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Alyssa Luck

Alyssa Luck

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CBCT Results: An Update on Implants [AGGA/CAB Update]

Alyssa Luck · Sep 3, 2021 · 2 Comments

Hey friends! Latest AGGA/CAB video update is up on YouTube, and as promised, below is a snapshot from my CBCT scan.

First, to summarize the video: this was supposed to be the appointment where my dentist showed me my CBCT results, told me that I had plenty of space and bone for implants (as expected), and referred me to the implant dentist for an initial consultation and to get on the books.

INSTEAD, he told me that despite having 7mm gaps in my mouth, I do not have 7mm gaps between the roots below the surface, which means not enough room for implants.

This was a huge bomb drop, since we’d been aligned from the beginning that the plan was to do implants, and he never once had any doubts that that would be possible for me. Up until he looked at the CBCT.

I was pretty taken aback, and he said that if I “held his feet to the fire,” he’d definitely try some things to make enough space – uprighting the teeth on each side, maybe doing a couple more bump-outs in the front, etc. But in his professional opinion, he thinks we should skip the implants and just bring my molars forward to close the gaps.

I pressed him on this pretty good, voicing concerns about relapse being more likely without implants, difficulty moving molars without losing growth, etc, but he’s extremely confident that he can give me great results this way. He said that if there was any part of him that thought we were sacrificing results by not doing implants, he would figure out how to make the implants work.

He also said that he’s thrilled with how my jaw looked on the CBCT, so he just wants to keep everything in place where it’s at, and again, is extremely confident he can do that by simply bringing my molars forward.

So, I’m trusting him. No implants. Bringing molars forward. I’ll most certainly not be out of braces by the end of this year, but it’s possible I could still be out of them by my 28th birthday in early March…wish me luck.

(And…skipping the implants does save me about $10k. So that softens the blow a bit.)

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Comments

  1. Paul says

    November 24, 2021 at 11:37 am

    Hi Alyssa,

    thank you very much for your work with your blog and videos! Very detailed and informative. And since there is not a lot of hard facts and information out there, rather some people seem to shout very loud from one direction, your input is highly appreciated.

    I am a functional prosthetic and biological dentist (no orthodontist!) myself and I am looking for a functional orthodontic solution for my brother, myself and my patients. So I am just learning about the AGGA/CAB and having a proposition to receive treatment myself. By the infos, that I found on the internet I am very unsure at this point. So I could learn a lot from your experience!

    So, I`ve been super interested, when I saw your post on with the after CBCT. My question is: Do you have any evaluation of your front teeth and maxillary arch? Especially concerning the bone in the front? Can you post some picture of the sagital slices on the front teeth (#12 and 13 e.g.)?

    By the way, as a hollistic, biological and functional dentist (2nd generation) I can agree on your decision to close the gaps with the molars. Maybe implants would be actually possible, but bearing some risk and a not so optimal situation probably.

    I would be super interested what your x-ray says about the front teeth, since it is such a major concern with the whole AGGA/CAB procedure.

    Thank you, whishing you all the best!

    Paul

    Reply
    • Alyssa Luck says

      December 6, 2021 at 11:33 am

      Hi Paul,

      Thanks so much for your comment, and apologies for my delayed response!

      I don’t currently have an evaluation of my front teeth and maxillary arch from my most recent CBCT. I’ll have to ask my dentist to go over that with me. (I’m certainly curious as well, but we always have such limited time at my appointments and there’s always much to discuss!)

      I’m assuming if I ask for what you say, “sagital slices on the front teeth,” he will know what that means? I’m getting a copy of the CBCT, but I’m guessing there won’t be any way for me to open/read it on my personal computer, so I imagine I’ll have to ask him for any images I want.

      I certainly appreciate your take on the molars vs. implants situation! At the moment I’m a bit stressed out at some noticeable retraction of my front teeth that I’m already noticing as we move the molars, but I’m going to discuss with my dentist (and maybe get a second opinion from an orthodontist as well) and come up with the best plan of action.

      I will do my best to get an assessment of my front teeth along with images from the CBCT scan to post, and please feel free to respond with any more questions/comments!
      Alyssa

      Reply

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Hi! I’m Alyssa. I like thunderstorms and cats, hate wearing shoes, and enjoy devising extensive research projects for myself in my free time. This is me in Bali with a monkey on my shoulder. And this is my blog, where I muse about health-related topics and document my relentless self-guinea pigging. If you want to know more about me, click here!

alyssa.luck

alyssa.luck
Photo dump from the last year. Thanks to everyone Photo dump from the last year. Thanks to everyone who made 28 the best yet - excited for 29🥰

(PS. In case anyone wants to know what it’s like in my head, I was going to write something like “year 28” or “my 28th year” but then I realized that the year between your 28th and 29th birthdays is not your 28th year of life, it’s your 29th year. I am turning 29 because I have been alive for 29 years. So then I had a whole thing about how to word it without being inaccurate and ended up going with what you see above which is vague and weird but the point is it was a good year and I love all the people in my life dearly)
Biology of Belief (2005) was written by Bruce Lipt Biology of Belief (2005) was written by Bruce Lipton, who earned a PhD in developmental biology in 1971 and was an anatomy professor and academic researcher in the 70s and 80s. Despite the book's presentation and Lipton's background, this is not a science book. It is an exposition of an ideology, supported by haphazard and poorly contextualized nuggets of evidence, rhetorical leaps, and a mind-boggling overuse of analogies. 

The book largely failed to deliver on its promised content. What it does is argue for the primacy of the environment over DNA in controlling life; propose that the cell membrane rather than the nucleus is the "brain" of the cell; invoke quantum physics to explain why modern medicine fails; explain that our behavior is largely controlled by our subconscious mind; inform parents that they therefore have a great deal of control over the destiny of their children; and conclude that humans must become nonviolent protectors of the environment and of humanity because Everything Is Connected.

It’s not that these points aren’t relevant to the topic at hand - they are. But they were not connected in a coherent way that would explain how “belief” actually works (like…biologically), and the treatment of scientific concepts throughout was careless, or perhaps disingenuous.

I think he's correct about many things, some of them being common knowledge. For instance, the "new" science of epigenetics is now old news, as is the critical role of parenting and early environment in shaping a child’s future. But however important these and attendant concepts may be, the book did not do a good job explaining, supporting, or connecting them. 

As far as practical guidance, he refers the reader to a list of resources on his website, which is fine, but I expected some scientific insight into how/why those modalities work. None was given. 

On the plus side, the book was quite thought-provoking, and I came away with loads of references and topics to follow up on. My favorite line? "There cannot be exceptions to a theory; exceptions simply mean that a theory is not fully correct."
Friedrich Nietzsche, The Gay Science (section 382) Friedrich Nietzsche, The Gay Science (section 382), as quoted in the introduction to Thus Spoke Zarathustra because I like the translation better.
This paper totally changed the way I think about e This paper totally changed the way I think about early nervous system development and the relationship between physiology and sociality. 

The authors propose that newborn babies are not inherently social, and have just one goal in life: physiological homeostasis. I.e. staying alive. This means nutrients, warmth, and regulation of breath and heart rate, i.e. autonomic arousal (it’s well-accepted that newborns sync their breathing and heart rate with caregivers through skin to skin contact). 

All these things are traditionally provided by a loving caregiver. So what the baby experiences during the first weeks of life, over and over, is a shift from physiological perturbation to homeostasis (a highly rewarding event inherently) REPEATEDLY PAIRED with things like the sound of a caregiver’s voice and seeing their face. Thus, over time, the face/voice stimuli become rewarding as well. 

The authors argue that THIS is the beginning of humans’ wiring for sociality, and may explain why loving social interactions can have such a profound regulating effect on physiology throughout life: because the brain was trained for it at an early age. 

This framework holds all kinds of fascinating implications for what happens if that initial “training” isn’t so ideal. What if the return to nutritional homeostasis via feeding is paired with negative expressions and vocalizations rather than loving ones, perhaps as could occur with PPD? What happens if the caregiver has poor autonomic regulation, such that social stimuli become paired with cardiorespiratory overexcitement in the baby? Could that have potential for influencing later introversion vs extroversion? (Because if social interaction is paired with autonomic overexcitement, that could lead to social interaction literally being more energetically draining, which is what introverts experience. Thoughts?)

For my energy metabolism enthusiasts: Table 1 in the paper draws a link between metabolic rate and sociality across species. Swipe for a screenshot. 

Anyway, check out the paper! It’s free, just google “growing a social brain pdf.”
I’ll be under general anesthesia in a couple day I’ll be under general anesthesia in a couple days to have two tooth implants placed, and I think I’ll take the opportunity to have a little heart-to-heart with my subconscious mind. A bit of medically-assisted self-hypnosis, if you will. 

I randomly stumbled upon these papers a couple months ago - an RCT showing reduced post-op pain in patients who listened to recorded positive messages while under general anesthesia, plus a post-hoc analysis of the same data that found reduced post-op nausea and vomiting in a subset of high-risk patients. 

The full review paper from the first slide is unfortunately in German, but it has long been recognized that even when unconscious, the patient is listening (for better or for worse). 

It boggles my mind that it isn’t standard of care to have patients listen to recordings like this while under sedation, considering that almost nothing could be easier, safer, or cheaper, and we have at least some evidence of significant efficacy. I mean c’mon, what more could you want from an intervention? 

(Yeah, I know. Profit. If anyone still thinks that our medical system operates with patient well-being as the foremost goal, you’re deluding yourself.)

“There should be a fundamental change in the way patients are treated in the operating room and intensive care unit, and background noise and careless conversations should be eliminated.”

“Perhaps it is now time to finally heed this call and to use communication with unconscious patients that goes beyond the most necessary announcement of interventions and is therapeutically effective through positive suggestions. When in doubt, assume that the patient is listening.”
If you've seen "vagus nerve exercises" that have y If you've seen "vagus nerve exercises" that have you moving your eyes or tilting your head, you've probably encountered the work of Stanley Rosenberg. The exercises he created and introduced in his 2017 book now appear in instructional videos all over the internet. 
 
The book itself has much to recommend it: it's accessible, it's practical, it's inspiring. But it has one major flaw: the solid practical and informational content regarding the cranial nerves is framed in terms of the scientifically dubious polyvagal theory. 
 
I particularly enjoyed the book as an introduction to the therapeutic arena of bodywork, of which Rosenberg is a skilled practitioner. His book is full of case reports that demonstrate how immensely powerful extremely subtle movements and physical manipulations can be. These do need to be kept in perspective: it's a small sample size of the most remarkable cases, and the results were achieved within the supportive clinical environment of a skilled practitioner. You can tell from his descriptions how refined his technique is. But nevertheless, it was a paradigm-shifting read for me, and the exercises give you something concrete to play around with. 
 
The book also brought the cranial nerves and the concept of “social engagement” to the fore as arbiters of health. Rosenberg has a solid background in cranial nerve anatomy and shares many interesting tidbits and considerations that you don’t typically hear; for instance, the potential impact of dental and orthodontic work on cranial nerve function.
 
So, is it worth reading? If any of the above piques your interest, go for it! Just read my post on polyvagal theory first – you can use the book to practice separating the wheat (solid informational content) from the chaff (pseudoscientific framing). If nothing else, the book is a nice reminder that genuine healers who get lasting results for their patients do exist.

But if you just want to try the exercises, you can easily find them all on YouTube. 

“You learn techniques to understand principles. When you understand the principles, you will create your own techniques.” -Stanley Rosenberg
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