The OrthoSmile™ Newsletter

What's New on the Block?

Thursday, November 13, 2008

The Homeoblock™ Appliance and Loss of Mid-Face Volume

We know that the loss of mid-face volume contributes to mid-face aging. The typical pattern of volume loss is shown by the green color in the Figure (1) below:

Bone volume is lost around the orbit and across the maxilla. The pattern of bone loss is consistent with Dr. Enlow’s “V” Principle

There is software available to accurately quantify the volume loss using 3D images generated by stereo-photogrammetry.

Fig. 2

Before and after images registered indicate 3.35 cc loss of volume over 4 years (Fig 2)

After 7 months of Homeoblock appliance therapy treatment we increased the volume by 1.99cc. (Fig 3)

The result of treatment shows a loss of only 0.85 cc after four years.


Before and after 7 months treatment, Fig. 4
Before and after facial images, Fig. 5


Facial changes related to palatal expansion are clearly outlined in Growth and Treatment a Meeting of the Minds, J.A. McNamara Jr. 2003. “The maxillary complex shows a change in size (and/or mass) allied with an increase in structural complexity, in association with biological processes.” “Palatal expansion presumably, switches on osteoblastic genes associated with active boney deposition and concomitant remodeling of the spatial matrix ensues.” In relation to the changes around the eyes we must recall that the maxilla forms the floor of the orbit and skeletal changes may become apparent post expansion.” Specifically, changes in orbital morphology may be reflected on the skin of the face as the lower eyelids become “fuller,” the lateral canthus becomes more horizontal.”, facial width increases, particularly at the zygomatico-maxillary sutures and the craniofacial form, putatively, not only functions better but looks more attractive.”