Special considerations
Condyle
The best treatment for condylar fractures is controversial. There are two main options, namely closed reduction or open reduction and fixation. Closed reduction may involve intermaxillary fixation, where the jaws are splinted together in the correct position for a period of weeks. Open reduction involves surgical exposure of the fracture site, which can be carried out via incisions within the mouth or incisions outside the mouth over the area of the condyle. Open reduction is sometimes combined with use of an endoscope to aid visualization of fracture site. Although closed reduction carries a risk of the bone healing out of position, with consequent alteration of the bite or the creation of facial asymmetry, it does not risk temporary damage to the facial nerve or result in any facial scar that accompanies open reduction. A systematic review was unable to find sufficient evidence of the superiority of one method over another in the management of condylar fractures. Paediatric condylar fractures are especially problematic, owing to the remaining growth potential and possibility of ankylosis of the joint. Early mobilization is often recommended as in the Walker protocol. Edentulous mandible
A broken jaw that has no teeth in it faces two additional issues. First, the lack of teeth makes reduction and fixation using MMF difficult. Instead of placing circumdental wires around the teeth, existing dentures can be left in (or Gunning splints, a type of temporary denture) and the mandible fixated to the maxilla using skeletal fixation (circummandibular and circumzygomatic wires) or using MMF bone screws.
Glipizide, sold under the brand name Glucotrol among others, is an anti-diabetic medication of the sulfonylurea class used to treat type 2 diabetes. It is used together with a diabetic diet and exercise. It is not indicated for use by itself in type 1 diabetes. It is taken by mouth. Effects generally begin within half an hour and can last for up to a day.Common side effects include nausea, diarrhea, low blood sugar, and headache. Other side effects include sleepiness, skin rash, and shakiness. The dose may need to be adjusted in those with liver or kidney disease. Use during pregnancy or breastfeeding is not recommended. It works by stimulating the pancreas to release insulin and increases tissue sensitivity to insulin.Glipizide was approved for medical use in the United States in 1984. It is available as a generic medication. In 2020, it was the 49th most commonly prescribed medication in the United States, with more than 13 million prescriptions. Mechanism of action
Glipizide sensitizes the beta cells of pancreatic islets of Langerhans insulin response, meaning that more insulin is released in response to glucose than would be without glipizide ingestion. Glipizide acts by partially blocking potassium channels among beta cells of pancreatic islets of Langerhans. By blocking potassium channels, the cell depolarizes, which results in the opening of voltage-gated calcium channels. The resulting calcium influx encourages insulin release from beta cells. History
It was patented in 1969 and approved for medical use in 1971. Glipizide was approved for medical use in the United States in 1984.