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 Apneahttps://a.co/d/aNsKjulHear from Dr. Yousefian's Patientshttps://youtube.com/shorts/EvOC51YXxREhttps://youtu.be/fYMy1Acnlwkhttps://youtu.be/uyRm7fTOF2wJawHacks Official eBookhttps://substack.com/@jawhacks1-on-1 Chat with Ronhttps://jawhacks.com/chatsAnd More on the Websitehttps://jawhacks.com/Timestamps00:00:00 - Intro & Airway Mechanics00:01:10 - Why MMA Doesn’t Always Cure Sleep Apnea00:03:40 - When MMA Surgery Isn't Enough (19.9 AHI Case Study)00:05:35 - The Critical Role of Turbinate Reduction in Airway Health00:07:03 - Empty Nose Syndrome Risks & Turbinate Management00:08:24 - Why Significant Expansion (7-10mm) Outperforms Minimal Expansion00:10:50 - Nasal Cavity Architecture: Height, Width & Airflow Dynamics00:12:00 - When Counterclockwise Rotation Isn't Possible00:14:20 - TMJ Complications After Surgery: Revision Challenges00:15:25 - Challenges of MARPE After LeFort I Surgery00:17:45 - Removing Plates for Successful Post-Surgical Expansion00:19:34 - DOME Procedure (DANE): Preventing Unilateral Cheekbone Distraction00:22:08 - MSDO to Expand Narrow Arch vs. Tongue Reduction Surgery00:28:12 - 53.6 AHI & Mandibular Tori (Case Study)00:32:10 - Tooth-Borne (with SARPE) vs. Bone-Borne Expansion Debate00:35:05 - 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 Constriction00:48:28 - 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 & MSDO00:53:42 - Lip Competence & Auto-Rotation of Mandible Through Orthodontic Treatment (Case Study)00:58:52 - Protecting & Supporting Front Teeth: Importance of Arms in Expanders01:01:00 - Managing Asymmetric Expansion & the Purpose of Molar Arms01:05:00 - Severe Complications: Mid-Facial Asymmetry Case Study01:09:05 - Double Vision Complication After Expansion01:12:08 - Benefits of Tooth-Borne Combined with Bone-Borne Anchorage01:13:10 - FME (Facegenics Mid-facial Expander) & Armless Expanders Discussion01:19:54 - Dentoalveolar vs. Skeletal Changes & Why They Are Both Important01:29:45 - Prof. Won Moon: The Originator of MARPE01:31:45 - Proportional Expansion Between...

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