The most popular of these techniques is the sagittal split osteotomy which "enables the body of mandible to be moved forwards or backwards by sliding the split ramus and angle". : 203  This provides a lot of bone overlap for healing. Damage to the inferior alveolar bundle is avoided by sectioning the buccal and retromolar cortex of the mandible and the cancellous bone is carefully split. After the mandible has been repositioned, screws or mini-plates can be used to fix the mandible directly. This is instead of fixing it indirectly with intermaxillary fixation (IMF). : 203

Genioplasty
Reduction or augmentation of the chin may be carried out either on its own or as part of a mandibular or maxillary orthognathic operation. : 203

Maxillary surgery
The Le Fort classification (which is used for fracture description) generally describes the surgical techniques which are used for maxillary surgery. : 203

References


== External links ==
There was negligible urinary excretion of ivacaftor as unchanged parent. The apparent terminal half-life was approximately 12 hours following a single dose in the fed state. The apparent clearance (CL/F) of ivacaftor was similar for healthy subjects and patients with CF. The mean (±SD) of CL/F for the 150 mg dose was 17.3 (8.4) L/h in healthy subjects at steady state. Society and culture
Legal status
The U.S. Food and Drug Administration (FDA) approved ivacaftor in January 2012, and soon afterwards so too did the European Medicines Agency (EMA) and Canada and across some European countries.Lumacaftor/ivacaftor was approved by the FDA in July 2015, under breakthrough therapy status and under a priority review. Economics
The cost of ivacaftor is US$311,000 per year, roughly similar to the price of other medications for extremely rare diseases. In the first nine months of its second year on the market (2014), ivacaftor sales were $339M, representing 54% of Vertexs product sales revenue. During the same period, total drug development expenses were $458M, most of which was spent on cystic fibrosis-related research.An editorial in JAMA called the price of ivacaftor "exorbitant", citing the support by the Cystic Fibrosis Foundation in its development and the contribution made by fundamental scientific research performed by the National Institutes of Health and relied upon by Vertex in its cystic fibrosis drug discovery programs.