RESUMO
This study is a multi-disciplinary approach to the regulation of the maxillary width in adults, based on published histological evidence of midpalatal synostosis and the analysis of nine cases. The treatment involves the maximal use of rapid expansion for movement with the minimal surgical intervention to free maxillae. The results provide a modus operandi for oral surgeon/orthodontist association with a three-stage series of age-related incremental surgical procedures to meet the resistance to maxillary separation and a tie-up with orthognathic surgery. It seems unnecessary to intervene surgically to free the maxillae under 25 years of age. Stage 1 applies between 25 and 30 years, Stage 2 between 30 and 40 years, and Stage 3 between 40 and 50 years. Attention is drawn to the respiratory improvement following these technics.
Assuntos
Má Oclusão/terapia , Osteotomia/métodos , Técnica de Expansão Palatina , Palato/patologia , Sinostose/patologia , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Má Oclusão/cirurgia , Maxila/cirurgia , Pessoa de Meia-Idade , RespiraçãoRESUMO
The aetiology of long-term bilateral dislocation of the mandibular condyle in the elderly patient is discussed. Two of the author's cases are used to illustrate the different ways in which the above condition may arise. The treatment of the above cases is discussed, one form of treatment being a modification by the author of a technique described by Archer & Gould, in which Gunning's splints fitted with a fulcrum were wired into the edentulous jaws. The dislocated mandible was then subjected to elastic traction. A second case of 5 year's duration had bilateral condylectomies performed, using a different surgical approach on each side in order to try and find a technique which would afford better access to the condyle when it is in the temporal fossa than the more usual pre-auricular approach.
