Comparison of bone-borne (BB) versus tooth-borne (TB) distraction in surgically assisted rapid maxillary expansion, secondary variables were bipartite (2S) or tripartite (3S) osteotomy, pterygomaxillary osteotomy (+PP) or not (jPP), and age (920 years old [920] and G20 years old [G20]). Fifty patients received three-dimensional computed tomography examination preoperatively and after expansion; 24 had BB, and 26 had TB distraction. Predefined preoperative landmarks versus postexpansion positions were assessed in multiplanar viewing. Bone-borne devices had bigger overall skeletal and dental maxillary expansion declining from anterior to posterior, more asymmetric expansion, less vestibular bone resorption, and less dental tipping; TB devices showed similar dorsal decrease in transverse skeletal and dental maxillary expansion from anterior to posterior, more vestibular bone resorption, particularly in the premolars, and more dental tipping. Bone-borne 3S +PP G20 had the biggest decrease in transverse skeletal widening and biggest segmental outward inclination; BB 3S +PP 920 had the biggest decline in transverse dental widening; TB 2S YPP G20 had the biggest segmental inward inclination; BB 2S YPP 920 had the biggest dental tipping; BB 2S G20 had the biggest vestibular bone resorption in molars; and TB 3S 920 and BB YPP had the biggest vestibular bone resorption in premolars. There was a significant correlation between transverse widening and segmental inclination; that is, a bigger amount of transverse widening provokes less segmental inclination.
Dislocated subcondylar fractures often require open reduction and internal fixation. This treatment modality results in better anatomy, early function, and facilitated physical therapy. Ideal stable fixation is obtained by use of two miniplates to control the tension zone in the sigmoid notch area and stabilize the posterior border region or, if there is not enough space, one stronger plate. That is most frequently achieved through extraoral approaches. Recently new instruments have facilitated the use of an intraoral approach, which is used usually with the aid of an endoscope. However, it is possible to perform the procedure without the endoscope if proper instruments and clinical mirrors for checking the posterior border reduction and fixation are used. A case of reduction and fixation of a medially dislocated condylar fracture is presented and discussed.
Not for all patients with peritonitis does it seem favourable to modulate PMNs-functions. If immunomodulation would be able to down-regulate exaggerated functions of circulating PMNs and to up-regulate the suppressed functions of emigrated PMNs patients with complicated peritonitis might benefit from this therapy.
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