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...