Management of Mandibular Condylar Fractures (MCF)

Management of Mandibular Condylar Fractures (MCF) Summary This paper reviews the literature of evidence based studies and textbooks on the management of mandibular condylar fractures (MCF). It also provides a brief outline of the signs and symptoms as well as the classification system of MCF. Optimal management of MCF is a controversial topic and there is also no consensus on its associated classification system. Overview The mandibular condyle is an articular surface that is part of the temporomandibular joint which facilitates the rotational and translational movement of the mandible. The condyle varies in appearance between individuals and also by age group to accommodate developmental variations, and also due to malocclusions, trauma and diseases. The condyle is a weak point due to its relatively low stiffness and as such is more prone to fractures than other parts of the mandible. The condyle acts as a buffer primarily to reduce intracranial injuries. Based on review of two studies, Boffano et al, 2015, reported that condylar fractures ranges from 35% to 43% of all mandibular fractures. According to Afrooz et al, 2015 condyle fractures represent 27.4% of all mandibular fractures. Based on their review of the US National Trauma Data Bank records, they also conclude that mandibular fractures are primarily caused by external causative factors such as assault, motor vehicular accidents and falls. Internal causative factors of fractures can include osteomyelitis and tumors; but are not as significant as the external factors. Signs of Mandibular Condylar Fractures Condylar fractures can be unilateral or bilateral. A patient with condylar fracture can show the following signs (Peterson Kruger, 2011): Occlusal Prematurity Reduction in vertical height of the mandible on the injured side as a result the injured side makes contact first; sometimes followed by rocking motion and then occluding to maximum intercuspation. Careful observation of the mandibular closure will show the alteration in the alignment Inability to Achieve Maximum Intercuspation In bilateral fractures, due to the fracture of both condyles there is a premature contact of the posterior teeth with a large anterior open bite. Bilateral condylar fractures along with symphysis fracture can cause posterior cross bites and anterior open bites Ipsilateral Laterognathia- In unilateral fractures there is laterognathia on the side affected by the condylar injury. Due to retrodisplacement of the mandible on the injured side, there may be Class II molar malocclusion on that side. Ipsilateral Deviation on Opening- In unilateral fractures, while opening the mandible gets deviated to the side of the injury Balancing Side Occlusal Interference during Contralateral Mandibular Translation Balancing side interferences may be present when performing contralateral jaw movements in unilateral condylar fractures Limited Mouth Opening This can be attributed to interferences of the fracture, displacement and/or rotation of the segments, coronoid impingement, bleeding, edema and pain from joint splinting. Classification of MCF There has been a lack of general consensus on the classification of the anatomical mandibular condyles which in turn has caused disagreement on the most effective way of management of MCF. There are a few systems used for classifying Condyle fractures. In the earlier days, a number of classification systems were based on radiological X-rays and were not supported by surgical experiences and findings. These systems included those proposed by Kohler, Reichenbach and Wassmund. The Lindahl system developed in 1977 is a popular method of classifying condylar fractures. In this method, the position of the fracture is the main determinant as to whether it falls in the condyle head, the condyle neck or the condyle base. These areas are delineated by specific landmarks and reference lines. This system was refined further by Loukota et al in 2005 by subdividing the condylar process more precisely and delineating defined anatomical landmarks[1]. However a drawback of this classification method is that the degree of displacement or dislocation which is essential to surgical intervention is not captured. The Spiessl method categorises the condylar fractures according to the point of occurrence of the fracture (low or high) without displacement and with displacement or dislocation as well as condylar head fractures. This classification system has been used in clinical and scientific use however there is still a limitation in that it does not define the degree of angulation nor clearly articulate the borderlines between low or high fractures. Management of MCF The management of mandibular condylar fractures has been a controversial subject. The options to management of condylar fractures include: do nothing (observation), closed reduction or open reduction techniques. With the do nothing option only practical in the simple and straight forward cases, the real debate is whether to pursue closed or open reduction. A number of variables must be taken into account to determine the treatment method. These variables include the patients age, presence of teeth, severity of fracture of the condyle and associated fractures of the mandible, fracture height, extent of malocclusion, patients adaptation, patients masticatory system and unilateral or bilateral occurrence. A literature review of many evidence based studies was undertaken with advantages and disadvantages of both the closed reduction and the open reduction methods as postulated by researchers and clinicians. The summarised findings are outlined below. Eckelt et al, 2006 undertook a study on 66 randomised patients and compared the results of open versus closed treatment of fractures of the mandibular condylar process. They stated that correct anatomical position of the fragments was achieved significantly more often in the operative group in contrast to the closed treatment group. They also found that the patients who had operative treatment reported less pain. In terms of mandibular function impairment, they reported that the persons who had operative treatment had less pain and discomfort. They also reported that there was significant differences in mouth opening/lateral excursion/protrusion between both groups (open 47/16/7mm versus closed 41/13/5mm). They concluded that both treatment options for condylar fractures of the mandible yielded acceptable results. However, operative treatment, irrespective of the method of internal fixation used, was superior in all objective and subjective functional parameters. In a study conducted on 27 patients in India, (Ragupathy, K 2016) comparing the outcomes of surgical vs nonsurgical treatment of mandibular condyle fractures, he reported that no group had malocclusion. Of the 11 persons in the open reduction group one person had a post-operative infection and two had temporary facial nerve weakness. In the closed reduction group, nine patients had loss of vertical ramus height and six had reduced mouth openings (less than 35mm). He concluded that .. nonsurgical treatment gives satisfactory clinical results, though the condyle is not anatomically normal in radiographs, whereas surgical treatment provided more accurate results clinically as well as radiographically. Kysas, 2012 et al undertook a meta -analysis of 20 studies involving analyses of 1,186 patient comparing closed reduction to open reduction in patients with condyle fractures. It must be noted that only 4 out of the 20 studies were randomised control trials (RCT). In addition, they noted that there was significant variation between treatment protocols, follow-up periods, and outcomes measured. Kysas considered a number of post treatment functionalities such as status of the post-treatment occlusion, mouth opening, protrusion, facial height, pain and the presence of postoperative ankyloses. They also considered facial nerve weakness and scarring in the case of open reduction method. The 4 RCT studies reported statistically significant conclusions favouring open reduction method over the closed reduction method; however Kysas et al found some shortcomings in these studies methodologies. Kysas et al concluded based on their meta-analysis that open reduction method for condylar fractures may be as good as or better than closed reduction. In addition, they reported that morbidity associated with surgery is low. However, they caution that available evidence is of poor quality and as such not strong enough to change clinical practice. Choi et al, 2012 summarised the advantages and disadvantages of both open and closed reductions methods. Advantages of Closed Reduction No injuries to nerves or blood vessels. No post-operative complications such as scar or infection. No tooth germ injury occurs because there is no establishment of crown of permanent teeth; this is beneficial for pediatric patients. Disadvantages of Closed Reduction Because of the insufficient reduction of bone fragments, there can be disorderly or excessive growth of the mandible and displacement of the ramus or mandibular deviation can occur. In addition there can be injury to the periodontal tissue and buccal mucosa, poor oral hygiene, pronunciation disorder, imbalanced nutrition, mouth opening disorder, and respiration disorder. Advantages of Open Reduction Minimise the number of displaced bone fragments to the best location possible. Prevent future complications such as respiratory disorder, original pronunciation and minimise nutritional imbalance Disadvantages of Open Reduction Possibility of damage to blood vessels and nerves exists. There is potential for post-operative complications. A permanent scar is very likely. Choi et al suggests that for pediatric patients, because of their elastic bone structure and thick soft tissue coverage, thin cortical bone and significant premature trabecular bone, no severe impact occurs upon receiving trauma. As such treatment methods can differ between pediatric and adult patients. They suggest that because most of the growing crown of the permanent tooth has not yet been completed, the ratio of bone tissue to the tooth is relatively low. In addition, in developing dentition, the teeth are in different stages of formation and maturation; they can also easily be in the line fracture which in turn can cause delayed eruption and ankylosis. Intermaxillary fixation of more than 2 weeks is not recommended for these pediatric patients and open reduction is not normally used since it is invasive and there is risk of facial nerve injury. They also report , no significant difference in prognosis is found compared to closed reduction. Conclusion Management of MCF remains a subject area where there is a lack of consensus on whether open reduction or closed reduction method is more suitable. Where there are some convergence of ideas include that intracapsular fractures are better treated closed6, it is better to deal with pediatric patients with closed reduction where practical and that physical therapy post treatment is important. Traditionally, closed reduction techniques were more prevalent; however with enhancement in tools available for surgical intervention, open reduction techniques are being practised more, with the added benefit of evidence based studies on such techniques becoming more available. References Afrooz, P., Bykowski, M., James, I., Daniali, L., Clavijo-Alvarez, J. (2015, December). The Epidemiology of Mandibular Fractures in the United States, Part 1: A review of 13,1442 Cases from the US National Trauma Data Bank. Journal of Oral and Maxiloofacial Surgery, 73(12), 2361-2366. Buffano, P., Kommers, S., Karagozoglu, K., Gallesio, C., Forouzanfar, T. (2015). Mandibular Trauma: A two centre study. International Journal of Oral and Maxillofacial Surgery, 44(8). Choi, K.-Y., Yang, J.-D., Chung, H.-Y., Cho, B.-C. (2012, July 291-300). Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture. Archives of Plastic Surgery, 39(4). Choi, K.-Y., Yang, J.-D., Chung, H.-Y., Cho, B.-C. (2012). Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction. Archives of Plastic Surgery, 39(4), 301-308. Eckelt U1, S. M., KL, G., E, K., R, L., M, R., J, S., H, T. (2006, July). Open versus closed treatment of fractures of the mandibular condylar process-a prospective randomized multi-centre study. Craniomaxillofacial Surgery, 34(5), 306-14. Goldman, K. E., Meyers, A. D. (2015, August 31). Mandibular Condylar and Subcondylar Fractures. Retrieved from Medscape: http://emedicine.medscape.com/article/870075-overview#a8 Hegde, S., Praveen, B., Shishir, R. (2013). Morphological and Radiliogical Variations of Mandibular Condyles in Health and Diseases: A Systematic Review. Dentistry ISSN, 3(1), 1. Kyzas, P. A., Saeed, A., Tabbenor, O. (2012). The treatment of mandibular condyle fractures: A meta-analysis. Journal of Cranio-Maxillofacial Surgery, 40(8). Neff, A., Cornelius, C.-P., Rasse, M., Torre, D., Audige, L. (2014, December). The Comprehensive AOCMF Classification System: Condylar Process Fractures Level 3 Tutorial. Craniomaxillofacial Trauma Reconstruction, 7. Peterson, L., Kruger, G. (2011). Petersons Principles of Oral and Maxillofacial Surgery. Connecticut: Peoples Medical Publishing House. Raghupathy, K. (2016). Outcomes of surgical versus nonsurgical treatment of mandibular condyle fractures. International Surgey, 3(1). [1] (Neff, Cornelius, Rasse, Torre, Audige, 2014)

Theories addressing learning styles Essay -- essays papers

Theories addressing learning styles There are several different learning styles and theories about approaching them. Some students learn better through one or more of the learning styles than another. As Rita Dunn of St. John’s University says, â€Å"A students best â€Å"modality† for learning may be visual, auditory, or tactile, according to the speakers†(Walton,1991). An auditory learner may learn better through hearing material spoken. A visual learner learns better by reading instructions to himself. And finally, a tactile learner will usually learn most effectively when they are able to use models or things that they can touch or manipulate. Technology supports these three learning styles; auditory, visual and tactile. Animated graphics of computer software support the needs of visual learners. Not just in a regular classroom can children benefit through visual aids, but also in a music classroom. Amy Casey, a former elementary teacher in the Kansas City school district said, â€Å"My exper iences in my own classroom have proven that integrating technology into the music curriculum entices students to actively engage in learning† (2005). Setting up music centers in a classroom allows students to learn to use technology in various ways. Children are able to learn how to read music or learn the piano keys with the use of a computer. Students who excel through auditory learning may use technology so regularly they do not realize how beneficial it is to them. Auditory learners may prefer to listen to a book on tape or sing a song about numbers or multiplication facts. These are all ways to reach out to the auditory learner in a classroom. Technology in the classroom also enhances the skills of tactile learners with the use of a keyboard o... ... from the World Wide Web:http://search.epnet.com Serim, Ferdi. Building Virtual Communties for Professional Development. www.ed.gove/technology/futures/serim.html Schank, Roger. Futureperspective- A vision of Education for the 21st Century. www.thejournal.com/magazine/vault/A2598.cfm www.aten.scps.kl2fl.us www.nces.ed.gov/quicktables/details.asp?key1069 Fine, L. (January, 2002). Writing takes a digital turn for special-needs students. Education Weekly. Retrieved April 22, 2005 from the World Wide Web: https://www.edweek.org/ew/articles/2001/01/30/20wordte ch.h21.html?querystring=assistive%20technology Walton, S. (November, 1991). Experts urge teachers to adapt to students’ learning styles. Education Weekly. Retrieved April 22, 2005 from the World Wide Web: http://www.edweek.org/ewarticles/1991/11/23/20wordtechh21.html

Archetype Research Project Essay

Archetypes are â€Å"An inherited idea or mode of thought in the psychology of C. G. Jung that is derived from the experience of the race and is present in the unconscious of the individual† (archetype). Archetypes are central in all cultures across the world and can provide important lessons and outlooks on the common aspects of human life. The journey, is an archetype in which the main character is in search of some sort of truth and typically faces many difficult trials along the way, this can be both physical and mental. While going through these trials a kind of hell is reached and the character must attempt to make their way back to society. Though the journey is not always well liked due to its dark and serious nature, it provides self-confidence and shows society how to react to difficulties they may face in life. This archetype can be found in slightly different forms in the three novels: â€Å"Jane Eyre† by Charlotte Brontà «, â€Å"The Odyssey† by Hom er, and â€Å"The Plague† by Albert Camus. Each author uses the archetype, the journey, to express their own thoughts; they create an overall theme or message to influence their readers. â€Å"Jane Eyre† was written in 1847 by Charlotte Brontà «. The novel follows Jane Eyre from her childhood as the family scapegoat, through her schooling at a poorly managed charity school, and later when she becomes a governess and falls in love with her employer, Mr. Rochester. Jane’s journey is in search of the love and acceptance of others, she goes through many trials before reaching her goal. The theme that Brontà « creates using the archetype of the journey is: In times of hardship you must persevere and not lose sight of yourself and your morals while striving to find happiness. This is one of the most important messages that she is sending to her readers through Jane Eyre. She does this by giving multiple examples of Jane’s strength. One example of Jane’s strength is when she struggles to regain her since of dignity and self-worth after discovering, on her wedding day, that Mr. Rochester was already married. This is the most devastating part of Jane’s journey but her reaction to the situation is what builds the theme. â€Å"Laws and principles are not for the times when there is no temptation: they are for such moments as this, when body and soul rise in mutiny against their rigour; stringent are they; inviolate they shall be† (Brontà « 369). Jane is very tempted to just give in to her weaknesses but she regains her composure and continues her struggle. Jane’s strength is also shown when she leaves Thornfield the night after the wedding. â€Å"But I was soon up; crawling forwards on my hands and knees, and then again raised to my feet — ­ as eager and as determined as ever to reach the road† (Brontà « 374). At this point Jane’s emotional turmoil has gone as far as to cause physical weakness. Which, she also finds courage to overcome. Brontà « uses Jane’s strength of morals and self-respect in times of trial to get her theme across to her readers. The importance of her perseverance throughout the novel is solidified in the fact that her suffering pays off in the end with a happy conclusion after Mr. Rochester’s wife is dead. â€Å"I hold myself supremely blest–blest beyond what language can express; because I am my husband’s life as fully is he is mine† (Brontà « 522). Jane would have been very unhappy if she had given in to her weaknesses before she felt morally sound in doing so. This shows how significant her waiting was in securing her happiness in the end. Charlotte Brontà « used the archetype of the journey in Jane Eyre to impact the reader by illustrating the importance of maintaining your moral standards and since of self-worth through times of trial and hardship when you are most prone to weakness. She has exemplified this through the strength and persistence of her main character, Jane. â€Å"The Odyssey† was written by Homer around 700 B.C. It is an epic that tells the story of Odysseus, a man who must make his way back home from war to his wife and son. His journey home however is delayed by a series of trials and while he is away suitors take over his household. Odysseus has been a role model not only in Greek culture but all around the world. Homer uses the characters reactions to the trials that are typical to the archetype of the journey to show the need for determination, hope and strength in the face of hardship. As Odysseus goes through the many challenges of his journey his perseverance is put to the test. One of these occasions is when Odysseus and his crew are within sight of Ithaca, but the curiosity of his crew causes them to be thrown severely off course and pushed back many days in their journey. â€Å"And I woke up with a start, my spirit churning— should I leap over the side and drown at once or grit my teeth and bear it, stay among the living? I bore it all, held firm, hiding my face, clinging tight to the decks† (Homer 10. 55-58). True strength is shown by Odysseus here due to the fact that it is laden with the dramatic irony of almost reaching your goal then being set back to the beginning. Homer uses Odysseus’s will to continue on and not give up to show the determination needed to overcome a trial such as this. Odysseus is not the only character in â€Å"The Odyssey† that the archetype of the journey applies to. Telemachus, Odysseus’s son, also goes through a journey and discovers darker truths as he searches for news of his father and watches the suitors tear apart his house. â€Å"But for me the gods have spun out no such joy, for my father or myself. I must bear up, that’s all† (Homer 3.236-238). Homer presents Telemachus much like his father, always determined to keep moving forward even when it seems all is against him. The archetype of the journey is constantly full of challenges and often disappointment. Odysseus comments on what he has learned of the nature of life and hardship. â€Å"But then, when the happy gods bring on the long hard times, bear them he must, against his will, and steel his heart. Our lives, our mood and mind as we pass across the earth, turn as the days turn† (Homer 18. 154-157). Odysseus has learned this lesson from experience and his calm warnings and advice on the subject contribute to the theme of the necessity of strength when it comes to the archetype of the journey. In relation to the archetype the journey Homer uses â€Å"The Odyssey† to create a theme of resilience and determination when encountering struggles and trials. This is created through the way that the characters handle hardship with their lives. Odysseus is a major role model whose success and failures can easily be learned from. â€Å"The Plague† was written by Albert Camus in 1947; the novel relates the story of a city falling into and later recovering from an epidemic of plague. Each character has his own personal interests but as the plague progresses and the gates of the city are closed, fighting the plague becomes everyone’s main interest. The entire town goes through an archetypal journey with each characters experiences differing in their own ways. When a group of people is suffering, each person has a duty to think more of the group and less of individual desires; everyone has to try to help others. It is the few people who fulfill that duty who make the difference for the whole of the community in the end. As the first few cases began to arise, nobody wanted to admit the high level of danger that came with them. Due to the town’s lack of experience with the plague things move slowly at first and no one really knows what to do. Despite this confusion and lack of knowledge it is important that there are a few people who are always fighting to make progress. â€Å"No, we should go forward, groping our way through the darkness, stumbling perhaps at times, and try to do what good lay in our power† (Camus 205). Camus shows the absolute need for action even when nobody is quite sure what to do. The town is urged to forget personal matters to devote themselves to following blind determination. After months of plague it becomes obvious to the townsfolk that they are all in the situation together and that they are in the same amount of risk even though nobody wanted to acknowledge it out loud. â€Å"No longer were there individual destinies; only a collective destiny, made of plague and emotions shared by all† (Camus 151). The atmosphere of the survival situation has made personal interests unimportant and the survival and health of the community the main point of the people’s lives. As the city of Oran attempts to regain its stability its citizens sacrifice their personal feelings such as love to go into a survival mode. â€Å"Evening after evening gave its truest, mournfulest expression to the blind endurance that had outlasted love from all our hearts† (Camus 168). People have become so engrossed in the plague and its effect on their lives that emotions like love are pushed to the back of the mind. Camus stresses the fact that in order for a community to endure, personal sacrifice is necessary. â€Å"The Plagues† main theme in relation to the archetype of the journey is that personal sacrifice may be needed in order for a community to go through a journey and still prevail in the end. It can also be seen that hope is necessary when you are faced with hardship even if you are completely lost and in the dark. All three novels, â€Å"Jane Eyre† by Charlotte Brontà «, â€Å"The Odyssey† by Homer, and â€Å"The Plague† by Albert Camus have strong examples of the journey archetype. Each tells a story of trials, hardship, and suffering. â€Å"Jane Eyre† focuses largely on Jane’s personal development and the challenges that she faces in her everyday life. Brontà «Ã¢â‚¬â„¢s main theme is to not lose sight of who you are when things get tough in contrast to the ideas behind â€Å"The Plague† which call for almost an exact opposite due to the community setting in which the journey takes place. â€Å"The Odyssey† is more about a since of strength and endurance, though Odysseus’s emotions are evident and are very important in maintaining his will to continue trying to reach home, they do not dominate the scene like in â€Å"Jane Eyre† and â€Å"The plague†. The journey archetype is very important in giving people insight to possible life situations. By reading about a characters development while going through a journey it is easy to realize their achievements and failures. This makes these types of situations easier to handle when they come up in real life later on because the reader has already been warned of what to do and what not to do. The main characters of a story focused on an archetypal journey are also inspirational and can provide the same hope and determination by giving people a â€Å"they did this so I can too† type of attitude toward life’s challenges.

Whats a Good Chemistry SAT Subject Test Score in 2018

The highly selective colleges and universities that require SAT Subject Tests will typically want to see a Chemistry Subject Test score of 700 or higher. Some students certainly get in with lower scores, but they are in the minority. Very top schools such as MIT will look for scores well above 700. Discussion of Chemistry SAT Subject Test Scores In 2017, 68,536 students took the Chemistry SAT Subject Test. The range of typical  scores will, of course, vary widely from college to college, but this article will give a general overview of what defines a good Chemistry SAT Subject Test score.   The table below shows the correlation between Chemistry SAT scores and the percentile ranking of students who took the exam. For example, 76% of students scored a 760 or below on the exam. Youll also note that nearly half of all test-takers scored a 700 or higher on the exam. Chemistry SAT Subject Test Score Percentiles (2016-2018) Subject Test Score Percentile 800 90 780 83 760 76 740 68 720 60 700 54 680 47 660 41 640 35 620 30 600 24 580 20 560 16 540 13 520 10 500 8 480 6 460 4 440 3 420 2 400 1 Source: College Board SAT Subject Test scores arent comparable to general SAT scores because the Subject Tests tend to be taken by a higher percentage of high-achieving students than the SAT. Whereas a large number of colleges and universities require SAT or ACT scores, only elite and highly selective schools require SAT Subject Test scores. As a result, the average scores for SAT Subject Tests are significantly higher than those for the regular SAT. For the Chemistry SAT Subject Test, the mean score is 666 (compared to about 500 for the general SAT math and verbal sections). What Colleges Say About the Chemistry SAT Subject Test Most colleges do not publicize their SAT Subject Test admissions data. However, for elite colleges, you will ideally have scores in the 700s. Some schools do, however, make clear what scores they typically see from competitive applicants. At  MIT, the middle 50% of students who took SAT Subject Tests in the sciences scored between 740 and 800. Thinking about that another way, over a quarter of all successful applicants scored a perfect 800. Applicants with scores down in the 600s will be well below the norm for the school The typical range for Ivy League applicants is slightly lower than at MIT, but youre still going to want to have scores in the 700s. At  Princeton University, the middle 50% of applicants scored between 710 and 790. Applicants to science and engineering programs in the Ivy League will want to be on the upper end of that range. Highly selective liberal arts colleges reveal similar ranges.  Middlebury College  notes that the admissions folks are used to seeing scores in the low to middle 700 range, while at  Williams College  over two-thirds of all admitted students scored above a 700. As this limited data shows, a strong application will usually have SAT Subject Test scores in the 700s. Realize, however, that all elite schools have a holistic admissions process, and significant strengths in other areas can make up for a less-than-ideal test score. Chemistry Course Credit and the Subject Test For course credit and placement in Chemistry, far more colleges recognize  AP exams  than SAT Subject Test exams. There are, however, a few exceptions. At Georgia Tech, for example, a Chemistry SAT Subject Test score over 720 can earn a student credit for CHEM 1310. At Texas AM, a score of 700 or higher can qualify a student to take the departmental exam for CHEM 102. In general, however, dont count on the Subject Test earning you college credit. Check with your colleges Registrar to learn the schools placement policy. You will also find some colleges that will accept a good score on the Chemistry SAT Subject Test as part of their science admissions requirement. In other words, if a school requires three years of high school science, it may be possible to take two years of science and do well on a science SAT  Subject Test in a third field. Check individual schools policies for fulfilling academic admissions requirements. A Final Word About the Chemistry Subject Test If chemistry isnt your strength, dont worry. No college requires the Chemistry SAT Subject test, and even top engineering and science schools allow students to choose from other science and math Subject Tests. Also, be sure to keep the Subject Tests in perspective. Most schools dont require Subject Test scores. Those that do have holistic admissions, so strong grades,  high scores on the regular SAT, a stellar essay, and impressive extracurricular activities can all help compensate for a less-than-ideal Subject Test score. You wont find a tool like this for the SAT Subject Tests, but you can use this  free calculator from Cappex to learn your  chances of being accepted to a college based on your unweighted GPA and general SAT scores.