Frequently Asked Questions
1. What are the main obstruction area that are visible of the CBCt scan of the head? –
· The CBCT scan, when it includes a large area of view, is ableto show upper airway constriction at different levels. Common areas ofconstriction include nasal base (reduced nasal base width), velopharyngeal area(area behind the soft palate), oropharynx (area behind the tongue), andhypopharynx (area below the tongue).
2. Can MARPE alone address obstructive sleep apnea?
· MARPE, as an appliance is not a “magic wound”. Even though multiple studies have shown increase in nasal base width, nasopharyngeal width, and sometimes oropharynegal width, after MARPE, it is not a “universal cure” .Our practice is specifically focused to taking expansion-based treatment further to improve other areas of constriction, such as oropharyngeal and hypopharyngeal, with manipulations (orthodontic repositioning and orthodontic advancement) on the mandible. This approach identifies and tackles anatomical phenotype of ObstructiveSleep Apnea.
3. Is a corticotomy also part of the treatment plan, or are piezocorticotomy and corticotomy the same procedure?
· Pieozocorticotomy, specifically 3D guided midpalatalpiezocorticitomy, is always a part of our protocol in pateints 18 years old andover. Corticotomy is a general term for ‘cutting’ the thick bone.
4. You mention that alignertreatment begins on day one. Doesthis mean aligners are delivered the same day MARPE is installed, and if so,what is the clinical rationale? Is this considered a “no-gap” protocol?
· In MARPEFACE protocol aligners begin day one, and are used on the lower arch to start consequtive movements there. This is NOT considered a no-gap protocol.
5. You mentioned myofunctional therapy would occur after expansion. How does tongue-tie release fit into the treatment timeline.
· Myofunctional therapy and tongue-tie release evaluation are always part of the treatment, and are timed after the MARPE/FME/MSE expander is removed.