ADULTS AND CHILDREN WITH PERMANENT TEETH.
The treatment of cases of the fourth class—shown in Figs. 14, 15, 16 and 17, all of the same case—is in all respects practically the same, except that the appliance needs to be made of strong material, because permanent teeth form points of attachment and older jaws give more resistance. When it is desired to hasten the contracting process, the patient is anesthetized and the surgical engine bur passed along the posterior portion of the buccal side of the jaw just under the teeth and the external plates of the maxillæ cut through, this being the point at which the greatest resistance is offered, and when weakened in this manner pressure is made by the use of suitably adjusted forceps, which bring the two sides as nearly together as possible without complete fracture. The appliance and screw hold the parts in place, and continuous