... ofroo:hngthethICkflapISclear.Thee~posedboneWligranulateands~uIdbecO\ICredWIthapackdurrnghealing.inflammationandpreventarise in airpressure in theantrum.TheupperfirstmolarISsituated In thelowestpointofthemaxillarysinus.PersistentInfectionorInflammalionwillinduceexudatesthatwilldraintothispaintandcausebreakdownoftheclot.Increasedairpressure In theSinus,forinstancefromsneezingorblowmgthenose,WlilforceairorexudatethroughthealveolardefectaswellasphySicallydlsruplingtheclotandflap.Decongestantsmaintainthepatencyoftheopeningofthesinustofavourdrainagetothenose.AsuitableantralregimewO\.Ildbe:•anabsolutebanonblowingthenosefor48hoors•sneezeallOWlngpressuretoescapethroughthemouth•nasaldecongestant(suchasephedrrnenasalspray0.5%)•decongestantInhalantle.g.Karvoll. In addition,chlorhexldlnemouthwashshouldbegiven.Therepairwillfailifthereisleakageofsahvaandbacteflapasttheflapfromtheofalaspect.Norinsingshouldbeperformedfor24hours.Fla:.15.6Preoperativeradiograph.OTHERPOSSIBILITIES•Howmix/II ... tlrl'mustlikl'f.vC/WSl'?Thereisnohistoryofsurgeryortrauma,nosuggesUonoffracture.noInflammallOnUlslbleovertheJOInttosuggestarthrrtlsandnosystemICcauseforarthritis.TraumaticsynovitisisapoSSIbilitybutdoesnotusuallycauseselectIVeImpallmentofmovement;alljOintmovementsarepainful.ThisleavesinternalderangementInvolvingtheintra-articulardiscasthemostlikelycause.TheprogreSSIonofc1rcklngtolockingWIthpainandIntra-artICulartrismusofrapidonsetistypicalofclosedlockandfitsWIththepatternofsymptomsandSIgnsseen In thiScase. In thiScasethepatientISstiliabletotranslatetheleftcondyleforward,causingdeviatlO/ltotherightonOJ)ening.lateralexcurSIontothelightwasnormalat8mm.Therelorethecause01therestrictedopemngisinternalderangementofthelightJoint."6 ... starts10feelllllWei.HISTORYComplaintThe patient complains thatshefeels unwell, hot andbreathless.History of complaintTh patient hasanappointmentfor routinedenialIrCillmentinvolvingsc.lling ilnd arcslor,llionunder.ltlC,l\anaL'Sthe~i,1ilnd...