MSE: 4 Week X-Rays
MSE (Maxillary Skeletal Expander) was installed on July 15, 2019 by Dr. Zubad Newaz, an orthodontist at the Gelb Center in Manhattan.
On August 14, at my first follow-up, Dr. Newaz took a CBCT scan. At the time of this scan I had turned the MSE screw 43 times.
Snapshots from that scan are shown below.
MSE Screws Are Upright, No Screw Drag
The first image shows 1) the suture split and 2) the condition of the four MSE screws.
Sometimes when MSE fails to split the suture, the screws end up just dragging through the maxillary bone. This is called screw drag and can be seen in a CBCT.
My CBCT shows that I had a clean split with no screw drag. All four of my 11mm MSE screws are fixed and upright in the maxillary bone.
This is good as it means continued MSE expansion (at a rate of 1 turn per day) should occur without issue. It’s all downhill from here.
Views of the MSE Suture Split
The images below depict a variety of views of my successful mid-palatal suture split. In all images, the blue arrow points to the split.
Disruption of Pterygomaxillary Suture
The pterygomaxillary suture or fissure, also known as the sphenomaxillary suture, can be effected by MSE.
Upon viewing my CBCT, Dr. Newaz told me that mine had clearly been disrupted by MSE (although he said it was not broken).
The image below shows the location of this suture.
The fact that MSE can disrupt a variety of sutures throughout the cranium is what makes the combination of MSE with FaceMask potentially effective.
When these cranial sutures are disrupted, they become more pliable. This makes it possible for the FaceMask, when attached to the maxilla by means of the MSE, to pull forward structures in the midface.
In theory, this should create bonafide forward movement of the A-point, not just forward movement of the alveolar bone and teeth.
Currently I am of the opinion that MSE is the only dental appliance that creates true skeletal maxillary expansion in adults.
I have no reason to believe that AGGA, Schwartz, DNA, ALF and other appliances do anything other than move teeth and alveolar bone in adults.
