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The most difficult problem in the treatment of ankylosis of the temporomandibular joint is to maintain the immediate jaw mobility gained by surgery over a long period of time. This article describes a spring-loaded device for physiotherapy which provides an active opening force from the mandibular splint, distributed against a splint on the maxillary teeth and hard palate. Because the force is continuous and broadly distributed, patients have been able to exercise with minimal discomfort, and they have been able to maintain their initial postoperative mobility.

Repair of the congenital deformity does not necessarily solve the child’s or the parent’s multiple problems since associated anomalies and side effects may remain and cloud the patient’s future. The study of congenital abnormalities may provide clues to etiology and prevention.

Image distortion of the jaws was assessed on films taken with the Panorex x-ray equipment. Linear distortion was determined on a simulated model and under clinical conditions. Through the use of intraoral calibration, direct measurements can be made on the films with sufficient accuracy that this technique can be useful in clinical research. The Panorex is radiologically safe for the subject and the operator.

Complete congenital absence of the nose and nasal airway is so rare that the following two cases, seen at Children's Hospital Medical Center in Boston, are presented

An unusual case of two primary tumors of the facial region is presented. Successful treatment was effected by radical resection and x-irradiation therapy. The deformity that resulted was absence of the hemimandible. This was corrected with a custom-made mandible, which gave a functional as well as an esthetic result.

IT is generally agreed that about 50 per cent of the population show some irregularity in tooth alignment. The percentage of cases actually in need of treatment is less, and the figure depends on t...

Surgical access to the cranial, orbital, and facial areas, as developed by Tessier, has produced not only definitive repair of previously uncorrectable congenital deformities such as orbital hypertelorism and facial stenosis (e.g., Crouzon's, Apert's syndromes) but also has improved markedly the treatment of traumatic and neoplastic defects. The surgical approach allows complete dissection of facial soft tisses including the orbits from the underlying bones followed by corrective osteotomies and fixation. Mobilization of the frontal lobes through a frontal bone flap exposure may be required. The ramifications of this latest intrusion by surgeons into a previously inviolate anatomic area have involved neurosurgeons, ophthalmologists, anesthesiologists, and dental and psycho-social disciplines. The disciplines of genetics and embryology are being influenced by this new field of surgery, much as the study of immunology was influenced by transplantation surgery two decades ago. This report analyzes a 10 year experience with over 100 patients with emphasis on patient selection by disease, age, intellectual status, morbidity, complications, and the psycho-social reactions of patient and family. Procedures initially planned to correct dental and aesthetic defects are proving beneficial for other functions including hearing, taste and smell, articulation and tongue movement, respiratory function, vision, and possibly bone growth. The development of self image, a normal process always in operation, is also strikingly altered. These operations may last as long as 14 to 16 hours. We have had no deaths or postoperative blindness. One postoperative cerebrospinal fluid leak was successfully repaired. Three partial losses of bone grafts and four instances of late cellulitis have occurred. Prevention of infection seems related to avoidance of dead spaces and primary closure of all mucosal, dural, conjunctival and skin surfaces.

The authors' personal experiences with defects secondary to cleft lip and palate, craniosynostosis, and congenital diastasis of the maxilla. The increasing role of maxillary osteotomies. A combined surgical and orthodontic approach.

1. 1. The objectives and advantages of early treatment are discussed as the orthodontic approach to patients whose cleft palates are repaired surgically at an early age. 2. 2. Bone repositioning by means of the Porter arch is illustrated.

DURING the last few years management of cleft palate has expanded rapidly and at the same time has become a very controversial field. It is no longer considered the sole province of the plastic surgeon, the prosthodontist or the speech therapist, but is recognized as an area demanding the Cooperative efforts of multiprofessional teams. The collective information and knowledge of such integrated groups is gradually producing the necessary wisdom for successful care of the child with a cleft palate. For many years, the majority of plastic surgeons have preferred to repair a cleft palate during the first two years of . . .