#92 – Dr. Jeremy Manuele – FME Leads to Eye Problem in Young Male Patient

In this episode, Dr. Jeremy Manuele breaks down the quality of adult maxillary expansion beyond just "did it split?" We compare FME, custom MARPE, and MSE Type 2, explore surgical assists, preview FME Pro, and analyze a rare complication case. Dr. Manuele did not disclose the actual number of FME cases he has performed, but he has been working with adult non-surgical skeletal expansion and other TAD-anchored appliances since 2016, and in that time he’s helped many hundreds of patients.In this podcast, Dr. Manuele delivers unique, never-before-seen visual demonstrations showing key differences between FME, Custom MARPE, and MSE, which are 3 top skeletal expander brands.Essential viewing for anyone considering adult palatal expansion or airway treatment.1:1 Coaching with Ron — Now Inside The Jointhttps://jawhacks.com/coachingJawHacks Newsletter (Substack)https://substack.com/@jawhacksAnd More on the Websitehttps://jawhacks.com/Pre-order Dr. Manuele's bookhttps://amzn.to/4oQXY4eConnect with Dr. Manuele‪https://www.youtube.com/@vegasorthodochttps://www.instagram.com/hm_orthohttps://www.facebook.com/hamiltonortho/https://vegasorthodoc.com TImestamps00:00:00 - Introduction: How Different Expanders Work00:02:08 - The Three Types of Expansion Explained00:03:16 - Why Dental Expansion Is Dangerous for Adults00:05:46 - Why Airway Cross-Sections Can Mislead You00:08:41 - Case Study: 3D Superimposition Reveals Only Dental Tipping00:10:30 - Dento-Alveolar Expansion: The Middle Ground00:12:16 - Fast vs. Slow Turning: How to Shock the Suture into Splitting00:16:24 - Age Ranges for Tooth-Borne Expander Success (and Why They Fail in Adults)00:19:24 - Case Study: When Dento-Alveolar Expansion Goes Wrong00:23:40 - Bonded RPEs: Using 360° Grip for Better Stability in Kids00:25:31 - Why Not Just Use MARPE on a Child? (Risk vs. Reward)00:30:00 - When Tooth-Borne Expanders Become Inappropriate00:31:20 - Expanding Toddlers (Ages 2-4): Is It Worth It?00:32:57 - True Skeletal (Orthopedic) Expansion Fundamentals00:34:30 - SARPE, DOME, and Why Surgical Assists Have Limitations00:39:48 - Top 3 Reasons for MARPE (and When Expansion Isn't the Answer)00:40:20 - Case Study: 10mm Skeletal Split in a Teenager00:44:31 - The 5 Factors of Jaw Growth (and ChatGPT's Shocking Ranking)00:56:42 - Case Study: How an Adult Got 4mm of Forward Growth (FME + Chewing)00:58:12 - The Key: Mobilizing Circum-Maxillary Sutures01:00:43 - How to Loosen Adult Sutures: FCPC, Osteopathy, and Chewing01:09:26 - Case Study: Patient X and the Wisdom Tooth Debate01:13:17 - Wisdom Teeth and Premolar Extractions Impact on Jaw Growth01:17:00 - Why Age 5-7 is Dr. Manuele's "Sweet Spot" for Expansion01:20:48 - Does Expanding the Maxilla Make the Mandible Grow?01:23:43 - Patient X's Journey: The EASE Procedure01:26:45 - Why The Field is Moving Away from Surgical Assists (EASE & Piezo)01:30:44 - Chewing, Clenching, and TMJD Risks During Expansion01:32:08 - Who Needs a Piezo? Thick Bone or Thin Bone?01:35:43 - Custom MARPE vs. FME for "Potato Chip" Thin Palates01:36:53 - Patient X's Expansion and the Start of a Major Complication01:39:47 - Cross-Eyed Vision From Expansion (Cranial Nerve 4 Palsy)01:43:04 - 3D Analysis: Did Expansion Compress the Superior Orbital Fissure?01:51:01 - Final Net Change and Key Lesson: "Slow is Predictable"01:56:55 - Suture Mechanics: The "Puzzle Piece" Analogy (Remodel vs. Snap)02:00:05 - Patient X's "Perfect Storm" for Complication02:02:07 - From MARPE to MASPE: Why Turning Protocols Are Slower02:04:00 - Dr. Manuele's Current "Stretching Turn" FCPC Protocol02:07:56 - Dimensional Stability: MSE vs. Custom MARPE vs. FME02:16:25 - Does Rotational Stability Matters? Preventing Asymmetric Dropping02:19:45 - Where Do Asymmetries Come From? (Lab vs. Doctor vs. Appliance)02:25:38 - Animation: How Expander "Wobble" Creates Vertical Discrepancy02:31:27 - Behind the Scenes: The FME Planning & Design Report02:32:50 - FME vs. Custom MARPE: Which is Safer with an Inexperienced Doctor?02:42:45 - Why Not Just Use an Armless Custom MARPE?02:44:44 - FME Pro: A Breakdown of the New Design Improvements02:50:20 - Resources: Courses, Coaching, and Dr. Manuele's New BookNO 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.