Questions & Answers
The examples below are general questions to John Mew. The answers to this questions may help others.
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Case specific or detailed personal questions can be asked for a fee.
Reversing Class III
Question:
First, I would like to say from the bottom of my heart "thank you" for all your hard work and dedication you have contributed in this area of health and truth. I believe that your efforts have effectively changed the world for the better and that Orthotropics will continue to magnify as the public grows in awareness over time.
I was astonished to see one of your student's most recent case (in the Cranio-Action Facebook group) of the 41-year-old male class 3 that was safely expanded anteriorly using Stage 1 Biobloc. I have precisely the same issue. I am a 31, Male, Class 3 edge-to-edge, narrow and recessed jaws and mild tmj. Fortunately I have found a skilled provider in my city of Toronto (Canada) that is open to assisting me using Biobloc. He appears already successful in expanding adult cases anteriorly (up to 10mm) using appliance therapy, coupled with other modalities such as osteopathy, physiotherapy, etc. Unfortunately I do not know all of his methods in detail but I trust that he has a degree of knowledge and wisdom in this area
I very much look forward to hearing back from you.
Answer:
Yes Orthotropics would be ideal for you and quite simple. Ask your clinician to use a Stage 1 Biobloc with a Purley wire. The Purley Wires need to be adjusted to 2mm below and 1mm in front of the gingival margin of the lower incisors.
Widen the screw i/8th of a turn EACH day and adjust the Purley wire 1mm down each two weeks but always keep it 1mm from the tissue. This will stop the jaw posturing forward and so stop it growing. He/she must wear it all the time including meals but can remove the wires for eating. Continue expanding until the upper first molars are 45mm apart at their gum margin and close the anterior spacing with the approximating wires. You can later move the remaining premolars forward.
It is VERY important to keep the tip of the tongue on the palate especially all night. Do not adjust the lower teeth.
FACIAL GROWTH.
“Research has shown that forward growth of the mid-face is the most attractive feature of facial appearance. Many people claim that the eyes are also important but actually the eyeball does not vary much and it is the ‘cheek bones’ which create facial beauty.
Many people have tried to find a way of measuring facial attractiveness, but it is surprisingly difficult. Back in the nineteenth century Physiognomists used to measure facial bumps and protrusions claiming to relate them to personality characteristics, but this has now been discredited.
In the 1920s WB Downs started to examine the shape of the skull using X-rays identifying certain points which appeared to be more stable during growth than others. However Brodie examined Downs X-rays in 1938 and declared that "The most startling find was the apparent inability to alter anything beyond the alveolar process". This view has been accepted by most orthodontists ever since.
In 1966 Bjork inserted small metal implants to the maxilla and mandible and found growth “varied individually from almost purely sagittal to purely vertical”. This is a bigger variation than is seen in any other primate or probably even animal. Subsequently in 1976 Isaacson re-worked Bjork’s material and claimed that “Remodelling occurs extensively in bony surfaces, making them too labile for use as stable landmarks”. In effect all the bones of the mid-face alter shape, size and relationships.
In reality the whole mid-face complex of ten or more bones hinges back at Nasion. However as Isaacson found, it is difficult to identify forward growth from X-rays. Battagel in 1996 found that "the vertical changes are not easily detected by conventional cephalometric investigations”.
How then can we measure forward facial growth? The amazing research of Samuels, & Elwy in 1985 showed that babies as young as 3 months old are able to recognize attractive forward growing faces. So clearly, the ability to recognize ideal facial shape is born within us. We just recognize it as beauty but we can see if it changes even 1 millimetre see illustration. If this is true then the human eye might be a better way of recognizing forward facial growth than X-rays or indeed any other measuring device.
Orthodox teaching creates traditional thinkers, it is time to think out of the box and recognize that facial change is better measured by the eye than a ruler. That is why the public prefer Orthotropics even although there may be spaces between the back teeth”.
Stage 3 Biobloc appliance
Question:
My question is about the Stage 3 Biobloc appliance. As I learned from various sources on the classic Orthotropic treatment, the Stage 3 appliance is uniquely designed to eliminate retractive forces on the maxilla, which are common with all other jaw advancing appliances used in children, like the twin bloc, and also with all adult mandibular advancing devices. It is easily understood why the Stage 3 biobloc works differently, as it requires a very active use of muscle force to hold the mandible in the desired position, which results in a very quick and sustainable training effect.
Contrary to this, with functional appliances the new mandible position is achieved through passive repositioning, which results in the mandible falling back easily when unconscious, exerting retractive forces on the maxilla. Due to its specific and sensitive functionality, the sucessful handling of the Stage 3 appliance requires very high skills. Now in individuals who have a history of unexpected vertical growth with conventional expansion, possibly due to an undiagnosed connective tissue disorder, and who have improved greatly with the Orthotropic Stage 1 treatment - is there any risk that during the Stage 3 some of the forward growth achieved might be lost? That the positive effects of the Stage 3 appliance regarding mandible position, a closed mouth and teeth contact might be overridden by a hypothetical residual traction force on the maxilla, which for most patients will be irrelevant, but for some - prone to maxillary damage - might still be too much? Thank you so much for answering my question.
Answer:
Thank you for your well informed question. You are quite right in all you say. I think the one point you have missed is that correct oral posture has to be subconscious.
I discovered this by chance and the Stage 3 appliance must be worn all night before a patient can learn the correct subconscious posture. All goodlooking people have that posture 24/7. It is natural for mammals but spoilt by modern lifestyles.
You ask about the long-term. I have been amazed by the stability of orthotropics results if their posture is OK there is no relapse at all. I tested this with Identical Twins.