#84 – Dr. Ilya Lipkin – The Midface Expander Debate: Why FME Falls Short

Ron interviews Dr. Ilya Lipkin, an orthodontist with extensive MARPE experience. They discuss the nuances of Custom MARPE versus FME, including design considerations, TAD stability, and innovations like “Lipkin Wings.” The conversation also covers the role of surgical assist, strategies to address and prevent asymmetry, and the importance of jackscrew orientation. Additionally, Dr. Lipkin shares insights on Facemask protraction therapy and offers perspectives on MMA surgery and selecting a surgeon.

Connect with Dr. Lipkin

https://www.instagram.com/drlipkinsmiles

https://www.gotbraces.com/

JawHacks Official eBook

https://substack.com/@jawhacks

1-on-1 Chat with Ron

https://jawhacks.com/chats

And More on the Website

https://jawhacks.com/

Timestamps

00:00:00 – Intro

00:00:40 – Dr. Lipkin’s Custom MARPE Experience & Course

00:02:33 – The FME Appliance: Dr. Lipkin’s Unbiased Impressions

00:05:10 – FME Design Flaws? TAD Tipping & Force Vectors

00:10:24 – Armless Expanders: A True Skeletal Solution or Marketing Hype?

00:13:06 – MARPE Arms to Prevent Pinching of Soft Tissue

00:15:49 – FME’s Locking TADs To Prevent Tissue Pinching

00:17:06 – Why Lateral TADs Are NON-NEGOTIABLE for Predictable Expansion

00:18:46 – The “High Palate” Myth & Problems with Distant Force Application

00:22:06 – The Disadvantage of Stock Appliances: Not Assessing Bone Thickness

00:24:59 – Surgical Assist (Piezo): Does It Always Guarantee a Midline Split?

00:29:44 – Revisiting Locking TADs (and 2-Piece Design): Are They the Future for All Expanders?

00:32:25 – Introducing “Lipkin Wings”: A Custom Solution for TAD Locking

00:33:16 – Facegenics Cephalometric Analysis vs. Dr. Lipkin’s Asymmetry Prevention Protocol

00:43:08 – Aligning the Expander to Avoid Exacerbating Asymmetries

00:45:50 – Expansion Sweet Spot: How Many Millimeters on Average?

00:47:12 – Can the Lab Catch a Orthodontist’s Design Mistakes?

00:49:05 – The Imperative of MARPE Courses for Aspiring Practitioners

00:51:08 – Why MARPE Post-Jaw Surgery is NOT a Good Idea

00:54:29 – Do Different Surgical Plates Impact Post-Op MARPE Expansion?

00:56:45 – MARPE’s Downward & Forward Vector: Is It to Be Expected?

00:58:21 – Is a Gummy Smile (Vertical Maxillary Excess) a Disqualifier for MARPE?

00:59:45 – Small Teeth Post-Expansion: Restorative Dentistry or Orthodontic Solution?

01:00:53 – Diastema Closure: Sliding Teeth Forward vs. Retracting Front Teeth

01:03:39 – Dr. Lipkin’s Unfiltered Opinion on AGGA (Anterior Growth Guidance Appliance)

01:06:35 – SFOT Planning & Lower Dental Tipping Mechanics: A MUST for Predictability

01:12:46 – The Critical Role of a Skilled Periodontal Partner for SFOT

01:14:31 – Ron’s Transformation & Traumatic Memory: From “Humpty Dumpty” to Facial Harmony

01:16:00 – Maxillary Protraction: Is it the Facemask’s Merit or MARPE’s Mechanics Alone?

01:17:50 – Case Studies: What Happens When You DON’T Wear Your Facemask?

01:20:04 – Facemask Indications: Is It Only for Class III Patients?

01:23:03 – Adult Facemask Use: Viable Option? How Many Hours Per Day?

01:24:45 – Facemask vs. Bollard Plates: Weighing TMJ Problems & Force Vectors

01:27:43 – The Future of Facemasks: Innovations from Partners Dental Labs & Facegenics (FMA)?

01:28:08 – Does Facemask Cause Undesirable Dental Tipping with MARPE?

01:29:29 – Long-Term Stability: How to Retain Facemask Protraction Results?

01:30:33 – Dr. Lipkin’s Concerns on Mandibular Midline Distraction Surgeries (MSDO)

01:32:11 – Thoughts on Multi-Piece Mandibular Surgeries

01:33:00 – Worst Jaw Surgery Outcomes: Aesthetic & Functional Nightmares

01:35:41 – Avoiding Surgical Complications: How to Plan for a Good Outcome

01:39:56 – The Role of Implants (Cheekbone, Orbitals) in Achieving Facial Harmony

01:42:32 – Dr. Lipkin’s Top Jaw Surgeon of Choice

01:44:27 – Advanced Surgical Assist: Separating Nasal Septum Before Expansion (MIND)

01:46:48 – Ron’s Gratitude & Dr. Lipkin’s Motivation Behind His Practice

01:48:50 – Dr. Lipkin Jr. vs. “Extract & Retract” Orthodontists

NO MEDICAL OR DENTAL ADVICE. Ronald Ead and JAWHACKS, LLC, dba JawHacks (collectively, “we”) does not give medical advice. We are not licensed medical professionals. The information provided in this video is for educational and informational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare provider with any questions you may have regarding your health or a medical condition. Reliance on any information provided in this video is solely at your own risk. We make no representations or warranties about the accuracy or completeness of the information presented. You should not use these materials to diagnose or treat any health issues, illnesses or diseases. In addition, we do not recommend or endorse any provider of health care or health-related products, items, or services.