Adult Palate Expansion + More

Hi! I have a 7+ year journey of TMJD .. through ENT, Chiro, massage therapy, dry needling, muscle relaxers, and night time splint. I also have extensive ortho treatment. I’ll keep this short though, I’m looking for anyone who has been recommended or treated with my newest recommended treatment plan:

I recently saw a general dentist who focuses on craniofacial orthopedic development. He did a CBCT, x-rays, sleep apnea test, etc. He’s recommending: 90 days of splint therapy + red light laser therapy (one daytime splint + one nighttime splint that locks shut). Then, he’d do ~1 year of Pre-Maxillary Advancer (PMA) appliance (he mentioned an RN Sagittal Appliance?). Then, he’d do ~1.5 year of braces with Upper and Lower ALF appliances. He’s also recommending myofunctional therapy which I’ve already started. I have horrible tongue posture.

He quoted me at $21,000 for all of this (I’m in the U.S.). My main questions:

  1. What are your experiences with palate expanders in adults (specifically forward growth)?
  2. What are your experiences with ALF appliances?
  3. Does this price seem reasonable?

I’m in so much pain. I know you all understand ❤️ thank you for sharing!