Zeitachse Kapitel Transkript Intro 0:00 all right guys so today we got the truth 0:03 about thumb pulling um yes the method I 0:05 credit to the majority of my facial 0:07 development i think the most common 0:09 rebuttal for thumb pullin

### Zeitachse #### Kapitel **Transkript** **Intro** 0:00 All right, guys, so today we got the truth about thumb pulling. Um, yes, the method I credit to the majority of my facial development. I think the most common rebuttal for thumb pulling is that they always have to contrast it with the MSSE, the medical skeletal expander, or any appliance in that genre of orthodontics. **Thumbpulling vs MSSE** 0:19 Look, people like to say thumb pulling does not work because it's not a real expander, but the mechanics are closer to MSSE than you think. The MSSE doesn't actually hold constant pressure either. It's not like it's pulling 24/7; you twist the screw, it applies a burst of force, usually around 10 to 20 pounds, and then nothing. It's a finite force, just like thumb pulling. MSSE requires manual activation, producing intermittent rather than continuous force. You activate, then you wait; bone responds, you activate again. The difference is the MSE can hold that new shape versus thumb pulling, which I'll go over later. Now imagine that same process, but instead of a screw, you're pressing with your thumbs. A decently strong person can press with 40 newtons per thumb, which is enough to meet or exceed the minimal amount of force to stimulate sutural strain in the mid-palatal and zygomatic-maxillary sutures. Frost's mechanostat theory puts bone adaptive thresholds as low as 15 to 25 in localized areas. In fact, Herring and Tang recommend that even minimal sutural strain, about 0.0015 m of displacement over 0.03 m of sutural length, was enough to register adaptive changes under natural loading. You're not trying to blast it open in a day; you're nudging it open over time. The mistake people make is thinking thumb pulling is about one long pressure session a day. That's not how tissue adapts. **Central Incisors** 1:51 Also, a main topic brought up is the central incisors not being separated while thumb pulling, which is the case because it doesn't work like it does for an MSSE. MSSE produces 20 to 60 times faster results. The periodontal ligament isn’t able to adapt; the ligament that keeps your teeth together isn’t able to adapt in time, so of course, it’s going to separate. Um, but for thumb pulling, especially if you do it correctly, you’re supposed to have more pressure over time in the posterior positioning of your palate. So just like how correct tongue posture over time will exert more force in the posterior direction because it's how your tongue works and your palate is designed, it’s going to keep the arch aligned correctly. The amount of duration it takes over the timeline of this development is way slower than the MSSE. **Challenges** 3:16 The MSSE can produce, you know, we’re talking four to six millimeters within just a few to a couple of months, but for thumb pulling, it’s a way slower process. We're talking two or even one millimeter or maybe 2.5 for me, around two to three millimeters in a span of 9 to 10 months. And that’s with complete dedication. With MSE, once that 0.13 mm of expansion is gained, the metal holds that position; it locks it in. That’s the big advantage; it holds tension over time. But think of thumb pulling like if you were to put the MSSE in, expand it for 30 seconds, then take it out, and you keep doing that six to 10 times a day. If you don’t keep it consistent, yes, you’ll lose progress. Bone doesn’t ossify instantly. If you thumb pull for three months and stop for two weeks, you can regress about 18 days of development, but it doesn’t erase the whole thing. You still have a net gain from the consistent sessions. It's a slow compounding process, but just because it’s harder to track doesn’t mean it’s not real. The big challenge with thumb pulling is that you’re the appliance; you have to know your anatomy. You need to be pressing at the right place, typically just lateral to the incisive papilla all the way down to your second to third molars of the alveolar ridge. I’ll go over how to thumb pull more later because there are a lot of things I haven’t revealed yet. But most people do it wrong or inconsistently, then call it a scam. Sure, MSE is a better overall alternative for palatal expansion, at least for that, um, you know, it’s fast and measurable gains, but it disrupts natural swallowing, facial muscle tone, and orthotropic practice while it’s in place. **Conclusion** 4:28 And although it fixes the structural problem in the moment, it doesn’t fix the reason why those structures are in the problem. You can even stack thumb pulling with proper tongue posture to help maintain your gains, but yeah, it’s not for everyone. It’s not easy, but if you understand force vectors, apply them frequently enough, and give your sutures time to respond and ossify, it works. It’s just biology and physics applied manually. Another thing about thumb pulling is that there’s not enough evidence. So we have scientific logic, but there’s not enough evidence, um, you know, to perform this experiment properly. For one, no one’s going to fund this; there’s no financial benefit for companies or anything to fund these experiments or for people who would do these experiments because this is a very rigorous process. I do recommend MSSE 100%. There are tons of types of appliances and surgical procedures in this genre, but for people who do not have access or do not feel like doing that, thumb pulling does work. But it really just depends on your genetics and your age. Some people’s sutures ossify way faster or are way more malleable or plastic compared to other people’s sutures. 6:00 But yeah, also the safety concerns—occlusions can happen if you do it incorrectly. You can misalign your occlusal plane; you can do a lot of things—overbites, overjets. If you're not pushing correctly, if you don’t know basic anatomy of the maxilla and the whole oral space. But yeah, just be careful. If you are going to do thumb pulling, make sure you know what you’re doing, you know the warning signs. It’s a long, rigorous process, but it does work.