TMD issues in patient with skeletal deformity of jaws.

Although there is little solid evidence that dental malocclusion directly results in significant TMJ problems, there appears to be strong correlation with malocclusions resulting from skeletal deformities. The highest correlation is generally noted in the patient with a deep bite or with asymmetry. Significant improvement can be anticipated with surgical correction of these deformities, but great care must be taken to properly diagnose the source of the deformity, and to use the correct technique, applied as atraumatically as possible.

Meniscal disorders.

The classical concepts of internal derangement (ID) of the TMJ meniscus are being challenged by findings focused at the microscopic and even molecular level. Acceptance of these findings means the definition of ID must be modified somewhat, along with the objective(s) of treatment modalities. It no longer seems appropriate to direct treatment primarily at mechanical restoration of 'normal' anatomical relationships within the joint.

Bilateral hyperplasia of the mandibular coronoid processes: a report of two cases.

Two cases of bilateral coronoid hyperplasia of the mandible are presented. Consistent with other reported cases, the patients were men whose onset of symptoms correlated with the onset of puberty. One case was unusual in that bilateral coronoidectomies did not relieve the restriction of mandibular movement. Additional masseter muscle and fascial surgery was required to provide unrestricted mandibular motion.

Risk in a "Fee for Service" Health Care System.

This paper describes an approach for assessing the financial risk inherent in a bid for the development and operation of a Management Information System (MIS) that includes processing of claims associated with a "Fee for Service" Health Care System. The discussion establishes the motivation for a risk assessment, defines the context of the problem, and proposes a risk-analysis procedure. Results attainable with the proposed approach are compared with those of a conventional analysis. The advantages of the proposed approach are addressed in terms of the added effort required.

Congenital arteriovenous malformations of the face. Report of a case.

Arteriovenous malformations (AVM) are uncommon vascular abnormalities which can be either developmental defects present from birth, or acquired ones, secondary to trauma. They may cause local swelling and discomfort, and also may present a potential for severe bleeding. Traumatic AVM are usually single fistulous channels, whereas congenital lesions are most often multiple interconnections of vessels of varying caliber that result in a diffuseness which renders clini-al delineation and treatment difficult. The nature of the lesion is determined by the stage of development of the vascular system during which it develops. Congenital lesions range from finely channelled capillary hemangiomas to large-bore, high-flow A-V fistulas. Most lesions are not observed at birth, but become manifest later in life; minor trauma and endocrine change are implicated as the stimuli for the initiation of hemodynamic activity. The diagnosis is clinical, with confirmation by arteriography. The treatment has not been completely satisfactory in all cases. Surgical intervention has been used most often, but newer techniques include cryotherapy and muscle embolization.