Best option ALF, DNA appliance, Invisalign or Myobrace? (photos)

Question

Had Damon for 18 months removed 18 months ago. Permanent retainer on lower jaw and using the retainer on upper but teeth are collapsing. Looking for options: 1-Go back to my ortho pay 1/3 of what I paid and get Invisalign then permanent retainer on lower and bottom. 2- Myobrace. I was told Invisalign or myobraces would be okay if Combined with myofacial exercises, but profile would only may get a little better with Myobraces. 3- DYI tongue training. 4- DNA appliance or ALF then braces again?

Ira Shapira, DDS · Answer

Myobrace may help but the best choices are ALF and the mRNA Version of the DNA Appliance.  
I would definitively start with a DNA Appliance (mRNA) version as it will most reliably grow the maxilla and develop the mandible.  I might consider shifting to the ALF in the future due to smaller size.
The primary issue is narrow maxilla which ideally should have been addressed prior to 8 years old. It is also possible to do rapid maxillary expansion with a surgical assist or SARPE procedure.  That would have been my first choice in the past but now I would chose DNA Appliance as first choice and ALF as second.

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