[Reconstruction of the lips after resection of malignant lesions].

This review deals with the presently used techniques for reconstruction of full thickness lip defects that occur as a result of resection of malignant lesions of the lips. Reconstruction of full thickness defects of the lip is not an easy task. Since the lips have such centrally important aesthetic and functional roles, successful maintenance of these roles after reconstruction is of paramount importance. Small defects of up to 1/3 of the lip are normally fairly easily reconstructed by means of primary closure, while extremely large defects of almost the entire lip will need to be reconstructed by means of distant free flaps with microsurgical techniques. We review a broad range of local flaps utilized for the reconstruction of full thickness defects greater than 1/3 of the lip up to the reconstruction of more than 1/2, but not the entire lip. The article presents the advantages and disadvantages of several techniques which are currently widely used.

Surgical options in deep-bite mandibular deficiency with prominent chin - aesthetic considerations.

INTRODUCTION: A deep-bite hypoplastic mandible associated with a strong chin poses an aesthetic challenge. Functional correction of the distal occlusion can bring the chin point beyond the ideal or normal profile line. The aim of the study was to outline the indications and drawbacks of four approaches that are currently used to deal with this problem. MATERIAL AND METHODS: A retrospective study was done using lateral cephalograms and pre- and postoperative pictures of 40 randomly selected patients, judged by a panel of four surgeons. The following parameters were studied apart from occlusion: A-P chin position, chin height, mentolabial and submental folds, cervicomental and gonial angles, antegonial notch, lower lip position, and anterior mandibular bowing. RESULTS AND CONCLUSIONS: Procedures that involve a setback of the chin are potentially prone to create or increase submental fullness, especially the mandibular advancement/chin setback osteotomy. Procedures involving advancement of the anterior dentoalveolar segment relative to the symphyseal prominence (e.g. mandibular advancement/chin setback osteotomy, dentoalveolar mandibular advancement osteotomy) are prone to flatten the mentolabial fold excessively. The position of the chin point after mandibular advancement-posterior rotation osteotomy is difficult to predict. Maxillomandibular posterior rotation has potentially the best aesthetic outcome, provided that the chin point is not set back.

Solid variant of odontogenic keratocyst.

A case of an unusual lesion from the maxilla is presented. Macroscopically, the lesion was solid and histologically consisted of 'multiple separate keratocysts' of varying size that infiltrated into the surrounding bone and soft tissues. Panoramic image and CT scans showed a multilocular honeycomb ill-defined radiolucency with infiltration into the maxillary sinus and floor of orbit. This lesion should be differentiated from similar odontogenic lesions, such as keratoameloblastoma and papilliferous keratoameloblastoma. As there was no evidence of follicles, islands of ameloblastoma, or papilliferous structures in the entire specimen, the lesion could not be diagnosed as either a keratoameloblastoma or a papilliferous keratoameloblastoma. The invasive and destructive growth behavior, the histopathological features, and the histochemical pattern of the collagen stroma imply that this solid lesion is a neoplasia. It is suggested that the proper term for this lesion is solid variant of odontogenic keratocyst.