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Lower Jaw Expansion, Maxilla Advancement, Biobloc Stage 3 : : Claiming. Power. Yes expanding the lower jaw or mandible in Adults is not easy, but certainly some expansion is possible as below pictures show. This is results of 3 years of treatment to reverse the damage of extraction orthodontics, where I spend good half of that time in acrylic palate expanders. Below picture shows the expansion of my lower palate arch both laterally & anteriorly. Expanded sideways and also forwards to regain the space for bicuspids.
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I got 4 bicuspid implants now, below shows how my palate has changed over the 3 years. Each bicuspid implant require 7 mm space, so we are talking pretty significant changes to regain all 4 spaces in the arch. The front teeth may appear to tip forwards, but they were tipped too far back before. The smile and lip support is so much better when the teeth is slightly tipped forwards, in the molds it may look too far out by visually they look fine actually and some of that may also balance out with proper lip seal over time. Lower Arch. Lower arch is challenging to expand because there is no suture down there like there is with the upper jaw, so it is mostly depositional bone growth, moving the teeth out little bit at a time and waiting for the bone to remodel underneath.
We eventually got to the point where we simply couldn’t move the teeth any further out. Like right at the edge of the gums almost. Its been a long while since I finished expanding the lower arch and still bone has not grown further out again, so in my opinion there may be limit to how much you can really expand the lower arch in adults. Perhaps something that applies that littlest of the forces, and it may take 5- 1. Other option is to surgically cut the front part of the jaw and create a suture. Well I expanded as much as I could and as much as needed to get the bicuspids back, so I moved on to the next phase. I’m not trying to wait 1.
Interestingly, I expanded the upper palate much further than the lower palate. You would think both palate need to be expanded equally or it would mess up the bite, right?
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That’s what I first thought as well, but Dr. Gibbs knew better. As we expand the upper palate further out, the lower jaw was able to slide forwards, which means it doesn’t have to expand as much as the upper because as it slides forwards, the posterior wider portion comes forwards to meet the top teeth. So there were phases where the lower teeth and upper teeth didn’t really match at all, like the lower teeth would be partially biting into the acrylic appliance above, but overtime the bite naturally came together, as the jaw slid forwards and we continued to expand the lower more and the upper teeth that were slightly tipped outwards, began to upright properly.
If you look at my ct scan above you will see just how solid of a bone the mandible is, and the bone remodeling by the teeth may not directly translate to expanding of the thick mandibular bone underneath, however I do believe that the muscle tone of the masseter muscle plays a large role in shaping that bone, and probably expanding the teeth will also help distribute biting forces differently on the bone which may contribute to widening of the jaw bone. Compared to my before pictures from 4 years back, my lower jaw looks wider, but part of that is caused by the fact that my lower jaw came forwards more.
Also when I began chewing more gum I feel like I did notice bit of widening take place as well. Upper Arch. Once we expanded as much as possible, I got into self- ligating bracket braces with coil springs to further create anterior expansion until we achieved 7 mm space for the bicuspids. Upper Palate Expansion Measurements. From around 3. 3 mm to 4. I had a narrow front arch so we used a hinge type of expansion device for about 8 months to get significant changes in the front palate.
So really the front of the mouth changed the most, after we got the front arch wide, I had Dr. Gibbs modify the appliance where we got rid of the hinge, added on acrylic and put the screw in the middle to get even more expansion on the entire palate. Also notice the flanges on the front of the appliance and the wires, those were adjusted by the doctor every month to provide forward expansion. There were few appointments where Dr thought we had enough expansion but I urged him to continue on, I was very aggressive in pushing for as much expansion as I could possibly get. My mouth posture at the time? I didn’t know much about Mewing back then. But Expansion was still very important step.
The biggest positive benefit are as follows.
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