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Summary Introduction Cartilage and bone graft are customarily used for dorsal augmentation in rhinoplasty. Daniel and Calvert described an original technique in 2004, using diced cartilage grafts wrapped in temporal fascia (DC-F). Technical note We describe the technical procedure used to correct severe nasal saddles with stable results. Discussion Diced cartilage grafts wrapped in temporal fascia is an interesting alternative in rhinoplasty with dorsal augmentation: this composite graft is malleable and can be used whatever the quality of the recipient site. It remains malleable postoperatively.

Resume Introduction Le traitement de l’encombrement incisif mandibulaire associe a un deficit osseux associe habituellement des extractions dentaires et un traitement orthodontique. La distraction symphysaire a ete proposee pour preserver le capital dentaire. Cette technique est encore marginale car percue comme invasive, complexe et risquee. Nous avons evalue cette technique afin d’en preciser les indications, les avantages et les limites, et pour proposer un protocole chirurgical simplifie. Patients et methodes Six patients ont ete traites par distraction symphysaire : trois avec un dispositif a ancrage osseux et trois avec un ancrage dentaire. Les parametres etudies ont ete la distance inter-canine et la stabilite occlusale. Resultats La distance inter-canine a augmente de 3,4 a 6,8 mm (moyenne de 5,2 mm). En fin de traitement, tous les patients etaient en classe I sans complication. Le dispositif a ancrage dentaire simplifie le protocole chirurgical. Discussion La distraction symphysaire par un dispositif a ancrage dentaire est un moyen simple, efficace et fiable pour traiter certaines insuffisances transversales mandibulaires. L’orthodontiste est autonome et il maitrise l’ensemble du processus d’expansion en fonction de ses imperatifs.

The parapharyngeal space may be a site for tumors, especially for those developed in the deep parotid lobe. The surgical route to parapharyngeal space tumors is a challenge because of neighbor anatomic structures and the specific risk of mandibular nerve damage. The aim of this study was to describe an original lateral transmandibular route, setting aside the mandible angle and preserving the mandibular nerve.

The finite element method is a numerical modeling tool used in various fields in medicine and surgery such as orthopedics, traumatology, and cardiovascular surgery. But this tool also has several applications in maxillofacial surgery. We present the advantages of this method by describing its principles as well as the various fields of application in maxillofacial surgery. This article was intended to help novices understand the results of various studies using this method.

Summary Introduction The platysma-myocutaneous flap is a surgical procedure little used in oral and oropharyngeal reconstruction after malignant tumor resection. However, it provides a fast solution of reconstruction in specific indications, with functional and esthetic results comparable to other methods. Anatomy The platysma covers the anterolateral area of the neck and constitutes a part of the superficial musculoaponevrotic system of the head and neck. The arterial vascularization relies on the external carotid network and venous drainage on the external and anterior jugular veins. Surgical technique The dissection of the myocutaneous-platysma flap is performed by a strict upward subplatysmal dissection. A strict subcutaneous dissection is then performed by an incision of the superior edge of the cutaneous paddle. Respecting the dissection planes as well as preservation of the facial artery, submental branch and external jugular vein improve chances of success. Indications and contra-indications The platysma-myocutaneous flap may help to fill defects of the oral cavity and oropharynx. The main contra-indications are prior cervical surgery and cervical radiotherapy, the presence of adenopathy requiring removal of the facial pedicle and submandibular tumor extension.

Summary Introduction Bisphosphosnates are reference products used to treat osteoporosis, malignant bone disease, Paget's disease, and hypercalcemia. However these drugs seem to induce osteonecrosis of the jaws. This osteonecrosis is frequently observed and must be evoked in patients presenting with oral ulceration under bisphosphonate therapy. Observation We report the case of a long-term fully dental implanted patient treated by bisphosphonates who presented a maxillar ostenecrosis with no previous radiotherapy. Discussion The risk factors and mechanism of this induced osteonecrosis are described. But could long term osseo-integrated dental implants be a triggering factor?

Cartilage and bone graft are customarily used for dorsal augmentation in rhinoplasty. Daniel and Calvert described an original technique in 2004, using diced cartilage grafts wrapped in temporal fascia (DC-F).We describe the technical procedure used to correct severe nasal saddles with stable results.Diced cartilage grafts wrapped in temporal fascia is an interesting alternative in rhinoplasty with dorsal augmentation: this composite graft is malleable and can be used whatever the quality of the recipient site. It remains malleable postoperatively.

Severe mandibular incisor crowding with bone insufficiency is usually treated by dental extractions and orthodontic management. Symphyseal distraction was proposed to avoid tooth extraction. This technique is still considered as invasive, complex and unsafe. We evaluated symphyseal distraction to clarify its indications, and to suggest a simplified surgical protocol.Six patients were treated by symphyseal distraction: three with a bone-anchored device and three with a dental anchored one. Pre and postoperative inter-canine measurements and occlusal stability were analyzed.Postoperative inter-canine measurements increased from 3.4 to 6.8mm (mean 5.2mm). All patients were in Angle class I occlusion without complications. Dental anchored device simplified the surgical procedure.Symphyseal distraction with dental anchored device is a simple, efficient and reliable to treat severe transverse mandibular deficiency. The orthodontist can manage the procedure by himself and controls the whole expansion process according to specific requirements.

The parapharyngeal space may be a site for tumors, especially for those developed in the deep parotid lobe. The surgical route to parapharyngeal space tumors is a challenge because of neighbor anatomic structures and the specific risk of mandibular nerve damage. The aim of this study was to describe an original lateral transmandibular route, setting aside the mandible angle and preserving the mandibular nerve.

The finite element method is a numerical modeling tool used in various fields in medicine and surgery such as orthopedics, traumatology, and cardiovascular surgery. But this tool also has several applications in maxillofacial surgery. We present the advantages of this method by describing its principles as well as the various fields of application in maxillofacial surgery. This article was intended to help novices understand the results of various studies using this method.

The platysma-myocutaneous flap is a surgical procedure little used in oral and oropharyngeal reconstruction after malignant tumor resection. However, it provides a fast solution of reconstruction in specific indications, with functional and esthetic results comparable to other methods.The platysma covers the anterolateral area of the neck and constitutes a part of the superficial musculoaponevrotic system of the head and neck. The arterial vascularization relies on the external carotid network and venous drainage on the external and anterior jugular veins.The dissection of the myocutaneous-platysma flap is performed by a strict upward subplatysmal dissection. A strict subcutaneous dissection is then performed by an incision of the superior edge of the cutaneous paddle. Respecting the dissection planes as well as preservation of the facial artery, submental branch and external jugular vein improve chances of success. INDICATIONS AND CONTRA-INDICATIONS: The platysma-myocutaneous flap may help to fill defects of the oral cavity and oropharynx. The main contra-indications are prior cervical surgery and cervical radiotherapy, the presence of adenopathy requiring removal of the facial pedicle and submandibular tumor extension.

Bisphosphosnates are reference products used to treat osteoporosis, malignant bone disease, Paget's disease, and hypercalcemia. However these drugs seem to induce osteonecrosis of the jaws. This osteonecrosis is frequently observed and must be evoked in patients presenting with oral ulceration under bisphosphonate therapy.We report the case of a long-term fully dental implanted patient treated by bisphosphonates who presented a maxillar ostenecrosis with no previous radiotherapy.The risk factors and mechanism of this induced osteonecrosis are described. But could long term osseo-integrated dental implants be a triggering factor?