MSE: 5 Weeks, 49 Turns

MSE (Maxillary Skeletal Expander) was installed by Dr. Zubad Newaz, an orthodontist at the Gelb Center in Manhattan, on July 15, 2019.

The photos below were taken on August 19, exactly 5 weeks after the install. 49 turns of the MSE had occurred at the time of the photos.


5 Week Observations

Where is the Diastema?

Very bizarrely, the diastema between teeth 8-9 (front two upper teeth) appears to have reduced in size since Week 2. This absolutely does not reflect the size of the split, which clearly has gotten bigger.

How do I know that the split is much larger than the diastema between 8-9 suggests? For starters, my Week 4 CBCT reveals a sizable split.

Second, the photos above clearly show that my crossbite has been drastically reduced by MSE. The maxilla is clearly widening.

Furthermore it should be noted that the gaps between teeth 7-8 and 9-10 continue to grow.

I do not know why MSE gaps form where they do. Dr. Newaz mentioned that there are tissues attached to my front teeth that are causing them to behave as they are.

Remember also that when the initial split occurred during Week 1, that the first gaps that formed were between teeth 7-8 and 9-10, NOT between my two front teeth.

You can tell from the images above that the bases of the front two teeth are trying to spread along with the maxilla, but the bottom of those teeth remain somewhat kissed together.

Crossbite Continues to Shrink

The photos above leave no doubt that my crossbite is shrinking fast. Any of the smile photos above reveal that my upper back teeth are now almost directly above the lower back teeth.

This was one of the major goals of my MSE treatment.


At this point MSE is almost completely painless. I don’t feel the cortical puncture wounds or the four 11mm appliance screws placed in my maxilla.

And the 1 turn of the appliance per day causes little or no strain across the cranium.

To repeat, almost all of the pain and discomfort of the appliance were limited to Week 1.

Whiter Teeth

My teeth look so much whiter in the “After” photos because I had a cleaning done at the Gelb Center on the same day as my follow-up with Dr. Newaz. I definitely needed it.


Not yet. I will not begin using the FaceMask until I’m done expanding with MSE.

Dr. Newaz says it is quite hard to “over-expand,” so for now I will continue to turn the MSE once per day, probably until my next follow-up in mid-September. At that time I will receive my FaceMask.

Nasal Breathing

Feels better than ever.

Oral Volume/Mewing

Improves by the day. Wow, once this appliance is removed Mewing is going to be a whole order of magnitude easier than it ever was. MSE is a Mewer’s dream come true.

Appliance Bending

Right around Week 3, long after the split had occurred, it became difficult for me to get the little wrench onto the MSE screw’s nut to turn it.


The small wrench used to turn the MSE screw.


This is because the little sidewalls around the nut became bent, preventing the wrench from reaching the nut.

The image below shows those bent sidewalls at the time that I contacted Dr. Newaz to ask what was going on.


He said that this bending was very common and that everything was fine but that it might be hard for me to turn the appliance for a while.

Leading up to my August 14th follow-up with Dr. Newaz, I was turning the appliance only every other day so as not to bend the appliance beyond repair.

At my appointment, Dr. Newaz straightened those sidewalls and now it is easy to turn the MSE again.

Dr. Newaz says “I haven’t seen any MSE of my own or in presentations that look all that pretty by the time they’re all used up!”

Even though the appliance had some bent parts, the 4-Week CBCT showed that all the screws were fixed and upright, there was no screw drag, and that a clean, even split had occurred.

Lesson: don’t let a beat up, bent MSE scare you into thinking something is wrong. Trust your orthodontist and your CBCT.

MSE is a grunt doing the tough, dirty job of splitting your skull. Don’t expect it to look pretty when all is said and done.

Ronald Ead33 Comments