Objective:To compare the effectiveness of the rapid maxillary expander and facemask (RME/ FM) and mandibular cervical headgear (MCH) protocols when followed by fixed appliances and evaluated at a postpubertal observation in patients with dentoskeletal Class III malocclusion. Materials and Methods: The sample treated with the RME/FM followed by fixed appliances included 32 patients (12 boys and 20 girls). The sample treated with the MCH followed by fixed appliances included 26 patients (eight boys and 18 girls). Cephalometric analysis was performed at T 1 (before treatment) and T 2 (after the first phase of orthopedic therapy and the second phase of fixed appliances). T 1 -T 2 changes were evaluated by means of t-tests. Results: Midfacial length, mandibular length, and the sagittal position of the chin all showed significantly smaller increases in the MCH group than in the RME/FM group. The amount of increase in the overjet was also significantly smaller in the MCH group, whereas the amount of molar correction was greater. The upper incisors were significantly less proclined and the lower incisors were significantly less retroclined in the MCH group when compared with the RME/FM group. Conclusions: RME/FM therapy appears to be indicated in Class III patients with a component of maxillary retrusion, whereas MCH therapy is preferable in patients with mandibular prognathism.
Carbon fiber strands were used experimentally to substitute for tendons in dogs and clinically to reconstruct tendons and ligaments in human. The investigation was carried out to determine the histologic appearance of the new composite structure and its tensile strength in comparison to the natural structure. The histologic picture disclosed a remarkable structure evolved by continuous irritation of the carbon fibers and consisting of two interrelated components: synthetic carbon fibers and biologic collagenous tissue. This carbon fiber composite structure was composed of long cylindrical units containing concentric layers of collagenous fibers and cells enveloping the core of each carbon fiber. After one year of physiologic use in dogs, the average ultimate tensile strength of the composite structure which replaced the quadriceps and triceps was 372 N, or 88% the strength of the natural tendons. One year after implantation the histologic picture of the composite structure in human showed a relatively dense collagenous architecture. However, a significant proportion of the structure was taken up by histiofibroblasts produced by the irritation of the carbon fibers. Thus, the density of the collagen in the composite structure remained relatively deficient in comparison to the nature tendon, and the structural tensile strength continued to depend entirely on the integrity of the carbon fibers.
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