Histological changes in the temporomandibular joint following prolonged bite opening procedures. (An animal study).
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Posterolateral segmentary maxillary impaction osteotomy has a role to play in the treatment of gaps between the upper and lower jaws. It has several advantages, especially an uncomplicated postoperative period and the single-maxillary contention it provides. The indication must be established after an articulator assessment in order to take into account the mandibular protrusion caused by autorotation and to prevent a sagittal shift. Associated marginal glossectomy will frequently be required. Similarly, in case of vertical excess, genioplasty for vertical reduction will improve the facial balance. This technique may also be proposed as "pre-prosthetic surgery" in cases of egression in the premolar and molar areas, for which it has shown excellent results.
With reference to a case reported here, the authors emphasize the importance of reducing the length of the ramus of the jaw in rather exceptional forms of gaps between the upper and lower jaws with an increase in the posterior height of the face. This procedure provides more stable results and the patient's gums are no longer revealed when smiling.
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A sucking habit slowly and persistently alters the shape of the alveolar ridge. The changes are so typical that the manner and even the object of sucking can often be inferred from them with considerable certitude. The authors describe an interesting case that was managed successfully with psychotherapy, timely and planned extraction of an upper central incisor, and prosthodontic resharping of the lateral incisor. The final outcome of treatment is illustrated with a photograph.