Strategies for surgically assisted rapid maxillary expansion according to the region of transverse maxillary deficiency

This study evaluated different techniques for surgically assisted rapid maxillary expansion (SARME) according to the type of transverse maxillary deficiency using computed tomography (CT). Six adult patients with bilateral transverse maxillary deficiencies underwent SARME. the patients were equally divided into three groups: Group I, maxillary atresia in both the anterior and posterior regions; Group II, greater maxillary atresia in the anterior region; and Group ill, increased maxillary atresia in the posterior region. in Group I, a subtotal Le Fort I osteotomy was used. in Group II, a subtotal Le Fort I osteotomy was used without pterygomaxillary suture disjunction. in Group III, a subtotal Le Fort I osteotomy was used with pterygomaxillary suture disjunction and fixation of the anterior nasal spine with steel wire. the midpalatal suture opening was evaluated preoperatively and immediately after the activation period using CT. for Group I, the opening occurred parallel to midpalatal suture; for Group II, the opening comprised a V-shape with a vertex on the posterior nasal spine; and for Group III, the opening comprised a V-shape with a vertex at the anterior nasal spine. the conclusion was that the SARME technique should be individualized according to the type of transverse maxillary deficiency.

Effectiveness and safety of cryotherapy after arthroscopic anterior cruciate ligament reconstruction. A systematic review of the literature

Cryotherapy is widely used in rehabilitation; however, its effectiveness after anterior cruciate ligament (ACL) reconstruction remains uncertain. To investigate the effectiveness and safety of cryotherapy following ACL reconstruction through a systematic review, randomized and quasi-randomized clinical trials were searched in the databases: MEDLINE, EMBASE, CENTRAL PEDro, SportDiscus, CINAHL, LILACS (June 2013). the primary outcomes measures were pain, edema and adverse events; the secondary outcomes were knee function, analgesic medication use, range of motion, blood loss, hospital stay, quality of life and patient satisfaction. the methodological quality of studies was evaluated using the Cochrane Collaboration risk-of-bias tool. Ten trials (a total of 573 patients) were included. Results of meta-analysis showed that the use of cold compression devices produced a significant reduction in pain scores 48 h after surgery (p < 0.00001), compared to no cryotherapy. the risk for adverse events did not differ between patients receiving cryotherapy versus no treatment (p = 1.00). the limited evidence currently available is insufficient to draw definitive conclusions on the effectiveness of cryotherapy for other outcomes. There is a need for well designed, good quality randomized trials to answer other questions related to this intervention and increase the precision of future systematic reviews. (C) 2014 Elsevier B.V. All rights reserved.