In this pilot study ZA reduced the progression of MRI bone oedema, indicating probable suppression of osteitis concordant with reduction in clinical measures of disease activity.

The correction of severe dentofacial discrepancies involving a combination of orthodontic and surgical therapies (termed ‘orthognathic treatment’) is commonplace. There is an abundance of evidence within this field but it is often inconsistent. This article is an evidence-based overview of such treatments and is aimed at the general dental practitioner. It will cover: the timing of treatment; the indications and risks associated with different surgical osteotomies; the magnitude of surgical movements that can be achieved with these procedures; and the importance of mandibular autorotation when planning treatment. Orthognathic treatment is considered to be the gold standard for comprehensive correction of severe dentofacial discrepancies. It is undertaken by a multidisciplinary team of clinicians involving, but not exclusive to, consultants in orthodontics and oral and maxillofacial surgery in secondary and tertiary medical centres throughout the United Kingdom. Clinical relevance: It is imperative that general dental practitioners have a good understanding of orthognathic treatment in order to recognize when such treatments are indicated, to inform the patient of possible treatment modalities and to be able to discuss associated risks in order to make appropriate referrals. Since treatment timing and magnitude of surgical movements have a profound effect on stability of the treatment result, these must be carefully considered by all clinicians involved in patient care to minimize relapse potential.

Trismus is a frequent post-op sequelae of third molar surgery. A history of long-standing post-operative trismus warrants further investigation. Myositis ossificans traumatica (MOT), as its name implies, is ossification and bone formation within muscle following an episode of trauma. When it affects the muscles of mastication, it causes severe trismus. This rare disorder and its limited treatment options can potentially have debilitating effects to the patient's normal oral functioning and health. The following is a case report of a patient who developed MOT of the muscles of mastication following surgical exodontia of a lower wisdom tooth, the progress over a 15 year period and a review of the literature. This case demonstrates the longterm difficulties in managing MOT of the muscles of mastication.

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