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Instead of using CR, it is recommended that an unrestrained condylar position that approaches CR but does not encroach upon in amed retrodiscal tissue nor rmly seat the condyles be used. Therefore, if a patient were to have his or her appliance adjusted to this position and clench on the appliance in maximum intercuspation, the condyles would tend not to forcibly seat or load against any structure. I refer to this unrestrained condylar position as the neutral position. To obtain the condyle s neutral position, adjust the back of the dental chair so it is approximately 10 above the horizontal plane of the oor. Ask the patient to tilt his or her head back as far as possible, place the tongue on the roof of the mouth, and slide it back as far as possible. Lightly place a nger on the inferior portion of the patient s chin and repeatedly ask the patient to close and open his or her mouth (Figure 12.3). After a few arching movements, the patient develops a consistent arching of the mandible. Each of the recommended positions helps to retrude the mandible and prevent the tendency of some patients to protrude the mandible inadvertently.4,13 The reader can easily observe how these positions tend to retrude the mandible on himself or herself. Sitting in your normal posture, close your teeth lightly and observe your rst tooth contact. Then, tilt your head back as far as possible and again close your teeth lightly and observe your rst tooth contact; most people notice that the mandible is more retruded. Continuing to hold your head back, place

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Depending on its severity, this disorder generally takes 5 10 days to resolve. On one occasion, a patient who had only minimal improvement with her limited opening was asked to implement a more aggressive stretching technique. This entailed her using wooden tongue depressors to stretch the medial pterygoid muscle more actively (up to tolerance), ten or more times a day, and hold the stretch for 1 minute. She inserted as many wooden tongue depressors as would t between her maxillary and mandibular incisors, and held them together with a rubber band. She next inserted an additional tongue depressor at the far end and slowly slid it between the others, providing additional stretch to her medial pterygoid muscle, as demonstrated in Figure 8.1. She continued to insert tongue depressors up to tolerance and eventually regained her normal opening. Tongue depressors could similarly be held together by placing them inside a nger cot or the nger of a glove. A case scenario of a patient with a medial pterygoid myospasm is presented in Case 7 in part V. Clinically a medial pterygoid myositis presents in a similar manner as a myospasm. The myositis can be due to a bacterial infection of the muscle, which can occur from

very specialized and narrow part of the value chain Instead, they have had to change or expand their initial roles and positioning which originally meant that service providers were just offering services to consumers and application providers were primarily developing applications to operators and service providers, whereas content providers focused on selling content to operators or service providers Conveniently, the issues arising from these transformations within the value net can be discussed using the nal Cs, namely co-opetition and complexity, in regard to understanding the business of service, content and application providers Co-opetition generally refers to a new mindset of business that combines competition and co-operation, and this is becoming a common way of working in the new network economy.

John P. Grancarich, CFE, is the Practice Support Manager of Electronic Discovery Consulting at Paul Hastings Janofsky & Walker LLP. He has extensive experience directing and managing electronic discovery and investigative projects on a global scale, including computer examinations, analysis and reporting. He is a Certi ed Fraud Examiner and an EnCase certi ed computer examiner.

Instead of viewing application and content providers as sole suppliers in the value chain, both service providers and operators can position themselves as more or less integral partners in their business, while at the same time, for instance, content providers may be selling their content to consumers directly, thus becoming buyers from application providers Many publishing and media companies, such as Time Warner, present a good example of this practice, as their content is available in several operator portals mainly as branded and sometimes even as non-branded content, but they also run their own direct content sales channel with optimized applications (as CCN is doing) Co-opetition as a mobile industry phenomenon illustrates how the same companies are simultaneously both complementing each other and engaging in competitive activities.

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