Dr. Kimberly’s Airway Journey

A class 2 malocclusion, 4 bicuspid extractions, neck gear (which she did not wear), retraction orthodontics completed in 2013.

She struggled with fatigue throughout high school despite healthy sleep hygiene.

Was diagnosed with mild obstructive sleep apnea in 2014.

Failed with oral appliance therapy (a mandibular advancement appliance).

Was CPAP tolerant and could not live without it!

When her clinical airway journey began, she started treating herself with all of the following:

DNA Appliance - wore it for 1 night. Could not tolerate it
AGGA - She did quite well with it. The appliance broke during COVID. She gained about 3mm of forward growth with this method, with zero loss of bone on the front teeth. A-point (the point under the nose that we reference for the position of the maxilla) moved forward 3mm.
She then took her first MSE/MARPE course at the end of 2020 with Dr. Won Moon and she decided she wanted a MARPE.
MSE w. corticopunctures (took place before PARTNERS custom MARPEs with tiger screws and the 6-8 TAD option and corticotomies) in 2021.
- Treatment failed due to inherent MSE appliance design, corticopunctures instead of corticotomies, and 4 TADs instead of 6 or 8.
- MSE removed. Dr. Santiago thought CPAP was it for the rest of her life. She could have done another MARPE…but then
She listened to Dr. David Alfi lecture at the Beyond Perio Ortho Limits course in January 2024, had her consult within the week, scheduled her jaw surgery for July 1, 2024!
Successful upper and lower jaw surgery with the famous Dr. Alfi - 74 minutes. He took his time:)
No orthodontics prior and no orthodontics after surgery! Perfect midlines, bite, optimized esthetics.

Vibrant, no apneas, she can breathe, her posture is awesome, and look at that smile.