[Le Fort type I segmentary and nasoorbitalethmoidal fractures. A case report]. / Fractura de Le Fort I segmentaria y nasoorbitoetmoidal. Informe de un caso.

The association of Le Fort fractures and those of the nasoorbito-etmoidal complex represent severe injuries usually associated to traffic accidents or physical violence. The occurrence of such combination of fractures represents a challenge for the maxillofacial surgeon due to the great index of comminuted and displacement fragments. The initial evaluation represents the opportunity to identify and treat possible life-threatening complications such as brain damage or airway compromise; this first evaluation will also allow the establishment of diagnosis and a suitable surgical plan in order to preserve both the aesthetic and functional aspects.

[Total temporomandibular joint replacement with alloplastic prosthesis]. / Articulación temporomandibular. Reemplazo con prótesis aloplástica.

Three total temporomandibular joint (TMJ) replacement surgeries were performed on two patients with TMJ ankylosis using W. Lorenz system. The first surgery was performed on a female patient with osseous ankylosis who had no mandibular movement since she was 18 months old. The second surgery was on a patient with fibrous ankylosis who had an interincisive opening distance of 12 mm. Her condition was the result of a three year old subcondylar fracture which didn't receive any treatment. The first patient had total replacement of both TMJs, while the other just one TMJ. The follow up until today has been of eight months with an interincisive opening of 29 mm in the first patient and 34 mm in the other. There has not been any mandibular deviation during opening, nor postoperative pain in both cases. Facial nerve affection was not permanent in both patients. For all of this, we can conclude that total TMJ replacement is an effective treatment with stable results in patients with TMJ ankylosis.

[Odontogenic myxoma]. / Mixoma odontogénico.

BACKGROUND: the odontogenic myxoma is a recurrent benign neoplasm that when it grows can generate pain, tooth mobility and dysesthesia. Prevalent in adults with an average between the 28.8 years and is rare in minors; It is more common in women. His prognosis is good after enucleation and its malignant transformation is rare. CASE REPORT: 53 years old woman who attended the service of maxillofacial surgery by increase of volume in right geniana region, without other symptoms; He referred traumatic background by fall of 5 m in height at age 33. Her studies were carried out laboratory; the results were normal. Computerized axial tomography revealed poorly delimited hipodensa central image. The histopathology of the incisional biopsy report indicated Odontogenic myxoma, so it was decided to resection in block, with margins of safety. In the follow-up to a year without complications or recurrence. CONCLUSIONS: described odontogenic myxoma presented in the right upper jaw, so it represented a challenge given the characteristics of the unusual location, it is crucial to recognize the progress of the lesion to individually regulate the therapeutic procedure.

[Ostegenesis bifocal distraction as an alternative of mandibular reconstruction. A case report]. / Distracción osteogénica bifocal como alternativa para reconstrucción mandibular.

Mandibular continuity can be lost due to several factors. Whatever the cause, the restitution of the anatomy is important for aesthetic and functional purposes. Nowadays many graft techniques are available. Some of them have been shown to be successful in a lot of cases, nevertheless the osteogenic distraction should be considered as an alternative procedure to mandibular reconstruction. The osteogenic distraction can offer some advantages like a short surgical time, low morbidity, avoidance of the risk of graft rejection and also less vascular problems. Some of the disadvantages associated to this technique are that patients require longer follow-up periods. More patient cooperation is required also and finally, a risk of deviation of the distraction vector is also present, This kind of complication can increase the necessity of placing an external orthopedic device. An adequate management requires knowledge of both the bony biology and the possible biomechanical implications. Suitable planning of the osteogenic distraction procedure in combination with physical and psychological training of the patient can produce good aesthetic and functional results.

[Orofacial clinical manifestations in adult patients with variable common immunodeficiency]. / Manifestaciones clínicas orofaciales en pacientes adultos con inmunodeficiencia común variable.

BACKGROUND: Common variable immunodeficiency is the primary immunodeficiency (CVID) frequently found in adults. Its prevalence is estimated from 1:25,000 to 75,000 alive newborns; there are variations by ethnic groups, it is estimated about 50-70% in Caucasian patients. Oral cavity lesions are rarely found in adult patients with CVID, there are reports about lesions on pediatric patients mostly caused by infections. OBJECTIVE: To describe the orofacial lesions (oral, maxillofacial and neck area) affecting adults with CVID. MATERIAL AND METHOD: A transversal, prospective study was done in patients with CVID attended at Specialties Hospital, CMN SXXI, Mexico City. Patients where examined by the oral and maxillofacial surgeon and clinical findings were reported, then the descriptive analysis of the lesions was done. RESULTS: We evaluated 26 patients, 16 female and 10 males, average age of 38.6 years. In 18/26 patients we found oral lesions on 7 different types. The most frequent was minor salivary glands hiperplasia (19/26),petechiae (12/26) and herpetic ulcers (7/26). In head and neck, we found 4 different lesions, the most common was lymphadenopathy <2cm (4/26). CONCLUSIONS: The immunologic alterations associated to CVID favors the development of lesions mainly of infectious and probably autoinmune origin that affects the oral cavity and head and neck area.

Antecedentes: la inmunodeficiencia común variable es la inmunodeficienci primaria más común en adultos. Su prevalencia se estima en 1 por cada 25,000 a 75,000 recién nacidos vivos; existen variaciones por grupos étnicos, se estima en 50 a 70% en pacientes de raza caucásica. Las lesiones de la cavidad oral raramente se describen en pacientes adultos con inmunodeficiencia común variable, en niños con esta enfermedad existen informes de lesiones principalmente de origen infeccioso. Objetivo: describir las lesiones orofaciales (cavidad oral, macizo facial y cuello) en pacientes adultos con inmunodeficiencia común variable. Material y método: estudio transversal, prospectivo, efectuado en todos los adultos con inmunodeficiencia común variable adscritos a la Clínica de inmunodeficiencias primarias, del Hospital de Especialidades, Centro Médico Nacional Siglo XXI, que fueron examinados por un cirujano maxilofacial; se realizó el reporte de hallazgos en lista de cotejo y, posteriormente, el análisis descriptivo de las lesiones. Resultados: se incluyeron 26 pacientes, 16 mujeres y 10 hombres, con edad promedio de 38.6 años. En 18 de 26 pacientes estudiados se observaron lesiones orales, con siete lesiones diferentes y predominio en el sexo femenino 2:1. Las lesiones más frecuentes fueron: hiperplasia de glándulas salivales menores (19/26), petequias (12/26) y úlceras herpetiformes (7/26). En la cara y el cuello se observaron cuatro lesiones distintas, las adenopatías < 2 cm (4/26) fueron las más comunes. Conclusiones: las alteraciones inmunológicas asociadas con la inmunodeficiencia común variable favorecen la aparición de lesiones de origen infeccioso y probablemente autoinmunitario que afectan la cavidad oral, la cara y el cuello.