Contribution of a better maxillofacial phenotype in Silver-Russell syndrome to define a better orthodontics and surgical management.

INTRODUCTION: Maxillofacial phenotype for SRS is incompletely described in literature. The aim of this study was to describe a maxillofacial phenotype for SRS, to determine a better treatment. MATERIALS AND METHODS: A retrospective study was conducted including 37 patients with SRS. 24-control patients had been included and appareled. The subjective clinical examination included analyzes of SRS defined criteria. Frontal and lateral photographs had been reviewed, according to Farkas analysis; dental photographs had been examined for the deep-bite and the crowding severity. Radiologic cephalometric analysis had been reviewed. RESULTS: Maxillofacial examination showed protruding forehead (55%), anteverted ears (55%) and low-set ears (16%), small triangular face (48%); retrognatia (29%) and micrognathia (13%). SSR patients presented a lower forehead transverse growth, forehead height, and higher sagittal and transverse mandibular growth than control patients. Deep-bite was present in 21 patients of patient, and crowding in 17 patients. Cephalometric analysis showed 18 patients with the skeletal class II. We did not note a correlation between sleep apnea and retrognatia, neither between genetic anomalies and craniofacial phenotype. CONCLUSION: In this study, we showed new SRS characteristics: small forehead, small mandible, skeletal class II and a dental phenotype, leading to a specific maxillofacial and orthopedic management.

Mandibular lymphoma.

INTRODUCTION: B-cell lymphoblastic lymphoma (B-LBL) rarely occurs in the oral cavity (3.5% of all intra-oral malignant tumors). Few cases of B-LBL mandibular bone involvement have been reported. OBSERVATION: We report the case of a 30-year-old female patient presenting with a single swelling of the left mandibular region, having grown for several weeks. Maxillo-facial CT and MRI showed inflammation of soft tissues and muscles without initial signs of osteitis, thus noncontributive to the diagnosis. A biopsy allowed diagnosing an intra-oral bone lymphoblastic lymphoma. The patient was referred to the hematooncology unit for treatment. DISCUSSION: Jaw localization of non Hodgkin's lymphoma is rare. Clinical symptomatology and radiological signs are poorly contributive. The diagnosis relies on a histopathological analysis.

[Masticatory system and maxillofacial prosthesis: From pathology to function recovering]. / Appareil manducateur et prothèse maxillo-faciale : de la pathologie à la fonction retrouvée.

Maxillofacial prosthesis (MFP) can be defined as the art and science of esthetic and functional reconstruction of the facial bones, art because it uses hand-crafted and empirical rules, science because of its technical rigorism and its integration in medicine. MFP aims to multidisciplinary rehabilitate patients presenting with cutaneous and underlying structures defects, It also allows for functional speech and swallowing rehabilitation related to temporo-mandibular joint disorders. Whatever the origin, (traumatic, infectious ortumoral), surgical treatment of these TMJ disorders is usually not indicated in first-line. Functional treatment is often sufficient if started early in an observant patient. The aim of our article was to present the different types devices available for the rehabilitation of the masticatory system according to pathology. The first part will treat about the preservation of the TMJ range of motion in a preventive way. A second part will treat about the possibilities to recover the range of motion in a curative way. A third part will treat about mandibular reposition. At last, we will focus on the devices allowing for mandibular kinetic rehabilitation in adults and in a special pediatric case.

[Functional treatment of children subcondylar fractures: An axiographic assessment]. / Traitement fonctionnel des fractures sous-condyliennes de l'enfant : une évaluation axiographique.

INTRODUCTION: Subcondylar fractures are common in children. Occlusion disorders resulting from these fractures in deciduous or mixed dentition do not have as much impact as in adults due to alveolar adaption possibilities. Functional treatment allows for good functional results, but does not treat the dynamic shortening of the ramus. The objective of this study was to evaluate the axiographic condylar slope changes after subcondylar fracture in children. MATERIALS AND METHODS: A prospective study was conducted from 2010 to 2015, including all the under-18 patients presenting with a subcondylar fracture. Examination by mean of a Quick Axis axiograph measured the length of propulsion and the condylar inclination on both sides. The main evaluation criterion was the amount of condylar inclination decrease on the fractured side. RESULTS: Twelve patients (mean age: 10.42; 5-16) were included. Eleven children had a loss of condylar inclination on the fractured side without occlusion disorders at 33.2 months on average (3-144 months) after the initial trauma. Only one patient had symmetric axiographies without loss of condylar inclination on the fractured side. DISCUSSION: Dynamic shortening of the ramus on the side of the subcondylar fracture is consistent at short and medium terms in children. Surgical treatment may be the solution for avoiding this dynamic disorder of the mandible and should be evaluated.