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