Lytic lesion of the mandible revealing a metastatic breast cancer.

INTRODUCTION AND IMPORTANCE: Breast cancer is the most common cancer in women and the second leading cause of cancer-related death. Breast cancer manifestations in the head and neck are relatively rare, have greater predilection for the jaws than for soft tissues. Metastasis in the oral cavity account for only 1 to 3 % of all oral malignant lesions. Regardless of the rare occurrence of metastatic lesions to the jaw, it should be taken into consideration in the individuals with a history of malignancy. CASE PRESENTATION: The article reports a rare case of metastatic lesion of breast cancer to unilateral mandibular ramus region. The 66-year-old female patient was complaining of pain and swelling in the right mandible angle. She was referred to our department by her oncologist with the differential diagnosis of osteonecrosis or metastasis. She had undergone radical mastectomy for invasive lobular carcinoma of the left breast without adjuvant treatment. Oral cavity examination did not reveal the existence of any ulcer or fistula. Based on the patient's medical history and paresthesia of the lower lip and chin, the metastatic disease was highly suspected. The patient was referred to her oncologist for chemotherapy treatment before any invasive surgical management. CLINICAL DISCUSSION: Breast cancer (BC) is the most common cancer affecting women globally. Bone is the most common site of metastasis in BC patients, with up to 75 % of stage IV BC patients developing skeletal metastasis. The frequent metastatic sites of bone are spine, ribs, sternum, femur, pelvis. Breast carcinoma metastasizes to the jaw bones are uncommon. CONCLUSION: The diagnosis of metastasis to the oral cavity is a significant challenge to the clinician due to the lack of pathognomonic signs and symptoms. The general dentist or dental specialist should maintain a high level of suspicion while dealing patients with a history of cancer.

[Isolated Fractures Of The Mandible In Children: Epidemiological, Clinical And Therapeutic Aspects]. / Les Fractures Isolees De La Mandibule Chez L'Enfant Au Centre Hospitalier Universitaire De Bouake : Aspects Epidemiologiques, Cliniques Et Therapeutiques.

INTRODUCTION: Facial fractures are rare in the pediatric population compared to adults. They represent 1 to 15% of maxilla-facial trauma. The objective of this study was to describe the epidemiological, clinical and therapeutic characteristics of mandible fractures in children in a developing country. MATERIAL AND METHODS: This was a retrospective descriptive cross-sectional study - from January 1, 2016 to June 31, 2020 involving 17 cases. It took place in the Department of Odonto-Stomatology and Maxillofacial Surgery of the Hospital and University Center (CHU) of Bouaké. RESULTS: There were 14 boys (82.35%) and 3 girls (17.65%) i.e. a sex ratio of 4.66. Road traffic accidents were the main cause with 64.72% (n=11). Unifocal fractures were found in 14 patients (82.35%). The seat was parasymphyseal in 29.41% (n=5). Bifocal fractures were found in 3 patients (17.65%). The site was condylar and symphyseal in 2 patients (75%). It involved the symphysis and the horizontal branch in 1 patient (25%). Orthopedic treatment was performed in all patients (100%). The evolution was favorable in all patients, i.e. 100% of cases. CONCLUSION: The fracture of the mandible in children is a traumatological entity which is an epidemiological and therapeutic particularity.

INTRODUCTION: Les fractures de la face sont rares dans la population pédiatrique par rapport aux adultes. Elles représentent 1 à 15% des traumatismes maxillo-faciaux. L'objectif de cette étude était de décrire les caractéristiques épidémiologiques, cliniques et thérapeutiques des fractures de la mandibule chez l'enfant dans un pays en voie de développement. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude transversale descriptive rétrospective - allant du 1er Janvier 2016 au 31 Juin 2020 portant sur 17 cas. Elle s'est déroulée dans le service d'Odonto-Stomatologie et de Chirurgie Maxillo Faciale du Centre Hospitalier et Universitaire (CHU) de Bouaké. RÉSULTATS: Il y avait 14 Garçons (82,35%) et 3 filles (17,65%) soit un sex ratio de 4,66. Les accidents de la circulation routière étaient la principale cause avec 64,72% (n=11). Les fractures uni focales étaient retrouvées chez 14 patients (82,35%). Le siège était para-symphysaire dans 29,41% (n=5). Les fractures bifocales étaient retrouvées chez 3 patients (17,65%). Le siège était condylien et symphysaire chez 2 patients (75%). Elle intéressait la symphyse et la branche horizontale chez 1 patient (25%). Le traitement orthopédique a été réalisé chez tous les patients (100%). L'évolution a été favorable chez tous les patients soit 100% des cas. CONCLUSION: La fracture de la mandibule chez l'enfant est une entité traumatologique qui relève d'une particularité épidémiologique et thérapeutique.

[Mandibular fractures in cattle - a review of 108 cases]. / Unterkieferfrakturen beim Rind ­ eine retrospektive Untersuchung von 108 Fällen.

INTRODUCTION: Mandibular fractures are among the most common fractures in cattle. The medical records of 108 cattle with a mandibular fracture, that were referred to the University of Zurich Veterinary Hospital from 2005 to 2019, were analysed to document the types of treatment, complications and long-term outcomes. Cattle, still alive at the time of retrospective analysis, underwent clinical and radiographic examinations. A fall was the single most common cause of a mandibular fracture (48,1 %), and a third of all cattle had a concomitant disease at the time of referral. Seventy-five cattle (69,4 %) had a single fracture, 26 (24,1 %) had two fractures and seven (6,5 %) had three fractures of the mandible. The molar part of the mandibular body was most commonly (40,7 %) fractured followed by the diastema (23,6 %), the pars incisiva (13,4 %), the ramus (12,1 %) and the symphysis (10,2 %) of the mandible. The majority of cattle (84/108, 77,8 %) had open fractures. Treatment was instituted in 63/108 animals (58,3 %) with 77/148 fractures. Of these fractures, 28 were treated with plate osteosynthesis, 25 with an external fixator, 8 with cerclage wire, 7 using mixed techniques, 4 with fragment excision, 4 underwent conservative treatment and one a mucosal suture. In total, 45/108 animals (41,7 %) were culled because of multiple fractures, concomitant diseases and because of economic reasons. Complications occurred in 34 (54,0 %) treated cattle; 22 had abnormal wound healing of which 18 developed osteomyelitis complicated by a sequestrum (14). Of the treated 63 cattle, 56 (88,9 %) were discharged. The mean postoperative productive life was 46 ± 29,2 months for animals that were deceased at the time of the study. Thirteen of the cattle with a sequestrum remained in the herd for 15 to 92 months (mean, 47 months) and one for 2 months. The life expectancy after treatment did not differ significantly from that of the Brown Swiss and Swiss Holstein dairy cattle populations, where the cattle of this study mainly came from. Eleven cattle were available for long-term follow-up; all had a good general health status but nine had dental abnormalities including missing teeth, steps or enamel points, which did not noticeably affect the body condition of the animals. Surgical treatment of selected mandibular fractures had a favourable prognosis (52/63 healed, 82,5 %) in cattle.

INTRODUCTION: Les fractures mandibulaires font partie des fractures les plus fréquentes chez les bovins. Les dossiers médicaux de 108 bovins présentant une fracture mandibulaire, référés à l'hôpital vétérinaire de l'Université de Zurich entre 2005 et 2019, ont été analysés afin de documenter les types de traitement, les complications et les résultats à long terme. Les bovins, encore vivants au moment de l'analyse rétrospective, ont subi des examens cliniques et radiographiques. Une chute était la cause la plus fréquente d'une fracture mandibulaire (48,1 %), et un tiers des bovins présentaient une maladie concomitante au moment de la consultation. Septante-cinq bovins (69,4 %) avaient une seule fracture, 26 (24,1 %) avaient deux fractures et sept (6,5 %) avaient trois fractures de la mandibule. La partie molaire du corps mandibulaire était le plus souvent (40,7 %) fracturée, suivie du diastème (23,6 %), de la pars incisiva (13,4 %), du ramus (12,1 %) et de la symphyse (10,2 %) de la mandibule. La majorité des bovins (84/108, 77,8 %) présentaient des fractures ouvertes. Un traitement a été institué chez 63/108 animaux (58,3 %) avec 77/148 fractures. Parmi ces fractures, 28 ont été traitées par une ostéosynthèse par plaque, 25 par un fixateur externe, 8 par cerclage, 7 par des techniques mixtes, 4 par une excision du fragment, 4 par un traitement conservateur et une par une suture muqueuse. Au total, 45/108 animaux (41,7 %) ont été abattus en raison de fractures multiples, de maladies concomitantes et pour des raisons économiques. Des complications sont survenues chez 34 (54,0 %) des bovins traités ; 22 ont présenté une cicatrisation anormale dont 18 ont développé une ostéomyélite compliquée par un séquestre (14). Sur les 63 bovins traités, 56 (88,9 %) sont sortis de clinique. La vie productive postopératoire moyenne était de 46 ± 29,2 mois pour les animaux qui étaient décédés au moment de l'étude. Treize des bovins avec un séquestre sont restés dans le troupeau pendant 15 à 92 mois (moyenne, 47 mois) et un pendant 2 mois. L'espérance de vie après traitement ne différait pas significativement de celle des populations de vaches laitières Brown Swiss et Swiss Holstein d'où provenaient principalement les bovins de cette étude. Onze bovins étaient disponibles pour un suivi à long terme ; tous avaient un bon état de santé général mais neuf présentaient des anomalies dentaires, notamment des dents manquantes, des différences de niveau de la table dentaire ou des pointes d'émail, ce qui n'a pas affecté de manière notable l'état corporel des animaux. Le traitement chirurgical de certaines fractures mandibulaires a donc eu un pronostic favorable (52/63 guéries, 82,5 %) chez les bovins.

[Isolated Fractures Of The Mandible In Children: Epidemiological, Clinical And Therapeutic Aspects]. / Les Fractures Isolees De La Mandibule Chez L'Enfant Au Centre Hospitalier Universitaire De Bouake : Aspects Epidemiologiques, Cliniques Et Therapeutiques.

INTRODUCTION: Facial fractures are rare in the pediatric population compared to adults. They represent 1 to 15% of maxilla-facial trauma. The objective of this study was to describe the epidemiological, clinical and therapeutic characteristics of mandible fractures in children in a developing country. MATERIAL AND METHODS: This was a retrospective descriptive cross-sectional study - from January 1, 2016 to June 31, 2020 involving 17 cases. It took place in the Department of Odonto-Stomatology and Maxillofacial Surgery of the Hospital and University Center (CHU) of Bouaké. RESULTS: There were 14 boys (82.35%) and 3 girls (17.65%) i.e. a sex ratio of 4.66. Road traffic accidents were the main cause with 64.72% (n=11). Unifocal fractures were found in 14 patients (82.35%). The seat was parasymphyseal in 29.41% (n=5). Bifocal fractures were found in 3 patients (17.65%). The site was condylar and symphyseal in 2 patients (75%). It involved the symphysis and the horizontal branch in 1 patient (25%). Orthopedic treatment was performed in all patients (100%). The evolution was favorable in all patients, i.e. 100% of cases. CONCLUSION: The fracture of the mandible in children is a traumatological entity which is an epidemiological and therapeutic particularity.

INTRODUCTION: Les fractures de la face sont rares dans la population pédiatrique par rapport aux adultes. Elles représentent 1 à 15% des traumatismes maxillo-faciaux. L'objectif de cette étude était de décrire les caractéristiques épidémiologiques, cliniques et thérapeutiques des fractures de la mandibule chez l'enfant dans un pays en voie de développement. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude transversale descriptive rétrospective - allant du 1er Janvier 2016 au 31 Juin 2020 portant sur 17 cas. Elle s'est déroulée dans le service d'Odonto-Stomatologie et de Chirurgie Maxillo Faciale du Centre Hospitalier et Universitaire (CHU) de Bouaké. RÉSULTATS: Il y avait 14 Garçons (82,35%) et 3 filles (17,65%) soit un sex ratio de 4,66. Les accidents de la circulation routière étaient la principale cause avec 64,72% (n=11). Les fractures uni focales étaient retrouvées chez 14 patients (82,35%). Le siège était para-symphysaire dans 29,41% (n=5). Les fractures bifocales étaient retrouvées chez 3 patients (17,65%). Le siège était condylien et symphysaire chez 2 patients (75%). Elle intéressait la symphyse et la branche horizontale chez 1 patient (25%). Le traitement orthopédique a été réalisé chez tous les patients (100%). L'évolution a été favorable chez tous les patients soit 100% des cas. CONCLUSION: La fracture de la mandibule chez l'enfant est une entité traumatologique qui relève d'une particularité épidémiologique et thérapeutique.

[Odyssey of the iliac. "Mandibular reconstruction by bone free flaps"]. / L'Odyssée de l'iliaque. « De la reconstruction mandibulaire par autotransplantation ¼.

The authors proposed here a retrospective analysis of a surgical procedure they performed for long time. It allows to put into questions some established principles, to find some unkwown datas which could be important to predict complications. It is also interesting to discuss about the use of indication and choice of the flaps along years of reconstructive surgery history in the way to improve protocoles and management of those large reconstruction. During ten years in one maxillofacial surgery departement, more than 200 bone free flaps (essentially fibula and iliac crest) have been used for mandibular reconstruction and analyse with a three years follow-up. The global failure rate is estimated as 28 % included all various complications from fistulas to infections. Five different points are discussed from the ambiguity of the reported studies to the way of doing of such surgery. It is also pointed out the importance of the biological dimension of all surgical procedures and the place of clinical figures regarding of the technical processes which usually forget the main clinical purpose.

[Ameloblastomas of the jaws: clinical and computed tomography analysis in 15 patients at the university hospital Sourô Sanou in Bobo-Dioulasso]. / Ameloblastomes des machoires : analyse clinique et tomodensitometrique chez 15 patients au centre hospitalier universitaire Souro Sanou de Bobo-Dioulasso.

INTRODUCTION: Ameloblastoma is a locally aggressive and relatively scarce odontogenic benign tumor. Bone swelling is the most common clinical expression. Computed tomography is a considerable diagnostic contribution. This work reports the clinical and computed tomography characteristics of ameloblastomas of the jaws. PATIENTS AND METHODS: a retrospective analysis of the medical records of patients with histologically confirmed ameloblastoma between January 2014 and December 2018 was carried out. RESULTS: The incidence of ameloblastoma was 3 patients per year. Of the 15 patients, there were 7 men (46.7%) and 8 women (53.3%), giving a sex ratio of 0.87. The age of the patients varied between 9 and 56 years with an average age of 33.7 years. All patients had bone swelling. Mandibular localization predominated with a frequency of 86.7%. Heterogeneity, sharpness of contours and setting of the contrast product were the predominant CT characteristics, each observed in more than 4/5 of the patients. CONCLUSION: The development of imaging techniques such as CT has significantly changed the diagnostic approach and the management of ameloblastoma.

INTRODUCTION: l'améloblastome est une tumeur bénigne odontogène localement agressive et relativement rare. La tuméfaction osseuse constitue l'expression clinique la plus fréquente. La tomodensitométrie est d'un apport diagnostique considérable. Ce travail rapporte les caractéristiques cliniques et tomodensitométriques des améloblastomes des mâchoires. PATIENTS ET MÉTHODES: une analyse rétrospective des dossiers médicaux des patients porteurs d'améloblastome histologiquement confirmé entre janvier 2014 et décembre 2018, a été réalisée. RÉSULTATS: L'incidence de l'améloblastome était de 3 patients par an. Des 15 patients, il y avait 7 hommes (46,7%) et 8 femmes (53,3%) soit un sex-ratio de 0,87. L'âge des patients variait entre 9 et 56 ans avec une moyenne d'âge de 33,7 ans. Tous les patients présentaient une tuméfaction osseuse. La localisation mandibulaire prédominait avec une fréquence de 86,7%. L'hétérogénéité, la netteté des contours et la prise du produit de contraste étaient les caractéristiques tomodensitométriques prédominantes observées chacune chez plus de 4/5 des patients. CONCLUSION: Le développement des techniques d'imagerie comme la TDM a largement modifié l'approche diagnostique et la prise en charge de l'améloblastome.

[Mandibular Langerhans cell histiocytosis: a case report].

Langerhans cell histiocytosis is commonly found in cranial bones and rarely found in the mandible. This article presents a case of mandibular Langerhans cell histiocytosis and discusses its pathogeny, clinical features, diagnosis, and treatment.

Examination of new parameters for sex determination of mandible using Japanese computer tomography data.

OBJECTIVE: In the field of forensic science, sex discrimination of skeletons is an important identification item for personal identification. The individual sex discrimination method using skeletons includes a determination method using measurement values and a macroscopic form observation method. Both methods have advantage and disadvantage. In this study, we used the homologous model technique and principal component (PC) analysis to determine gender difference from morphology of the mandible. METHODS AND MATERIALS: 45 patients (23 males and 22 females) of CT imaging for tooth extraction from January 2018 to March 2019 at department of oral surgery, Osaka Medical College. The mean age was 43.1 ± 14.6. Patients with less than 14 remaining teeth were excluded because the number of remaining teeth may affect the shape of the mandible. 3D images were constructed, and 20 landmarks plotting on the 3D model surfaces. We generated template models of the mandible consisting of approximately 8434 polygons. The template model automatically fitted into the individually scanned point cloud of the mandible by minimising external and internal energy functions. As described above, the mandibles were constructed for each sample by using the Homologous Body Modeling software (HBM, Digital Human Technology, Inc.) and the mHBM-Rugle (Medic Engineering Corporation). The mandibles were analysed using the PCA. RESULTS: The contribution of the most important PC was found to be 27.2%. 12 PCs explained over 75% of the total variance. That is, it was able to express 75% or more of the mandible expression with 12 PCs. A significant difference between male and female was observed in the first PCs (Wilcoxon test, p < 0.05). Visualising the result of the first PC showed that the mandibular branch of male was larger than that of female, and the mandible angle was overhanging outside. CONCLUSION: This method is a combination of the determination method using the previous measurement values and the determination using macroscopic observation, and is considered to be innovative method.

[Intensity-modulated radiotherapy for head and neck cancer. Dose constraint for salivary gland and mandible]. / Radiothérapie conformationnelle avec modulation d'intensité des cancers des voies aérodigestives supérieures. Dose de tolérance des tissus sains : glandes salivaires et mandibule.

Intensity-modulated radiation therapy (IMRT) is the gold standard for head and neck irradiation. It allows better protection to the organs at risk such as salivary glands and mandible, and can reduce the frequency of xerostomia, trismus and osteoradionecrosis. At the time of treatment planning, the mean dose to a single parotid gland should be kept below 26Gy, the mean dose to a single submandibular gland below 39Gy, the mean dose to the mandible below 60 to 65Gy and the D2% to a single temporomandibular joint below 65Gy. These dose constraints could be further improved with data extracted from cohorts of patients receiving IMRT exclusively. The dose administered to the target volumes should not be lessened to spare the salivary glands or mandible.

[Rational use of distraction osteogenesis in craniofacial surgery]. / Utilisation rationnelle de la distraction osseuse en chirurgie craniofaciale.

Distraction osteogenesis, initially developed by Ilizarov for limb, is the tissular extension caused by the progressive space of the osseous pieces following an osteotomy. Distraction is osteogenesic and histogenic. Twenty-five years ago, at the instigation of McCarthy, this technique was used to handle the craniofacial malformations in the various floors of the face : mandibular, mediofacial and cranial. The most wide-spread protocols respect a latency period from 0 to 7 days, a rhythm of distraction from 1 to 2mm a day in 2 at 4 times and a period of consolidation from 4 to 8 weeks. Distraction is the result of the inventiveness of the pioneers then the work to always adapt to the multiple complex clinical situations. The surgeon has to choose between internal or external materials allowing a mono- or multi-vectorial extension, in osseous and/or dental anchoring. The mandibular distraction is very effective for the treatment of the secondary obstructive syndromes in the unilateral or bilateral severe hypomandibular malformations. She also allows desobstruction of the superior airways within the framework of the mediofacial hypoplasies as well as the secondary treatment of the growth defects in cleft lips and palates. Finally, the distraction osteogenesis enhanced reliability of the fronto-facial advancement in early and secondary treatment of craniofaciosynostosis. This is a real support of the facial growth, which has to be included in a plan of global treatment.

[National survey: Avulsion of included wisdom teeth in mandibular orthognathic surgery]. / Enquête nationale : avulsion des dents de sagesse incluses en chirurgie orthognathique mandibulaire.

INTRODUCTION: There is no recommendation concerning wisdom teeth (WT) extraction in mandibular orthognathic surgery. We carried out an investigation among the members of the French Society of Stomatology and Oro-maxillofacial Surgery (SFSCMFCO), in order to evaluate the practices and habits of maxillofacial surgeons in this field. MATERIALS AND METHODS: We emailed the 424 members of the SFSCMFCO with a questionnaire. RESULTS: We obtained 143 feedbacks that could be exploited. In total, 72.5% of practitioners prefer WT to be extracted before performing a bilateral sagittal spilt osteotomy (BSSO). In this case, a period of 6 months between the two surgeries was considered as desirable by more than 70% of the surgeons. In total, 74.6% of the surgeons thought that the presence of WT could make a BSSO more complicated. However, 73.9% of the surgeons would not postpone the BBSO in a patient ready for surgery but with remaining impacted WT. DISCUSSION: A majority of surgeons think that the presence of impacted WT may complicate a BSSO and increases the risk of bad split. Most of the authors recommend extracting the impacted WT 6 months before BSSO at least. However, these potential complications are easy to overcome and don't compromise the final result. Therefore, we think that impacted WT should not delay a BSSO if the orthodontic preparation makes the patient ready for surgery.

Mandibule rehabilitation after embolization of hemangioma with implant overdenture using existing endosseous implants: A clinical report.

PATIENT: A fifty-year-old man received embolization for mandibular hemangioma two years ago, and the surgeon had placed four implants in his mandible and made a removable denture upon the implants. His denture however fractured repeatedly in the past years. After examination and communication with the patient, an implant-assisted overdenture incorporating bar attachment combined ERA attachment and Locator abutment was re-fabricated. A sixteen months follow-up showed acceptable outcome. DISCUSSION: There are some guidelines on design of implant over-denture, the site of implant will affect the final result. The unfavorable bone structure of mandibular hemangioma restricts the number and the site of implant, modification of design is essential to improve the final result. CONCLUSION: Multi-disciplinary cooperation should be established for extensive edentulous case. Overlay type prosthesis incorporating several types of attachments can be suitable for complex case because of acceptable results and easy maintenance.

[Anterior mandibular bone augmentation techniques. Literature review]. / Les augmentations osseuses mandibulaires antérieures. Revue de la littérature.

INTRODUCTION: Mandibular edentation may lead to major symphyseal resorption making the placement of dental implants impossible. In this situation, bone augmentation techniques are available. The goal of our study was to make a review of the literature of the different techniques in use. METHOD: A bibliographic research was conducted on the Medline, Ovid and Cochrane Library databases with the following keywords: anterior mandible, bone grafting, mandibular symphysis reconstruction. We selected only articles written in English, published from January 1975 to August 2014 and expressly dealing with anterior mandibular bone augmentation techniques. RESULTS: Sixty-nine articles were analyzed. Eight bone augmentation techniques were reported. Bone grafting using iliac or calvarial bone and immediate or delayed implantation was the most popular technique. The main complications were infection, exposure or resorption of the graft, and chin and lip hypo- or anesthesia. The other reported techniques (osteotomies, distraction osteogenesis, transmandibular implants, mandibular reconstruction plates, fibula free flaps) were more confidential or had specific indications. There was no indication for biomaterials excepted if combined with autologous bone.

[Support at home for a patient with cancer of the jaw]. / Accompagnement au domicile d'une patiente atteinte d'un cancer de la mandibule.

Home care presents specific difficulties. The support of Ms. C, suffering from a malignant tumour of the lower jaw illustrates a difficult care context due to a painful and poorly-healing wound, low self-esteem and communication difficulties. Maintaining the right distance and providing professional support are therefore essential in order to give high quality care to this patient.

[Superolateral dislocation of the temporomadibular joint: Case report]. / Luxations supéro-externes bilatérales de l'articulation temporo-mandibulaire: à propos d'un cas.

INTRODUCTION: Superolateral disclocations of the temporomandibular joint are rare. They mostly occur after high-energy trauma and are frequently associated with fractures of the mandibular body. CASE REPORT: A 35-year-old man was admitted for the management of a high-energy craniofacial trauma due to a road accident. The initial assessment revealed bilateral superolateral temporomandibular joint disclocations, with bilateral sagittal fractures of the condyle head and a fracture of the right parasymphysis. The treatment consisted in an external reduction of both condyles, followed by open reduction and internal fixation of the parasymphysis. The patient quickly started physiotherapy after the procedure and recovered a normal mouth opening after a month of follow-up. DISCUSSION: For most authors, a quick management of superolateral dislocations is necessary in order to achieve a proper reduction of the temporomandibular joint dislocation and avoid surgical reduction. Temporomandibular joint ankylosis is the main complication of such lesions. Early physiotherapy is indicated in order to prevent ankylosis.

[Contribution of the cervical vertebral maturation (CVM) method to dentofacial orthopedics: update]. / Intérêt de la méthode de maturation des vertèbres cervicales (CVM) en orthopédie dento-faciale : mise au point.

The successful orthopedic treatment of skeletal Class II malocclusions is closely related to the reasoned determination of the optimal time to initiate the treatment. This is why various methods have been proposed to assess skeletal maturation, such as a hand-wrist radiograph or the cervical vertebral maturation (CVM) method. The hand-wrist radiograph was up to now the most frequently used method to assess skeletal maturation. However, the clinical and biological limitations of this technique, as well as the need to perform an additional radiograph, were reasons to develop another method to explore the maturation stages of visible cervical vertebrae on a simple lateral cephalometric radiograph. The authors compare the 2 methods and prove the greater contribution of the CVM method compared to the hand-wrist radiograph.

[Ewing's sarcoma of the mandible in children: reconstruction by induced membrane]. / Sarcome d'Ewing mandibulaire chez l'enfant : reconstruction par membrane induite.

INTRODUCTION: Ewing's sarcoma (ES) is a malignant bone neoplasm that develops during the first two decades of life, and affects male more than female patients (sex ratio 1.6/1). ES head and neck bone localization is extremely uncommon (2 to 4%). We report a rapid induced membrane reconstruction without primary bone autograft. OBSERVATION: A 7-year-old boy presented with a 50mm mandibular ES centered on the horizontal branch of the right mandible. This patient was treated by a combination of neo-adjuvant chemotherapy, surgery, and adjuvant radio-chemotherapy, according to the Euro-Ewing 99 protocol. The right horizontal mandibular branch was resected, following induction chemotherapy. A macroplate and a cement spacer were used for the reconstruction, while expecting anatomopathological results. Seventeen days later, we removed the spacer because of scar disunion. The radiographic controls revealed a spontaneous osteogenesis along the macroplate despite the early cement spacer removal. This spontaneously bone growth allowed avoiding a free vascularized bone transfer for the reconstruction. The tissue regeneration potential of this young boy and the cement spacer induced membrane could explain this spontaneous osteogenesis phenomenon. DISCUSSION: Induced membrane can be added to the therapeutic options for pediatric oncologic mandibular bone loss. It avoids using of a free vascularized bone transfer.

Intra-mandibular adenoid cystic carcinoma.

Intra-mandibular localization of adenoid cystic carcinoma is rare. This tumor is characterized by progressive local, regional, and distant aggressiveness. We reviewed the latest data on this rare type of cancer with a small number of reported cases, alack of consensus for its treatment, and its bad prognosis.