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The surgical correction of mandibular prognathism
736
Abstracts
and
ECeuiews
alimentary canal. Cultures of the exudate from growths of Xtaphylococcus au’reus and Xtreptococcus
the lesions will usually henaolyticus.
In children, it is a serious disease with a high percentage tions, crippling results, and causes a long convalescence.
give
of fatal termina-
Trauma and infection of the bone in a person of low nutritional state will usually be the history of the case. It is seen most frequently among the poor classes of city children, although it is found in children living in rural communities. Early drainage seems to be the surgical procedure; however, the proper time for this procedure is a controversial question. Sulfanilamide therapy was used without much success, and was therefore discontinued. When sulfapyridine was introduced, it was used with very good results, mainly because of its favorable effect against staphylococcus organisms. Sulfathiazole therapy was used, in cases of osteomyelitis, with the same results as sulfapyridine, except that the patients stood this drug a little better. The method of taking the drug was by mouth. Recently the local use of sulfanilamide in the treatment of compound fractures has either resulted in a marked decrease in the occurrence of cornplicating bone infections or has aided in combating such infections when present. J. 2. Mackenson.
The Surgical Correction
of Mandibular
John B. Erich, l’he American
Journal
Prognathism: of Surgery
By Gordon B. New and 1941.
53: 2-12, July,
‘(An abnormal protrusion of the lower jaw, ” in the majority of cases, is the result of disturbances of the normal eruption of the teeth and the subsequent growth of the mandible. The causative factors which induce malposition of the teeth and, in turn, prognathism of the mandible, are inheritance, supernumerary teeth, abnormalities of the tongue, early loss or long retention of deciduous teeth, late eruption or loss of permanent teeth, and improperly made dental restorations. Other general causes are rickets, syphilis, and diseases of childhood, which not infrequently disturb the normal physiologic processes of the growth and eruption of teeth. The methods of treatment employed in correcting mandibular prognathism may be grouped as follows : (1) Bilateral resection of a segment of the mandible in the bicuspid or first molar regions ; (2) bilateral resection of a portion of the body of the mandible near the angles ; (3) osteotomy of the ascending rami above the mandibular foramina; (4) osteotomy through both necks of the mandible; (5) removal of the condyles ; and (6) use of orthodontic methods. In treating these cases by the bilateral resection method, the first step is to obtain two sets of models of the patient’s teeth (Fig. 1). One set is used by the surgeon to study and decide upon how much bone is to be removed and where it is to be removed. The second set of models is to be used to make cast silver splint appliances for the upper and lower jaw. The day before the operat,ion these appliances are cemented into position, one on the lower anterior teeth, one on t,he upper teeth, and molar bands on t,he lower second molars.
Abstructs
737
rind Reviews
The following day, when the patient is completely out of the anesthesia, the segments are brought together and immobilized by wiring the cast silver appliances together. The drain is removed from the incision in a week, and
A.
6.
Transmucoperiosteal technique of resection of a segment of the lower jaw in Fig. 1.-A, the second bicuspid and first molar regions without injury to the mandibular nerve and blood vessels; a, parallel lines indicate the segment of bone to be removed, and the motor driven circular saw makes two cuts from the lower border of the jaw up close to the level of the is used to remove the intervening bone ; c, two similar parallel cuts mandibular canal ; b, a chisel are made from above down close to the canal with a Gigli saw, and a chisel cuts away the bone between these two cuts. B, Continuation of technique described in A; a, rongeurs are used carefully to remove the remaining portion of bone about the mandibular nerve and blood vessels; b, the mandibular nerve and vessels are exposed intact; c, the two bony fragments are placed in apposition to each other. If, by means of a curette, a small amount of cancellous bone surrounding the nerve and vessels in either fragment is removed, a cavity is created in which the nerve and vessels can rest without injury.
the wiring to the upper jaw is removed in four weeks. Following the removal of the wiring, a rigid wire is attached to the molar band and immobilization of the segments made sure for another seven weeks, although the mandible at the articulation can be used. J. Z. Mackenson.
The Thyroid
Gland in Acromegaly
of the American
Association
: By Austin C. Davis, The 1940 Transaction for the Study of Goiter.
The thyroid gland is frequently enlarged elevated in the presence of acromegaly.
and the basal metabolic
rate is
Abstracts
and
ECeuiews
alimentary canal. Cultures of the exudate from growths of Xtaphylococcus au’reus and Xtreptococcus
the lesions will usually henaolyticus.
In children, it is a serious disease with a high percentage tions, crippling results, and causes a long convalescence.
give
of fatal termina-
Trauma and infection of the bone in a person of low nutritional state will usually be the history of the case. It is seen most frequently among the poor classes of city children, although it is found in children living in rural communities. Early drainage seems to be the surgical procedure; however, the proper time for this procedure is a controversial question. Sulfanilamide therapy was used without much success, and was therefore discontinued. When sulfapyridine was introduced, it was used with very good results, mainly because of its favorable effect against staphylococcus organisms. Sulfathiazole therapy was used, in cases of osteomyelitis, with the same results as sulfapyridine, except that the patients stood this drug a little better. The method of taking the drug was by mouth. Recently the local use of sulfanilamide in the treatment of compound fractures has either resulted in a marked decrease in the occurrence of cornplicating bone infections or has aided in combating such infections when present. J. 2. Mackenson.
The Surgical Correction
of Mandibular
John B. Erich, l’he American
Journal
Prognathism: of Surgery
By Gordon B. New and 1941.
53: 2-12, July,
‘(An abnormal protrusion of the lower jaw, ” in the majority of cases, is the result of disturbances of the normal eruption of the teeth and the subsequent growth of the mandible. The causative factors which induce malposition of the teeth and, in turn, prognathism of the mandible, are inheritance, supernumerary teeth, abnormalities of the tongue, early loss or long retention of deciduous teeth, late eruption or loss of permanent teeth, and improperly made dental restorations. Other general causes are rickets, syphilis, and diseases of childhood, which not infrequently disturb the normal physiologic processes of the growth and eruption of teeth. The methods of treatment employed in correcting mandibular prognathism may be grouped as follows : (1) Bilateral resection of a segment of the mandible in the bicuspid or first molar regions ; (2) bilateral resection of a portion of the body of the mandible near the angles ; (3) osteotomy of the ascending rami above the mandibular foramina; (4) osteotomy through both necks of the mandible; (5) removal of the condyles ; and (6) use of orthodontic methods. In treating these cases by the bilateral resection method, the first step is to obtain two sets of models of the patient’s teeth (Fig. 1). One set is used by the surgeon to study and decide upon how much bone is to be removed and where it is to be removed. The second set of models is to be used to make cast silver splint appliances for the upper and lower jaw. The day before the operat,ion these appliances are cemented into position, one on the lower anterior teeth, one on t,he upper teeth, and molar bands on t,he lower second molars.
Abstructs
737
rind Reviews
The following day, when the patient is completely out of the anesthesia, the segments are brought together and immobilized by wiring the cast silver appliances together. The drain is removed from the incision in a week, and
A.
6.
Transmucoperiosteal technique of resection of a segment of the lower jaw in Fig. 1.-A, the second bicuspid and first molar regions without injury to the mandibular nerve and blood vessels; a, parallel lines indicate the segment of bone to be removed, and the motor driven circular saw makes two cuts from the lower border of the jaw up close to the level of the is used to remove the intervening bone ; c, two similar parallel cuts mandibular canal ; b, a chisel are made from above down close to the canal with a Gigli saw, and a chisel cuts away the bone between these two cuts. B, Continuation of technique described in A; a, rongeurs are used carefully to remove the remaining portion of bone about the mandibular nerve and blood vessels; b, the mandibular nerve and vessels are exposed intact; c, the two bony fragments are placed in apposition to each other. If, by means of a curette, a small amount of cancellous bone surrounding the nerve and vessels in either fragment is removed, a cavity is created in which the nerve and vessels can rest without injury.
the wiring to the upper jaw is removed in four weeks. Following the removal of the wiring, a rigid wire is attached to the molar band and immobilization of the segments made sure for another seven weeks, although the mandible at the articulation can be used. J. Z. Mackenson.
The Thyroid
Gland in Acromegaly
of the American
Association
: By Austin C. Davis, The 1940 Transaction for the Study of Goiter.
The thyroid gland is frequently enlarged elevated in the presence of acromegaly.
and the basal metabolic
rate is