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...

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...

Dr. Tracey Nguyen, a cosmetic and airway-focused dentist, joins Ron for an in-depth discussion on topics ranging from chronic headaches and pediatric expansion timing to the complexities of MARPE, maxillary protraction, and digital surgical planning. Explore how personalized treatment strategies and practical goals can help optimize airway function, facial development and aesthetics.

Connect with Dr. Tracey Nguyen

https://www.instagram.com/drtraceynguyen

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

00:01:19 – Ron’s Journey & Jaw Surgery Motivation

00:03:07 – Tongue Posture, Neck Pain & Airway Connection

00:04:31 – Anatomy, Gut Health & Chronic Inflammation

00:07:00 – Pediatric vs Adult Expansion: Why Timing Matters

00:09:47 – Bone-Borne vs Tooth-Borne Expanders Explained

00:12:08 – Why General Dentists Are Stepping In

00:15:55 – Facial Esthetics, Asymmetry & Expansion Protocols

00:19:55 – Tag Placement, Engineering & Predictability

00:24:27 – Custom Expanders: Technology & Innovation

00:28:47 – Planning Expansion with Visual Outcomes

00:34:27 – Avoiding Overexpansion & Managing Expectations

00:38:45 – Risk Factors, Disqualifiers & Patient Management

00:42:08 – Beyond MARPE: Forward Growth & Alternatives

00:45:48 – Face Mask Protraction: What Works & What Doesn’t

00:50:26 – Class I, Setbacks & Protraction in Adults

00:53:12 – How Much Expansion Improves Airway Function?

00:55:13 – Choosing a Surgical Team & Digital Planning

01:00:15 – Balancing Airway Gains with Facial Aesthetics

01:03:19 – Patient Psychology, Satisfaction & Outcomes

01:07:16 – Full Disclosure & Informed Consent

01:10:24 – Tooth Size Discrepancies & Restorative Planning

01:11:25 – TMJ, Occlusion & Bite-Based Pain

01:16:06 – Multidisciplinary Approach & Final Takeaways

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.