this CBCT).

My Questions:

  1. Has anyone dealt with this specific discrepancy (normal piriform but narrow intermolar width)?
  2. Biomechanically, what makes more sense here: expanding the whole palate beforehand with MARPE, or just widening the dental arch with a 3-piece Segmented LeFort during DJS?
u/HugeIntroduction8707 — 22 days ago
▲ 1 r/jawsurgery

My Case:

  • 29M. steep mandibular plane, recessed jaws, and very narrow airway (chronic fatigue).
  • Had old-school ortho as a kid (extractions + headgear), which retracted my jaws and severely collapsed my dental arch.

MARPE vs. 3-piece LeFort I My upper arch is so narrow that my tongue drops and blocks my throat. But my CBCT shows a huge discrepancy:

  1. My piriform aperture (nasal base) is completely normal (24.0 mm).
  2. My intermolar width is severely narrow (27.8 mm).

I'm consulting with specialists before locking in a surgical plan. Ortho #2 told me that since my nasal base is normal, doing MARPE/SARPE might unnecessarily over-expand my nose just to fix a dental issue. She suggested skipping MARPE and doing a DJS with a 3-piece Segmented LeFort I to only widen the dental horseshoe. (Note: I'm still waiting for Ortho #1's final feedback on this CBCT).

My Questions:

  1. Has anyone dealt with this specific discrepancy (normal piriform but narrow intermolar width)?
  2. Biomechanically, what makes more sense here: expanding the whole palate beforehand with MARPE, or just widening the dental arch with a 3-piece Segmented LeFort during DJS?
u/HugeIntroduction8707 — 22 days ago
▲ 13 r/BocaJuniors

Tambien me parece increíble que haya hecho linea de 5 tan temprano en el partido cuando ellos no demostraban NADA.

En fin, una paja

u/HugeIntroduction8707 — 23 days ago