JawHacks

In this episode, Dr. Jeremy Manuele breaks down the quality of adult maxillary expansion beyond just "did it split?" We compare FME, custom MARPE, and MSE Type 2, explore surgical assists, preview FME Pro, and analyze a rare complication case. 

Dr. Manuele did not disclose the actual number of FME cases he has performed, but he has been working with adult non-surgical skeletal expansion and other TAD-anchored appliances since 2016, and in that time he’s helped many hundreds of patients.

In this podcast, Dr. Manuele delivers unique, never-before-seen visual demonstrations showing key differences between FME, Custom MARPE, and MSE, which are 3 top skeletal expander brands.

Essential viewing for anyone considering adult palatal expansion or airway treatment.

1:1 Coaching with Ron — Now Inside The Joint

https://jawhacks.com/coaching

JawHacks Newsletter (Substack)

https://substack.com/@jawhacks

And More on the Website

https://jawhacks.com/

Pre-order Dr. Manuele's book

https://amzn.to/4oQXY4e

Connect with Dr. Manuele

‪https://www.youtube.com/@vegasorthodoc

https://www.instagram.com/hm_ortho

https://www.facebook.com/hamiltonortho/

https://vegasorthodoc.com 

TImestamps

00:00:00 - Introduction: How Different Expanders Work

00:02:08 - The Three Types of Expansion Explained

00:03:16 - Why Dental Expansion Is Dangerous for Adults

00:05:46 - Why Airway Cross-Sections Can Mislead You

00:08:41 - Case Study: 3D Superimposition Reveals Only Dental Tipping

00:10:30 - Dento-Alveolar Expansion: The Middle Ground

00:12:16 - Fast vs. Slow Turning: How to Shock the Suture into Splitting

00:16:24 - Age Ranges for Tooth-Borne Expander Success (and Why They Fail in Adults)

00:19:24 - Case Study: When Dento-Alveolar Expansion Goes Wrong

00:23:40 - Bonded RPEs: Using 360° Grip for Better Stability in Kids

00:25:31 - Why Not Just Use MARPE on a Child? (Risk vs. Reward)

00:30:00 - When Tooth-Borne Expanders Become Inappropriate

00:31:20 - Expanding Toddlers (Ages 2-4): Is It Worth It?

00:32:57 - True Skeletal (Orthopedic) Expansion Fundamentals

00:34:30 - SARPE, DOME, and Why Surgical Assists Have Limitations

00:39:48 - Top 3 Reasons for MARPE (and When Expansion Isn't the Answer)

00:40:20 - Case Study: 10mm Skeletal Split in a Teenager

00:44:31 - The 5 Factors of Jaw Growth (and ChatGPT's Shocking Ranking)

00:56:42 - Case Study: How an Adult Got 4mm of Forward Growth (FME + Chewing)

00:58:12 - The Key: Mobilizing Circum-Maxillary Sutures

01:00:43 - How to Loosen Adult Sutures: FCPC, Osteopathy, and Chewing

01:09:26 - Case Study: Patient X and the Wisdom Tooth Debate

01:13:17 - Wisdom Teeth and Premolar Extractions Impact on Jaw Growth

01:17:00 - Why Age 5-7 is Dr. Manuele's "Sweet Spot" for Expansion

01:20:48 - Does Expanding the Maxilla Make the Mandible Grow?

01:23:43 - Patient X's Journey: The EASE Procedure

01:26:45 - Why The Field is Moving Away from Surgical Assists (EASE & Piezo)

01:30:44 - Chewing, Clenching, and TMJD Risks During Expansion

01:32:08 - Who Needs a Piezo? Thick Bone or Thin Bone?

01:35:43 - Custom MARPE vs. FME for "Potato Chip" Thin Palates

01:36:53 - Patient X's Expansion and the Start of a Major Complication

01:39:47 - Cross-Eyed Vision From Expansion (Cranial Nerve 4 Palsy)

01:43:04 - 3D Analysis: Did Expansion Compress the Superior Orbital Fissure?

01:51:01 - Final Net Change and Key Lesson: "Slow is Predictable"

01:56:55 - Suture Mechanics: The "Puzzle Piece" Analogy (Remodel vs. Snap)

02:00:05 - Patient X's "Perfect Storm" for Complication

02:02:07 - From MARPE to MASPE: Why Turning Protocols Are Slower

02:04:00 - Dr. Manuele's Current "Stretching Turn" FCPC Protocol

02:07:56 - Dimensional Stability: MSE vs. Custom MARPE vs. FME

02:16:25 - Does Rotational Stability Matters? Preventing Asymmetric Dropping

02:19:45 - Where Do Asymmetries Come From? (Lab vs. Doctor vs. Appliance)

02:25:38 - Animation: How Expander "Wobble" Creates Vertical Discrepancy

02:31:27 - Behind the Scenes: The FME Planning & Design Report

02:32:50 - FME vs. Custom MARPE: Which is Safer with an Inexperienced Doctor?

02:42:45 - Why Not Just Use an Armless Custom MARPE?

02:44:44 - FME Pro: A Breakdown of the New Design Improvements

02:50:20 - Resources: Courses, Coaching, and Dr. Manuele's New Book

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.

In this episode, I reconnect with Dr. Reza Movahed, an oral and maxillofacial surgeon based in St. Louis, MO, who performs 90 to 100 total TMJ joint replacement surgeries per year, ranking among the most experienced joint surgeons worldwide. He shares his personal journey through three jaw surgeries that transformed his approach to patient care and surgical planning. We discuss idiopathic condylar resorption (ICR), why certain patients are at higher risk for double jaw surgery failure, and when total joint replacement becomes essential. Dr. Movahed details his bone grafting methods, collaboration with top orthodontists, and how counterclockwise rotation with joint replacement achieves superior esthetic and functional results. He also highlights his MCO mandibular expansion device, the role of DISE in planning, and long-term joint data proving decades of success.

Contact Dr. Reza Movahed

https://www.instagram.com/movahedoms

https://movahedoms.com/

1:1 Coaching with Ron — Now Inside The Joint

https://jawhacks.com/coaching

JawHacks Newsletter (Substack)

https://substack.com/@jawhacks

And More on the Website

https://jawhacks.com/

Timestamps

00:00:00 - Introduction

00:05:00 - What Is Total TMJ Joint Replacement Surgery?

00:11:42 - The Joint as Your Foundation: ICR Explained

00:15:35 - Which Patients Are at High Risk for Relapse

00:22:25 - Dr. Movahed's Personal Story: Three Jaw Surgeries for OSA

00:30:46 - Why Most Surgeons Avoid Joint Surgery

00:33:39 - Case Study: Two Failed Double Jaw Surgeries

00:40:03 - Grafting Techniques: Using the Patient's Own Bone

00:46:12 - Extreme Reconstruction: Goldenhar Syndrome Case

00:55:31 - Esthetics and Function: PEEK Implants and Facial Harmony

01:02:14 - Segmental Surgery and Counterclockwise Rotation

01:10:51 - The Critical Orthodontist-Surgeon Relationship

01:20:28 - Custom Plating and Locking Screw Technology

01:30:02 - Post-Op Protocol: Nutrition, Steroids, and Minimal Swelling

01:38:34 - History of Jaw Surgery: Dr. Wolford's Legacy

01:46:25 - The Art of Surgical Planning: Precision and Collaboration

01:54:31 - Why Counterclockwise Rotation Was Revolutionary

02:05:01 - DISE: Predicting Surgical Outcomes with Sleep Endoscopy

02:18:45 - Surgical Planning: Frankfurt Horizontal and Neck Posture

02:26:30 - Joint Longevity: 38 Years of Data and Minimal Wear

02:40:30 - Virtual Surgical Planning: From CT Scan to Custom Joint

02:51:24 - MCO Device: Patent-Pending Mandibular Expansion

03:03:29 - Patient Collaboration: Avoiding Surgical Planning Mistakes

03:20:18 - Maxillomandibular Expansion Before MMA Surgery

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.

In this episode, I reconnect with Dr. Aişe Cemile, an orthodontist based in Istanbul, Turkey, who has treated between 500 and 1,000 MARPE cases over the years. She shares updates on her custom MARPE appliance designs, face mask protocols, and innovative methods for managing asymmetry. Dr. Cemile explains how she collaborates with a local lab to create fully customized devices tailored to each patient’s bone anatomy, achieving consistent split success by carefully planning TAD placement. She also discusses her use of face mask protraction, even in adult males, the role of cranial osteopathy and manual therapy in enhancing results, and practical techniques for preventing and correcting asymmetry through exercises, heat, and targeted pressure. A standout case features an 18-year-old male with severe skeletal Class III who achieved jaw-surgery-level changes through two rounds of MARPE and face mask therapy, making this episode essential viewing for anyone seeking advanced and affordable MARPE treatment outside the United State.

Contact Dr. Cemile

https://www.aisecemilecansiz.com

https://www.instagram.com/aise_cemile

[email protected]

(Find her in The Joint for a Q&A session on Saturday, Nov 1, 2025)

1:1 Coaching with Ron — Now Inside The Joint

https://jawhacks.com/coaching

JawHacks Newsletter (Substack)

https://substack.com/@jawhacks

And More on the Website

https://jawhacks.com/

Timestamps

0:00 Intro

3:41 MARPE Treatment in Children

4:56 Age Considerations for MARPE

6:15 Custom MARPE for Children

10:58 Laboratory Collaboration

17:57 Cranial Osteopathy and MARPE

27:17 Face Mask Techniques

34:33 Surgical Considerations

39:20 FME device

44:24 Innovative Approaches and Techniques

48:23 No Diastema protocol

50:58 Managing Asymmetry in Patients

51:32 Exercises and Techniques for Symmetry

52:59 Placing and Aligning the Appliance

55:17 Sharing Examples and Workflow

1:08:05 Working with International Patients

1:20:11 Case Study: MARPE and Face Mask

1:31:02 Closing

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.

In this episode, I talk with Dr. Newaz and Dr. Jaffari — the world’s most experienced FME providers — about what really works, what fails, and the complications they’ve seen across nearly 100 cases. We look at success rates, asymmetry, and how FME compares to custom MARPE, with Dr. Newaz sharing his own 8–9mm expansion results and CBCT analysis. We also explore the new FMA Protraction device, post-surgery expansion challenges, pricing debates, and the key question: when should you expand before jaw surgery versus doing a segmental LeFort?

Dr. Newaz & Dr. Jaffari Social Media

https://www.youtube.com/@airwayortho

https://www.instagram.com/dr.jaffari.dds

https://www.instagram.com/drnewazzz

All GIFs courtesy of Shuikai 

https://www.reddit.com/r/UARSnew/

1:1 Coaching with Ron — Now Inside The Joint

https://jawhacks.com/coaching

JawHacks Newsletter (Substack)

https://substack.com/@jawhacks

And More on the Website

https://jawhacks.com/

Timestamps

00:00:00 - Dr. Newaz's 9mm expansion results and facial changes

00:00:31 - Ron introduces FME technology and episode overview

00:04:10 - Defining success and failure across 98 FME cases

00:13:03 - How many failures to split?

00:21:01 - Who benefits aesthetically from midface expansion?

00:26:30 - FME vs custom MARPE clinical comparison

00:31:23 - Septum avoidance and preventing asymmetry with guide rods

00:38:19 - Lab planning process and final doctor approval

00:47:17 - Why turning protocols have slowed down dramatically

00:53:51 - How many cases had no corticotomy at all?

01:01:18 - Is pterygoid maxillary release necessary with FME?

01:06:41 - Using another MARPE to correct prior asymmetry

01:17:55 - Dr. Newaz's CBCT analysis and superimposition walkthrough

01:29:22 - True cheekbone enhancement without implants

01:33:03 - How long did 9mm expansion actually take?

01:44:35 - Nasal resistance spectrum and empty nose syndrome risk

01:57:11 - Segmental LeFort vs midface expansion

02:09:39 - Can you do MARPE after jaw surgery?

02:14:22 - Soft tissue aesthetic improvement

02:22:27 - Plan for the mandible and considerations on condyle stability

02:31:37 - Why did Dr. Newaz go this far with expansion?

02:34:48 - Pushing boundaries in the expansion space

02:42:11 - Listening to educated patients as part of the treatment team

02:47:39 - First look at the FMA protraction device

02:52:37 - MRI results show Dr. Newaz's jaw joint is healing

03:00:34 - FMA Device Deep Dive: Components and Mechanics

03:07:58 - Patients building their own DIY protraction devices

03:08:47 - Clinical potential and workflow for the FMA device

03:14:42 - A discussion on the cost of FME appliance

03:22:46 - US healthcare frustrations and goal of making treatment accessible

03:27:02 - Ron shares his personal story of being priced out of jaw surgery

03:32:45 - The major risks and challenges of expanding after jaw surgery

03:40:25 - Where to find Dr. Newaz and Dr. Jaffari online

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.

In this episode, I sit down with Evan Lavizadeh — a former YouTube creator who overcame severe sleep apnea through MARPE expansion with Dr. Audrey Yun and double jaw surgery with Dr. Benjamin Walin in Los Angeles. Evan shares his full journey, from surgical planning and a 20mm advancement to the challenges of recovery and TMJ complications. Beyond the medical side, he opens up about how fixing his airway transformed his sleep, confidence, relationships, and outlook on life, as well as how therapy supported his recovery and inspired him to return to creating educational content in the airway health space.

Evan's YouTube Channel

https://www.youtube.com/@evanlavizadeh4032

1:1 Coaching with Ron — Now Inside The Joint

https://jawhacks.com/coaching

JawHacks Newsletter (Substack)

https://substack.com/@jawhacks

And More on the Website

https://jawhacks.com/

Timestamps

00:00:00 - Introduction and initial questions about Evan's journey

00:03:26 - Evan explains he's cured and why he stopped making YouTube videos

00:06:01 - Discussion about returning to YouTube content creation

00:06:56 - Revealing Evan's surgical team (Dr. Audrey Yoon, Dr. Benjamin Walline)

00:08:11 - Evan's surgical movements and measurements (20mm at the pogonion)

00:10:56 - Discussion of Dr. Walline's reputation and conservative approach

00:13:51 - Genioplasty details and comparison with other surgeons

00:17:56 - Surgical planning timeline and patient involvement

00:19:06 - Surgeon selection process and considerations

00:22:21 - Orthodontist-surgeon relationship and communication

00:23:16 - Dr. Walline's attitude toward MARPE and airway focus

00:25:31 - Evan's satisfaction with surgical results

00:26:36 - Before/after appearance discussion and aesthetic results

00:29:46 - Discussion of "pretty privilege" and confidence changes

00:33:46 - Personal growth and self-acceptance philosophy

00:35:51 - MARPE experience and expansion details

00:42:16 - Discussion of MSE vs custom expanders and evolution of techniques

00:42:56 - Evan's advice on the "less invasive fallacy"

00:48:31 - Key advice for patients and avoiding analysis paralysis

00:50:41 - Role of therapy in surgical journey

00:56:56 - Family dynamics and generational trauma discussion

01:09:31 - Religious and philosophical discussion on wealth and ethics

01:18:46 - Christianity, Judaism, and religious exclusivity

01:20:01 - Spiritual effects of improved health post-surgery

01:21:06 - Recovery timeline and gradual improvement

01:22:46 - Skateboarding and physical activities post-surgery

01:26:36 - TMJ pressure complications from surgery

01:30:16 - Technical explanation of BSSO complications

01:32:46 - Career discussion (AI/machine learning engineer)

01:33:46 - AI-assisted surgical planning possibilities

01:38:11 - Other surgical complications and mouth opening limitations

01:41:01 - Condylar resorption risks and TMJ complications

01:45:11 - Joint replacement surgery considerations

01:47:56 - Closing thoughts and future YouTube content plans

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.

Dr. Kimberly Santiago returns to share her raw, unfiltered jaw surgery recovery experience. She reveals her post-op survival tips, the emotional and physical challenges she faced, and how the surgery impacted her nasal breathing, for better and for worse.

Connect with Dr. Kimberly Santiago

https://www.instagram.com/dr.kimberly.airsyncwellness/

https://www.airsyncwellness.com/

1:1 Coaching with Ron — Now Inside The Joint

https://jawhacks.com/coaching

JawHacks Newsletter (Substack)

https://substack.com/@jawhacks

And More on the Website

https://jawhacks.com/

Timestamps

00:00:00 - Intro

00:01:05 - Numbness, swallowing & the challenge of staying hydrated

00:06:35 - Post-op cheat sheet: what every patient needs

00:09:20 - Did Spicy Food Irritate the Wounds?

00:11:27 - Fasting after surgery for autophagy: is it a good idea?

00:17:31 - The emotional toll & psychological low point of recovery

00:24:59 - How Dr. Santiago mentally prepared for surgery day

00:31:18 - Recovery tools: lasers, photobiomodulation, hyperbaric oxygen

00:36:20 - Why she chose her surgeon without shopping around

00:45:29 - Did jaw surgery fix her nasal breathing? (shocking result)

00:53:49 - The unexpected post-op nasal congestion

01:01:35 - Can you get MARPE after jaw surgery?

01:10:43 - How jaw surgery changed her approach as a clinician

01:14:11 - An overlooked aspect: aligning the cranial base before surgery

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.

In this episode, Ron chats with Dr. Gabriella Tehrany, a maxillofacial surgeon at Kaiser Permanente in Southern California. She shares what it’s like to work as a salaried surgeon in a system focused on function and patient care. Dr. Tehrany also expresses her passion for integrative medicine, explaining how diet, lifestyle, and supplements can make a big difference in recovery.

Dr. Gabriella Tehrany at Kaiser Permanente

https://healthy.kaiserpermanente.org/southern-california/physicians/gabriella-tehrany-2329453

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 - Introduction

00:05:17 - Salaried Surgeon: A Different Approach to Jaw Surgery  

00:08:28 - Kaiser’s Functional vs. Aesthetic Jaw Surgery Coverage  

00:13:35 - How Instagram Has Changed Patient Expectations  

00:20:41 - Why I Don’t Give Patients Detailed Surgical Plans Upfront  

00:25:36 - Patient Trust vs. Taking Marketing Claims at Face Value  

00:31:01 - Integrative Medicine for Jaw Surgery  

00:33:34 - How a Bad Diet Can Wreck Your Surgical Outcome  

00:39:32 - Biohacking Your Jaw Surgery: Supplements, Light & Grounding  

00:43:41 - The Vitamin D Deficiency Epidemic in Southern California  

00:46:36 - The Optimal Pre-Jaw Surgery Diet  

00:51:34 - How to Mentally Prepare for Jaw Surgery Recovery  

00:57:49 - 3-Week Pre- and Post-Op Healing Cheat Sheet  

01:09:18 - Are Environmental Toxins Making Gen Z Sicker?  

01:14:13 - The Great Debate: Surgical Expansion (SARPE) vs. MARPE  

01:18:59 - Do Custom Plates & Implants Make Surgery Better?  

01:31:01 - Final Warning to Patients Seeking Perfection

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.

Ron sits down with sleep medicine specialist Dr. Anil Rama and medical speech therapist Jenny Opalinski from Aspire Respiratory Products. They explore Respiratory Muscle Strength Training (RMST), a non-invasive therapy using the EMST150 device to strengthen airway muscles, improve nasal flow, and potentially reverse sleep apnea.

Connect with Dr. Rama

https://www.sleepandbrain.com/anil-rama-md

EMST150 Expiratory Muscle Trainer (no commission or affiliate relationship)

https://emst150.com/product/emst150/

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 - Introduction

00:04:41 - A Non-Surgical Sleep Apnea Treatment Alternative

00:06:50 - Unboxing & Assembling the EMST150

00:08:10 - The "5x5" Weekly Training Protocol

00:09:10 - Why Pressure Threshold Trainers are Superior

00:11:54 - MEP & MIP: How We Measure Breath Strength

00:15:54 - The Anatomy of a Powerful Breath

00:17:51 - Does Mouthpiece Training Ruin Nasal Breathing?

00:19:52 - Training at 75% vs. 100% of Max Pressure

00:23:33 - Expiratory vs. Inspiratory: AHI Reduction vs. Fatigue

00:27:11 - LIVE DEMO: Mastering the Expiratory Rep

00:34:42 - Finding Ron's Max Expiratory Pressure

00:38:43 - "This Hurts My Neck": Avoiding Muscle Compensation

00:42:52 - Is This Just a High-Tech Didgeridoo?

00:52:16 - Normative Data: How Ron Stacks Up to the Average Male

00:56:43 - Why Study Results Seem Unattainable

01:02:59 - How Long to Train for Lasting Brain Changes (BDNF Study)

01:07:56 - LIVE DEMO: Inspiratory Muscle Strength Training (IMST)

01:13:33 - Endoscopy Reveals Airway Expansion

01:15:40 - Ron's Inspiratory Strength Test: The Diaphragm Burn

01:21:34 - Fast-Twitch vs. Slow-Twitch: Building Powerful Breath Muscles

01:29:55 - Does Pre-Bed Training Keep the Airway Open All Night?

01:39:44 - How RMST Can Make CPAP Therapy Tolerable

01:42:17 - The 5 Reasons for Poor Nasal Flow

01:46:34 - CASE STUDY: Jaw-Dropping Nasal Flow Increase from RMST Alone

01:49:56 - Who Should NOT Use This Device

01:55:09 - Ron's 12-Week Public Experiment Begins

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.

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.

Orthodontist and sleep medicine specialist Dr. Joseph Yousefian explains why Maxillomandibular Advancement (MMA) doesn't always resolve sleep apnea. Drawing on case studies and clinical experience, he highlights the procedure’s limitations and the importance of addressing nasal anatomy and TMJ health. Dr. Yousefian also introduces his patented expansion techniques—MANE, DAME, and MAPES—which have shown strong results in improving airway health. This conversation explores airway dynamics, skeletal development, and the value of a personalized, multi-faceted treatment approach.

Dr. Yousefian's book: Pediatric Treatment of Sleep Apnea

https://a.co/d/aNsKjul

Hear from Dr. Yousefian's Patients

https://youtube.com/shorts/EvOC51YXxRE

https://youtu.be/fYMy1Acnlwk

https://youtu.be/uyRm7fTOF2w

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 & Airway Mechanics

00:01:10 - Why MMA Doesn’t Always Cure Sleep Apnea

00:03:40 - When MMA Surgery Isn't Enough (19.9 AHI Case Study)

00:05:35 - The Critical Role of Turbinate Reduction in Airway Health

00:07:03 - Empty Nose Syndrome Risks & Turbinate Management

00:08:24 - Why Significant Expansion (7-10mm) Outperforms Minimal Expansion

00:10:50 - Nasal Cavity Architecture: Height, Width & Airflow Dynamics

00:12:00 - When Counterclockwise Rotation Isn't Possible

00:14:20 - TMJ Complications After Surgery: Revision Challenges

00:15:25 - Challenges of MARPE After LeFort I Surgery

00:17:45 - Removing Plates for Successful Post-Surgical Expansion

00:19:34 - DOME Procedure (DANE): Preventing Unilateral Cheekbone Distraction

00:22:08 - MSDO to Expand Narrow Arch vs. Tongue Reduction Surgery

00:28:12 - 53.6 AHI & Mandibular Tori (Case Study)

00:32:10 - Tooth-Borne (with SARPE) vs. Bone-Borne Expansion Debate

00:35:05 - TMJ Health & MSDO Mandibular Expansion (Osteoarthritis Case)

00:40:34 - Why MMA Can Put Stress on the TMJ (Condylar Resorption)

00:46:40 - Airway Changes After MMA Surgery: Temporary Feeling of Constriction

00:48:28 - Distraction Technique After MMA (Unique Case Study)

00:50:01 - 38% Cure Rate from MMA vs. 92% from TTP (Teledontic-Telegnathic Protocol)

00:51:33 - MANE (Micro-implant Assisted Nasomaxillary Expansion) & DAME (Distraction Assisted Mandibular Expansion) aka MARPE & MSDO

00:53:42 - Lip Competence & Auto-Rotation of Mandible Through Orthodontic Treatment (Case Study)

00:58:52 - Protecting & Supporting Front Teeth: Importance of Arms in Expanders

01:01:00 - Managing Asymmetric Expansion & the Purpose of Molar Arms

01:05:00 - Severe Complications: Mid-Facial Asymmetry Case Study

01:09:05 - Double Vision Complication After Expansion

01:12:08 - Benefits of Tooth-Borne Combined with Bone-Borne Anchorage

01:13:10 - FME (Facegenics Mid-facial Expander) & Armless Expanders Discussion

01:19:54 - Dentoalveolar vs. Skeletal Changes & Why They Are Both Important

01:29:45 - Prof. Won Moon: The Originator of MARPE

01:31:45 - Proportional Expansion Between Maxilla and Mandible

01:33:00 - Why DAME (MSDO) Is Safe for the Condyles & TMJ

01:37:00 - Recovery from Asymmetric Expansio (Case Study)

01:38:50 - SFOT vs. DAME: Severity of Surgical Procedure

01:41:11 - Addressing Critique from Kasey Li on MSDO

01:43:02 - MAPE (Micro-implant Assisted Protraction Expansion) for Children

01:48:36 - MAPES (Micro-implant Assisted Protraction Expansion Surgery) for Adults

01:51:50 - MAPES: When MMA is Not an Option

01:53:04 - AGGA vs. MAPES: Controlled Advancement Without Teeth Flaring

01:56:43 - The Legendary Case & Vertical Control for Counterclockwise Rotation

01:58:25 - Teledentics: Medical Utilization of Dentistry for Sleep Apnea

01:59:12 - Restorative Dentistry: How Crowns Support Expansion Stability

02:01:50 - MAPES and Sensitivity of Front Teeth

02:03:15 - The Limitations of Treatments & The Risk-Benefit Ratio

02:05:00 - Dr. Yousefian's Book: Pediatric Treatment of Sleep Apnea

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.